Background & Etiology

Ligaments are fibrous bands of connective tissue made of collagen, which join bone to bone. They provide stability and limit excessive motion of the joint. In the wrist there are several ligaments, including the palmar wrist ligaments and the carpal ligaments that can be stretched or torn, causing a sprain.

There are three grades of wrist sprain

Grade 1 – This mildest type of sprain, where the ligament is stretched, but not torn.

Grade 2 – The ligament is partially torn

Grade 3 – The ligament is completely torn. The most serious type of sprain, this condition may require surgery

It is important to have a wrist injury evaluated by a physician to properly diagnose the grade of a wrist sprain. In some cases an X-Ray or CT scan will be used to evaluate the injury.

Wrist sprains are a common injury, often caused by a fall on an outstretched hand (FOOSH.) Typically these falls are the result of athletic or recreational activities, where an individual breaks their fall by bracing the ground with their hands.

  • Wrist pain or tenderness
  • Swelling or bruising at the wrist
  • Pain when moving or using the wrist in daily activities
  • A “popping” or “tearing” feeling in the wrist
  • Warmth or redness of the skin on the injured wrist
  • Decreased ability to move the wrist and use effected hand

If an individual suspects they have a wrist sprain, the initial treatment should consist of avoiding the positions and activities that produce the pain. A course of conservative treatment is usually recommended that includes rest and immobilization, ice, hand therapy and non-steroidal medications to reduce inflammation. If symptoms persist, treatment by your physician may be necessary. This may include steroidal medication or injections, in conjunction with therapy. In severe cases surgical intervention may be needed to repair the torn ligament.

Hand Therapists are occupational or physical therapists educated and trained to administer interventions. As stated in The Guide to Physical Therapist Practice, interventions are the skilled and purposeful use of therapy methods and techniques to produce changes consistent with the diagnosis, prognosis and goal of the patient or client. Common interventions in the treatment of Wrist Sprain include:

  • Manual Therapeutic Technique (MTT): hands on care including soft tissue massage, deep friction massage and joint mobilization by a physical therapist to regain mobility and range of motion of the wrist and ligament.
  • Therapeutic Exercises (TE) including stretching and strengthening exercises to regain range of motion and strengthen the wrist.
  • Neuromuscular Reeducation (NMR) to restore stability, retrain the upper extremity, and improve movement technique and mechanics (for example, throwing or lifting activities) in daily use of the involved upper extremity.
  • Modalities that can include the use of ultrasound, electrical stimulation, ice, cold laser and others to decrease pain and inflammation at the wrist and ligament
  • Home program that includes strengthening, stretching and stabilization exercises and instructions to help the person perform daily tasks and advance to the next functional level.

Procedures that your physician may recommend and perform in addition to physical therapy may include:

  • REST and ICE
  • Splinting or bracing the affected area
  • The use of NSAIDS (Non Steroidal Anti-Inflammatory Drugs)
  • Steroidal injections to reduce inflammation
  • Pain medication to reduce the discomfort and allow the patient to perform the recommended exercises
  • Surgery to correct ligament damage.

Prognosis

Most people recover full function following a course of conservative care that includes physical therapy, medication and/or injections. It is important that once the pain and inflammation is reduced, and motion and strength are restored, the patient gradually returns to full activities. Instruction in daily activities or sport performance is helpful for reducing a reoccurrence of wrist sprain.

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"Twin Boro Piscataway/South Plainfield is great! I was treated for occipital neuralgia and posture issues. Aside from performing wonderful treatment, everybody there is super friendly and accommodating (you will always be greeted with a smile) and also very focused and helpful! Bri is a knowledgable and experienced physical therapist who is not only a great PT, but also one of the friendliest people you will ever meet. Her pacing with my various exercises was perfect, as she pushed me, but not to any point that was uncomfortable for me. I enjoyed the variety of exercises and treatments, from heat and stim to exercises with weights and stretch bands. I thoroughly enjoyed going in 3 times a week to be treated by Bri. It is clear that she cares about and wants the best for her patients, with her passion and expertise for physical therapy! My posture has gotten much better and the headaches and pain I used to experience have completely disappeared after 3 months at Twin Boro. 5/5 I would recommend Twin Boro Piscataway/South Plainfield to anyone seeking physical therapy."

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"After my back surgery my doctor wanted me for physical therapy. He suggested Twin Boro Physical Therapy as one of the locations to go to. I checked out all the locations in the area and decided to go to Twin Boro. I stopped by on a Saturday but they were closed. Someone was at the desk doing paperwork and gave me all the information that i needed to fill out. She put the paperwork through and gave me a schedule to return on Monday for my first visit.The therapist ( Andrew ) examined me an put me through a series of work outs three times a week along with his daily exam. As each exercise became easier I was given something a little harder. They were slowly building up the strength in my lower back, core, legs and arms. After years of back pain I am now able to begin to get back to a normal life. I had a chance to work with other therapist there, they are all fantastic and there to help us return to a healthy life. The entire staff is was a pleasure to work with. They listen to what you have to say and and pay attention to what you said. I looked forward to going there, the staff was caring, kind and funny at times. I would highly recommend Twin Boro for physical therapy."

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