Wrist and Hand Pain with Movement Coordination Impairments

• If your patient presents to clinic after falling on an outstretched arm or has a history of repetitive/forceful use of the wrist, they may have incurred a sprain of the carpal ligaments! For more clinical findings click here!

Anatomy

Key Finding

• Although other mechanisms such as repetitive forceful use of the wrist can potentially cause carpal ligament sprains, a history of falling on an outstretched hand significantly increases the likelihood of carpal ligament pathology! (Click image to watch 1-2 minute video)

Special Test

The scapholunate ligament is one of the more common injured carpal ligaments. With moderate sensitivity and specificity, the Watson test can help the clinician determine potential involvement! (Click image to watch 1-2 minute video)

Treatment

• If the patient suffers from acute symptomology then techniques such as wrist isometrics for muscle activation and pain gating may prove beneficial; however, if subacute mobility deficits arise then wrist mobilizations with movement (MWM) can help restore the lost motions! (Click image to watch 1-2 minute video)

Therapeutic Exercise

• Various ways exist to help strengthen the musculature, which cross the wrist joint. Here is an example of wrist flexion and extension strengthening using a flexbar! This technique not only allows for strengthening, but can also help with range of motion! (Click image to watch 1-2 minute video)