After a wrist injury, rehabilitation exercises should be performed, but only as soon as pain allows. Here we explain exercises to improve mobility and strengthen the muscles in the wrist, hand, and forearm.
Wrist splints & casts
There is often a balance to be struck between restricting movement of the wrist with splinting or casting to allow it to heal, and the need to restore full range of motion.
Wrist splints are used to immobilise the wrist allowing the tissues to heal. It is vitally important that any splint or cast is applied arrucately depending on your particular injury.
- Commercially available splints are quick, easy and cheap to fit and are suitable for simple wrist sprains and strains.
- Wrist splints with solid metal stays or ‘spoons’ restrict movement more and are often used for treatment of Carpal tunnel syndrome.
- Custom made splints and plaster casts are the best option for may injuries if available. Casts are often essential for wrist fractures.
After the splint/cast is removed
- If your wrist has been immobilised for a period of time then it is likely it will be very stiff and weak once the cast or splint is removed.
- Any swelling must be reduced and a compression type wrist support is useful for this.
- You may benefit from wearing a splint overnight, or when returning to sport for protection as you regain full strength and mobility.
- Mobility and stretching exercises are important along with strengthening. Eventually functional or sports specific type exercises should be done before returning to full competition fitness.
Wrist stretching & mobility exercises
The following are examples of wrist mobility exercises:
Wrist flexor stretch
Assisted Supinator Stretch
This stretch requires the help of a partner or therapist to stretch the muscles which supinate the wrist (turn the hand over).
- Lie in a relaxed position with the upper arm supported.
- The therapist fully pronates your hand (so the palm faces down).
- A mild stretch may be felt in your wrist and forearm.
- This position can be held for up to a minute, provided it does not cause pain.
- It can also be done with the elbow bent. This reduces the stretch on the biceps muscle to isolate more the supinator.
- Biceps Brachii
Prolonged Wrist Stretches
This exercise aims to increase the range of motion into pronation and supination. Pronation is the movement of turning the hand so the palm faces downwards. Supination is the opposite movements so the palm ends facing upwards.
- Biceps Brachii
- Pronator Teres
- Pronator Quadratus
Wrist strengthening exercises
Putty Exercises (Various)
Putty can be used to strengthen the small muscles of the wrist and hand. This is useful after injuries such as a fracture to any of the small bones in the hand or a wrist, thumb or finger sprain.
- Grip in both hands and pull apart to work on wrist deviation strength.
- It can be held in one hand and twisted with the other to work on wrist extension
- Putty can also be squeezed to improve grip strength.
Muscles Worked: This depends on the exact exercise, but generally, the intrinsic muscles of the hand are worked to grip it and then the forearm muscles which control wrist extension, flexion, and radial and ulna deviation.
Ulna & Radial Deviation
Ulna and radial deviation are the movements of tilting the wrist from one side to the other. Radial deviation is to move the thumb side of the hand down towards the wrist and ulna deviation is moving the little finger side down.
- To work on ulna deviation, the athlete holds a weighted bar in the hand with the arm by their side so that the palm faces inwards and the weight is at the back, as shown.
- The athlete then tilts the wrist so that the little finger moves upwards.
- To work radial deviation, the arm stays in the same position but the weight is moved to be in front of the hand.
- The wrist is then pulled up so that the thumb moves towards the wrist.
This wrist flexion exercise can be performed with a dumbbell as shown, or with a resistance band. It is great for strengthening the wrist flexor muscles of the forearm after wrist and elbow injuries.
- To strengthen the muscles which flex the wrist, the athlete sits with the forearm supported and palm facing upwards.
- Starting with the wrist bend downwards and a small weight in the hand, the athlete pulls the wrist upwards, keeping the forearm flat on the table.
- They then slowly reverse this movement.
- Flexor Carpi Radialis
- Flexor Carpi Ulnaris
- Flexor Digitorum Superficialis
- Flexor Pollicis Longus
Wrist extension exercises are rarely used in weight training programmes, although it is a great exercise for rehabilitation of injuries such as tennis elbow and sprains/fractures of the wrist.
- Support the arm on a bench or table as shown, with the palm facing downwards.
- Pull the wrist back so that the dumbbell moves towards the body.
- Slowly return to that starting position.
Muscles Worked: Extensor Carpi Ulnaris, Extensor Carpi Radialis Brevis, Extensor Carpi Radialis Longus, Extensor Pollicis Longus, Extensor Digitorum Communis.
Finger Exercises with Rubber Band
Rubberband exercises are a great way for strengthening the finger extensors and is commonly used in treating tennis elbow injuries as the same muscles causing pain at the elbow, also control finger extension.
- A rubber band is placed around the fingers and thumb.
- The athlete spreads the fingers apart as far as possible.
- This can be done on all fingers at once, or between two individual fingers.
- Extensor Digitorum Communis
- Extensor Pollicis Longus