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Wrist & Thumb Injuries

Wrist & Thumb Injuries

Hand and wrist injuries are a common cause of complaint, not only for people involved in sport and exercise. Injury can be caused from repetitive actions, carried out daily by most people, such as typing. In sports and exercise the repetitive action at the wrist during racquet sports can cause injury, as can trips and falls, which may result in sprains and breaks of the wrist and hand. In addition to this physiological and mechanical changes around the wrist joint can cause abnormal sensations at the base of the palm and thumb.

Detailed Overview

Anatomy of the hand and wrist

The wrist and hand consists of twenty-seven bones. Eight carpal bones, arranged in two irregular rows of four, form the wrist. The carpal bones and connective tissue form the carpal tunnel, several tendons pass through the carpal tunnel, as does the median nerve. There are five bones which make up the palm of the hand, these are the metacarpals. Each finger consists of three bones called the phalanges, except the thumb which only has two. Movement of the wrist and hand is controlled by extrinsic and intrinsic hand muscle groups. The extrinsic muscles are located on the forearm and control the flexion and extension of the hand and fingers. Finer movements of the fingers are controlled by muscles located within the hand; these are known as the intrinsic hand muscles, of which there are over sixty.

Some of the injuries that affect the wrist and hand include:

Carpal Tunnel Syndrome – According to the NHS Carpal Tunnel Syndrome (CTS) is relatively common, affecting about three in 100 men and five in 100 women in their lifetime.  It is caused when the median nerve that runs through the carpal tunnel is compressed. The median nerve controls the movement of the thumb, as well as sensation in the thumb and the next two-and-a-half fingers. The main symptoms are tingling, numbness and pain in these areas. Other symptoms of CTS include, discomfort in the hand, forearm or upper arm, a sensation in the hand similar to pins and needles, dry skin, swelling or changes in the skin colour of the hand, becoming much less sensitive to touch, weakness in the thumb when trying to bend it at a right angle, away from the palm and weakness and wasting away of the muscles in the thumb.

Gamekeepers / Skiers Thumb – Gamekeepers / Skiers Thumb affects the main ligament in the thumb. The ligament which stabilises the thumb in order to pinch objects becomes injured when the thumb is moved away from the index finger, stretching and damaging the ligament. Damage can be caused from the repetitive movement of the thumb away from the index finger, this is named Gamekeepers Thumb, after research carried out found thumb injuries of this nature to be common amongst Scottish gamekeepers. The condition can be acute, generally caused when a person lands on their outstretched hand following a fall, this is common in skiing, hence Skiers Thumb.

Strains and Sprains – This is one of the more common wrist injuries experienced, often caused when a person trips or falls and us their hands to break the fall. The wrist is bent or twisted and the ligaments are stretched past their natural limit. Depending on the severity of the sprain symptoms include pain, swelling, bruising and sometimes a burning or tingling sensation at the wrist.

As with all sprains and strains protection, rest, ice, compression and elevation are advised. If you are in severe pain or if it doesn’t ease up after a few days you should visit your GP.

Bracing & Supports

The use of a wrist support or wrist splint is becoming common practice following an injury, offering additional protection of the joint during recovery. There are a variety of products on the market, each designed to manage specific conditions therefore a professional diagnosis may be advisable before making a purchase.

In a general a wrist support, or wrist splint as they are also referred to, offers protection of the injured area and as well as giving you the confidence to continue being mobile helps to reduce the risk of further injury at a time when you need it most. The majority of options also offer compression, designed to help manage inflammation and pain which typically appear following the initial injury.

It is important to note that a wrist support should not be used in isolation following an injury as it is designed to support you during recovery in conjunction with physiotherapy or strengthening exercises and is not a long term solution to a condition. If you have further questions regarding the use of supports and the best way of returning to full fitness you should speak with a clinician.