Nagging wrist injury
January 6, 2014 10:45 AM   Subscribe

I have a nagging wrist injury that I would like to fix. More below the fold.

My left wrist has had a nagging injury for a few years. The wrist hurts when I bend it all the way back and apply weight. Pushups and handstands hurt, as do many yoga poses. When I bend both my wrists back, the injured wrist has a reduced range of motion. I don't notice the injury any other times than the above. Typing, for example, is fine. The only other quirk about the wrist I will add is that I can actually crack the joint by internally pulling the hand using my right hand. I cannot crack my right wrist.

I believe that the injury is due to weight lifting, specifically doing a dumbbell bench press with too much weight. Back in college, I went through a period where the range of motion was severely inhibited and I had forearm pain. I thought that I had done something to one of the tendons in my arm. I went to a physical therapist and he realized that one of the bones in the wrist was out of alignment. He worked on the joint a bit and it was much improved afterward.

Since that injury there have been other times where the wrist has felt bad with the range of motion impaired. When those times have occurred, I have myself tried to realign whatever bone is out of place and the symptoms would go away.

I'm not sure whether the problems that I'm now experiencing ever did go away. That is, I'm not sure after seeing the trainer whether I ever was fully healed. Doing pushups with fists, for example, doesn't bother me. Nor does doing a bench press. I think instead that I viewed this as a minor annoyance and ignored it.

Now I've taken up yoga, however, and the injury is preventing me from doing a number of poses that require a significant amount of wrist flexibility and strength.

I'm not opposed to going to an sports medicine doctor for this, but the injury feels so minor to me that if it's possible for me to fix it on my own with stretches / strength exercises I'd like to do so.

As aways, your advice is much appreciated.
posted by prunes to Health & Fitness (11 answers total)
If you have insurance it's worth it to get it evaluated. What if you were exacerbating the injury by not knowing what it is, and how to mend it.

Clearly whatever it is that you're doing is causing pain. Pain is your body telling you, "Hey! Knock it off!"

Huge injuries can start off as "minor" twinges.
posted by Ruthless Bunny at 10:53 AM on January 6, 2014 [1 favorite]

1) Most yoga poses can be modified for all kinds of difficulties with range of motion or strength, and I'm sure that there are some for wrist injuries. For example, plank on fists instead of on flat hands. Do the modifications. You are still doing the yoga if you modify. Your wrists are not the only part of your body.

2) Hey, do you have a ganglion cyst? I only ask because my husband has one, and also has the same difficulty with putting weight on that hand at all. If you have a bump on the top of your wrist (even a smallish one!) then you might be able to get some relief by having it drained, but obviously go see a doctor about that. However, one of the differential diagnoses for ganglion cyst is the scapholunate disassociation that it sounds like your physical therapist tried treating. Either of those things can re-occur, and cause pain until they are dealt with again.
posted by Made of Star Stuff at 11:26 AM on January 6, 2014

Pushups on fists/knuckles isn't flexing your wrist. It sounds like the stuff that you can't do is the hands flat on the floor type things (hand perpendicular to the arm) which is very different (in my opinion) from exercises where the hand stays parallel to the arm.

I'd say get it looked at. This is from a girl who had a nagging foot issue for two and a half years only to find out I had a torn ligament and required major orthopedic surgery to correct it. Because I walked on it broken for so long I permanently damaged it, so even post surgery it still isn't great.
posted by PuppetMcSockerson at 11:28 AM on January 6, 2014 [1 favorite]

Were it me, I would want an xray and/or bone scan to determine if way back when, you fractured or broke your scaphoid/navicular bone. I broke mine falling down a mountain in a ski accident; it was mis-diagnosed as a sprain because it was not that painful or swollen and I have a permanently limited range of motion in that hand pretty much as you describe. If that's the boat you're in, it may or may not be possible to fix it surgically at this point.
posted by DarlingBri at 11:31 AM on January 6, 2014 [1 favorite]

Assuming that doctor doesn't find something else wrong, I would ask for a referral to a physical therapist - a PT can both select specific exercises and (even better) make sure that you are doing them correctly. (Correct form can often make the difference between regaining mobility and reinjuring the body). When I saw a PT, she was pretty flexible about scheduling appointments in a way that made sense. So, if you go that route, talk to the PT about how to get the most value from her/his input while doing most of the work on your own.
posted by metahawk at 2:06 PM on January 6, 2014

I had similar pain that I nagged several orthopedists about. They never really figured out what was wrong but they were theories if repetitive stress injuries and long ago injuries and they gave me several cortisone shots over the years to see if they would help. And they did because it was an inflammatory arthritis. I am taking enbrel now and it is very helpful. If I were you knowing what I do now about my wrist, I would go see all those orthopedists and see if they can find a reason for your pain, but also keep in mind a rheumatologist if things drag on too long.
posted by Tandem Affinity at 7:23 PM on January 6, 2014

I have the same problems as you describe. As as with DarlingBri, the cause was a long-ago fractured scaphoid. I went to physio for this 10 years after initial injury due to the pain that I felt in yoga in similar positions. The conclusion of physio: my loss of range of motion in the wrist is permanent. I can certainly work to improve it but it is likely that I will not get 100% range of motion back.

I would recommend that you go to physiotherapist and get your own set of exercises. The wrist has 8 bones and there is no way for us to know which one you wrecked. If you don't want to see a physiotherapist you could google for scaphoid wrist rehab and see examples of the common wrist curls, rotations, etc used for strengthening. Doing these exercises never got me back to 100% ROM so I have gone the yoga modification route to avoid wrist pain.

So, some modifications, suggestions, contraindications:
* I would not do arm balances (eg crow) or handstands in this condition, sorry.
* You can use a foam or cork yoga wedge for downward dog. If you have issues with traction using the wedge you can place it under the mat.
* Another alternative for downward dog if you find the wedge cumbersome (it is) is to focus on leaving a little cup of space in the area of your wrist where the carpal tunnel is, and never press that area down to the floor. You can then spread weight through fingers with that area raised. If you are not having too much pain on a given day this can work. I find that this modification works well generally for hands and knees position (otherwise use wedge or drop to forearms)
* I prefer forearms to floor for plank, side plank
* I use fingertips to floor, straight wrists down to support lunges, side angle, triangle, etc.
* Fists for pushup, I have been given instruction to avoid over-use of fist as modification for wrist position as students tend to collapse into it if tired

Wrist injuries are common in yoga and many teachers have good modifications to work around them. Take classes with different instructors, tell them you have wrist problems, and ask them to call out the wrist modifications in class. Try them all and see which ones work for you.
posted by crazycanuck at 9:39 PM on January 6, 2014

Oh yes and I should add that I now avoid vinyasa style classes like the plague due to stress and strain on wrist, it is hard to carry wrist modifications through a fast paced routine of sun salutations.
posted by crazycanuck at 9:44 PM on January 6, 2014

Wanted to give you guys an update. I met with my orthopedist recently and had some x-rays taken. The bones look fine. My doctor suspects that I might have torn my TFCC--triangular fibrocartilage complex. I need to go back for an MRI. Treatment options could be anywhere from 6 weeks immobilization to surgery. We shall see!
posted by prunes at 1:16 PM on January 13, 2014

Turns out it was a ganglion cyst.
posted by prunes at 9:49 AM on February 11, 2014

It's always a ganglion cyst. Thanks for coming back and letting us know. :)
posted by Made of Star Stuff at 2:51 PM on August 11, 2014

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