Wrist related injuries are some of the most common people face regardless of fitness level. The wrist is one of the smallest, and therefore weakest joints in our body. To get started, I’ll review the structure of the wrist and some of the ways wrist pain can develop. Understanding how this works can help you treat any pain you might have.
IF YOU WANT TO SKIP AHEAD TO THE WRIST ROUTINE, THEN SKIP AHEAD TO THE FOURTH SECTION: “BULLETPROOFING THE WRISTS”
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Wrist structure and injuries
Tendons are long fibrous tissue that connect bones in the hand to muscles in the forearm. There are many tendons that control wrist extension and flexion. When doing Capoeira, the majority of injures will result from moving on the ground. These injuries are most closely associated with wrist extension. To understand the difference between extension and flexion, hold your arm in front of you, palms down. Extension is when you bring your hands up, while flexion would be when your hand is bent downwards.
What is injured in the wrist
Here is a small list of wrist related injuries from the least severe to the most severe
- Tendonitis – inflammation of the soft tissue (tendons)
- Tendinosis – Inflammation that is chronic
- Sprain/strain – stretching, partial tearing, or complete tearing of a ligament, tendon, or muscle
- Bone fracture – A partial or complete break in bone tissue
To provide a brief overview, the most likely of these cases is tendonitis. Explained in more detail below, tendonitis is caused either by repetitive motions or traumatic impacts. These are the most common kinds of injuries and can usually heal on their own. If the injury is ignored or exacurated, you’ll run into the second category. Tendinosis is a chronic inflammation of soft tissue. This is what happens when you don’t see the physical therapist or get lazy about doing your exercises. Tissue will be very sensitive and swollen. Once the injury reaches this level, it will take significantly longer to heal.
The next category is a sprain or strain. A sprain just means that you pulled a ligament to the point that you damage the tissue. A strain is the equivalent injury for muscles and tendons. In a more severe case, you can tear the tissue which can result in some nasty bruising in the area. A complete tear is much worse and will definitely require medical attention.
The last category is a fracture. Breaking or fracturing a bone is difficult to do. There are many different kind of bone fractures, which depend on how the injury occurs. I won’t go further into these kinds of injuries because it’s damn near impossible to break a bone doing normal hand balancing. This may happen if you fall on your hands, but again, this is very rare.
Getting to know the Anatomy of the wrist
According to a peer reviewed article by Sports Health, wrist injuries commonly include damage to the Triangular fibrocartalge complex and the Scapholunate Ligament. The Triangular fibrocarilage complesx is a small piece of cartilage that lies on top of the ulna bone. These are some of the body parts in the wrist that can experience inflammation or severe damage.
The most common forms of wrist sprains stems from the tissue surrounding the lunate and scaphoid bones. Damage to the scapholunate ligament, which connects these two bones together, can be pulled, causing tears in the tissue. These injuries can range in their severity from a small tear to a complete tear of the ligament.
Sources for this section: https://www.sports-health.com/sports-injuries/hand-and-wrist-injuries/what-wrist-sprain?slide=1
Why are wrist injuries common?
There’s very little muscle tissue in the wrist. This means that there’s a limited supply of blood flow as compared to other parts of the body such as the forearm or the bicep. This limited supply of nutrition makes it more difficult for the wrist to recover after taking a beating. Joints do not have a dedicated blood supply like a muscle do. Joints take whatever fluids they can from the surrounding muscles. This usually comes in the form of synovial fluid, and is another reason warming up is so important.
As mentioned earlier, the wrist is one of the smallest joints in your body. This means that the amount of a load that in the wrist can take is relatively small compared to the rest of your body. Something that might not seem heavy for your knees or your ankles to handle might be very difficult for your wrist because of their size.
Types of injuries: Traumatic
If you do a martial art, then a very common type of wrist injury can come from punching. Punching a heavy bag for example can cause some serious damage to your wrist. It is very common for boxers to break their wrists during training camp or even during matches. Another way that you can damage your wrist is through falling. This is very common in martial arts and other movement practices, such as dance. If you don’t know how to break your fall properly, the likelihood of you injuring yourself increases.
Types of injuries: Repetitive motions
Another way that you can damage your wrist is through a repetitive motion. For athletes, repetitive motions might refer to something such as sprinting on a hard surface, causing shin splints. Constant movement on the ground can also cause injury. The best way to prevent this kind of injury would be to take breaks to ensure your body has enough time to heal.
Types of injuries: Poor of Range of Motion
Another risk factor that is not very well discussed is having poor range of motion. If you have a poor range of motion, then doing something like a bridge/wheel pose can damage your wrist.
Wrist pain while doing a bridge is not necessarily because the wrists cannot bear the load of your body weight. It can be that the person is working in a range of motion that is extreme to their wrists. Doing a bridge often requires the wrists to go past 90 degrees of extension, which is farther than some people can extend their wrists. Doing so can cause injury in the same way constantly bench pressing near max can cause injury. Improving your range of motion is an excellent way to decrease your risk of wrist injury.
Tendonitis, the most common wrist injury
One of the most common complaints people have is that they have pain or discomfort around their wrist. There are many reasons for this including sprains, fractures, carpal tunnel, and tendonitis. This guide focuses on tendonitis though some exercises that can be used as prehab and rehab.
The proper medical term for tendonitis is tendinopathy, which refers to pain or swelling in a tendon that limits range of motion. As discussed earlier, the most common ways of getting tendinopathy is either by repetitive motion and by traumatic injury. Think office or construction worker for the former, and gymnasts for the latter (broadly speaking).
What does tendonitis feel like?
Tendonitis or tendinopathy can feel like a sharp pain when you move the wrist into a certain range of motion. This is not the same as a fracture, which is not only much more painful, but usually completely blocks your ability to move into a range of motion. Tendinopathy pain might kick in as you move your hand, or it could start hurting after doing a few pushups.
Usually tendinopathy corresponds with an end range of motion. Meaning you won’t feel the pain when your wrist is in a neutral position, but will kick in when you flex, extend, or rotate the wrist. The amount of pain also varies and generally dulls as the injury starts to go away.
Options confronted with wrist tendinopathy
When people start to feel pain in their wrist, they think they have the following options.
- Wait until the pain gets better
- Go to the doctor
- Stretch their wrists
Waiting till the pain gets better is a good strategy if the pain is very minor. In these cases, you might be able to lay off of your wrist for a few days and expect to be better after. If this is not the case, you will probably move to the second step. Seeing a doctor or physical therapists is a great option if you have persistent wrist pain. You only need to feel wrist pain for a week before you know you’re dealing with a problem that will likely not go away on its own!
An alternative, you might consider to treat yourself is to do whatever wrist stretch you know (not recommending this). Passive stretching is not the best tool to heal tendinopathy or prepare your wrists for something like hand balancing. The following exercises are designed to improve your range of motion and at the same time, build strength. This method staves away injury and can be used to rehab existing ones.
Your wrist can fatigue just like a muscle. Before you get started, it is imperative you understand this concept. Your wrists are just like your muscles. Wrists can fatigue from excessive load, lack of endurance, or working in a range of motion where there is poor neurological connection. The easiest way to illustrate how strength diminishes at different ranges of motion is to look at weight lifting. Let’s say you can push 150lb in standard bench press position. At an incline, this might reduce to 110lb. By the time you move the arms to do an overhead press, the weight reduces even more. As we move to more extreme ranges of motion, our strength diminishes as a general rule.
Bulletproofing the wrists
The following wrist exercises are part of a method I use to make sure that my wrists are resilient and strong enough to endure the pressure I place on it.
Here is the basic wrist routine that can be done every other day to improve wrist health and resilience.
Things to keep in mind during the wrist routine
One of the most common things people get wrong about this routine is leaning away from their hands to take away pressure from their wrists. Make sure your wrist is directly below your shoulders. If this hurts, then I recommend placing your hands closer to your knees. The second most common thing people get wrong is lifting their upper body to ease the pressure on their wrists. Having your wrists under your shoulder can be very painful for some people. Lifting the torso up slightly to lighten the load is a common compensation. Again, placing the hands closer to the knees is good regression.
Lastly, not being able to keep your elbows straight is a common issue. Not having your elbows straight is a compensation for a lack of wrist mobility. Once your wrists can’t bend any further, your elbow will kick in to take up the slack. Don’t let it. Again, be humble and move the hands closer to the knees.
What if the exercise is painful?
The above routine should be mildly uncomfortable and give you a significant burn in the forearms (especially the first exercise), but they should in no way give you a sharp pain in your wrist. If you do feel this, you can do two things. Either stop the exercise all together or regress to an easier variation of the same movement.
Working on the wall is a variation that can be done if your wrists are very sensitive. Useful if your wrists are in pain as soon as they touch the group. Doing the exercise while leaning on the wall allows you to adjust the amount of pressure on your wrists.
Will this routine make my wrists invincible?
Something I noticed with myself and with my students is that doing this wrist routine does provide a great deal of resilience in the short term. This makes it great to do prior to any difficult hand balancing work. At the same time, this routine will not make your wrists invincible. You can strengthen the wrists, but this can only be done by regularly doing this routine.
I strongly suggest doing this routine a few times a week to start building strength and endurance in your wrists. Our goal with this routine and any other ancillary exercises is to make it so you don’t even need a warm up. You should be able to do pushups, handstands, or whatever ground movement without immediately feeling discomfort in the wrists. If you do this routine regularly, this is the wrist strength and endurance you will build up to.