Advice on a wrist injury

[basketballjoe]

Last summer I was out with some friends and we were messing about and i punched my friend on the arm (stupid, I know). It wasn't intent on hurting him, just playing around as boys do, but nevertheless i felt too stupid about it to go see a doctor. as I hit him my wrist turned and most of the impact was on the top of my wrist.

I play basketball at least 3 times a week, and instead of resting the injury i continued playing basketball, even a little bit on the day I injured it, making the injury a lot worse. The season started in September, and I decided to wait until the end of the season to seek attention, despite it affecting my shot.

Now the season has finally finished and my wrist still hurts. It's ok when i have it straight with my forearm, so i can do press ups on my knuckles instead of using my hands, but when i extend my wrist fully at the end of my shot I still feel it. I think possibly the injury has heeled, as I tried resting it as much as possible outside sport during the season, so possibly its now just tightened up as I've not used it as much. If it's actually damaged, how can I fix it? And if it's just tight due under-using it, how can i restore its flexibility and range of movement i previously had?

Sorry about being unsure of the injury, but i would seriously apreciate help with this, I'm 15 and play basketball at a national level in England, I need my wrist to be 100% again. Please help!

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[umerphysio]

hello,
you should try some exercises. give me your email i will send you a literature

[umerphysio]

I have emailed you an exercise literature which will be helpfull to you. and view my recently posted blog on selfcare of wrist injury at home.
best regards
umer physio

[basketballjoe]

Sorry I didn't reply sooner, but my emails wouldn't send and my internet connection hasn't let me on for the last week, but I've been doing the excercises every day since you gave them me. After the exercises I have a wider range of movement in my wrist and can fully extend it, although my wrist is still tight the next day, and I need to do the exercises before games if I want it's full range of movement. Should I just carry on with the exercises? Sorry for the late reply.

[smshaffe]

as always there is no substitute for a good, thorough in person professional eval. however, let's have some fun.

where exactly does it hurt? same side as the palm? back of the hand? side near the thumb or little finger? is it deep or superficial? any tingling? popping or clicking? does it feel stiff? if it cracks does it help the pain, make it worse, or not change it?

try this and report what happens: if you put both arms in the same position and move each wrist can you see that one doesn't move as far as the other? if so, which direction is it? check all six planes of movement: put your elbows at your sides and your hand out like you are going to shake someone hand and move your palms together and away, little finger toward the floor and thumb up, palms turned down toward the floor and then up to the ceiling the whole time keeping your forearm parallel toward the floor. Look very closely to see if one moves more or less than the other and if it hurts. if one position or more causes pain carefully try to pull on the hand as if to pull it off your wrist - be very careful to not alter the position of the wrist. You may need someone to help you with the pulling part.

what are the results?

[basketballjoe]

I have a smaller range of movement in my injured wrist than my other in every direction. It feels more tight than in pain. When I do the movements you asked me to, the bad wrist extrends and moves to the same extent a the other, however when I get to the point of full extention i start to feel it, not as much pain but just stiffness. It doesn't hurt at all when I pull it, only when I move it back and forth, to the sides, or rotate it. The injury is along the top of my wrist.
Also, when I rotate my ankles and wrists, they both click. It doesn't hurt, the bones just seem to click, especially in the morning. I can no longer rotate my injured wrist enough to make it click but can with my other hand. Also, is it bad that they click when i rotate them?

[smshaffe]

sounds like a classic case of stiffness in the wrist (carpal hypomobility). if it isn't painful you may be able to just force it in all directions and stretch it out. this would imply pushing it in all of the six major directions until you felt about a moderate stretch. the length and intensity of each stretch is up for debate and probably dependent on a lot of variables. this also may not work sufficiently as it may not accurately stretch out all of the individual joints in the wrist. i am also assuming you feel the tightness in the wrist and not the forearm when i say that.

however, and this is a big however, the stiffness is more likely to be helped by mobilizing joints in the wrist (and possibly at least one in the elbow). yet, there are lots of joints in there and evaluating and treating it properly should be done by a trained (and good) physio. i don't know about were you live but where i live lots of physios are bad at treating the wrist. i'd see if you can find a certified manipulative physio or a certified hand therapist of some sort. i could be off on that idea.

there are some relatively easy things you could do to see if it increases your movement and decreases your perceived stiffness. for example, "slide" the hand, the whole hand, in the exact opposite direction you move it into. let me explain that more. as you move the palm toward the anterior aspect of the forearm or inward in that hand shake position i previously described, you can stretch the hand by pulling it out from the forearm (as if to stretch the arm and make it longer) or glide/slide it straight inward (not an angular movement like what you used to get the hand into that position but rather more of a translation as if to slide it off the forearm and not just pivot while still attached). that may be tough to follow and certainly isn't the most well organized though, sorry about that. pictures would be best. anyway, in reference to that hand shake position, if the hand moves down to the floor you'd want to slide the hand up to the ceiling and always in the opposite direction for each movement. that should help stretch the wrist.

that having been said the wrist is a very intricate and complicated area that requires an intimate knowledge of underlying anatomy when treated. it may not be the type of thing you want to treat yourself. did you see a physio?