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  1. #1
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    Brief Medical History Overview

    Age: 33, Male, Presenting Problem Since: Just over 1 month, Symptom Behaviour: Seemingly remaining constant, Symptoms Worse (24hr Behaviour): Have not noticed any difference, Aggravating Factors:: Described in post, Easing Factors:: Described in post, No Investigations, No Diabetes, No history of High Blood Pressure, No Medications, No Osteoporosis, No Hx of Cancer, No Unexplained Weight Loss, No Bowel/Bladder issues, Other Info: I don't think so.

    Major problem / Symptomatic Areas

    Wrist, Hand - Anterior - Right

    Question Wrist sprain (possible hyperextension) that does not seem to be healing over time

    Physical Agents In Rehabilitation
    Hi,

    I have recently injured myself, I will be honest it was not a sports injury but a drunken injury, I simply fell over from standing while intoxicated and used my wrist to brace myself against my kitchen counter, proceeded to (I presume) hyperextend something in my wrist-to-forearm joint, by which I mean, my wrist bent backwards significantly and quickly and there was immediate pain. I did break my fall in that I didn't faceplant into anything but I immediately knew I had injured myself in some way. However at the time the pain was not unbearable immediately after the injury (admittedly, intoxication may have played a part in this) and the next day I found that even though some activities caused some discomfort and pain, on the whole, if I was exerting no particular pressure on my hand, not putting any pressure on my wrist, there was no pain at all, so I presumed it would just get better on it's own.

    However - this was the 16th of October that I did this. It is now November 19th, so over a month ago. If it is getting better - it is happening very, very slowly.

    This is my right wrist, and I am right handed. I will note that my job means I spend a lot of time using a mouse in my right hand, which does not cause pain but maybe, has some relevance.

    On reviewing the body segments to click on, I wondered for a moment if it was an anterior or posterior injury but with some movement of my wrist it is immediately obvious that it is a discomfort localised in the anterior region, possibly more-so in the side of my hand opposite to my thumb (if I put my wrist in an uncomfortable position, flexing my ring finger and little finger causes a very very minor aggravation to the discomfort whereas flexing my thumb, forefinger or middle finger seems to have little to no effect.

    Movements that will induce discomfort are bending my wrist forward naturally too far (which is quite far, almost as far as it will go - so it is not that easy to induce discomfort with unloaded, simple movements) - I just experimented with bending my wrist forward, then twisting clockwise or anticlockwise as I expected that possibly twisting one way or the other would exacerbate the discomfort, but this does not seem to be the case. Naturally bending my wrist backwards seems not to cause pain - unless I attempt to stretch by pulling the fingers of my right hand further backwards with my left hand - then I also get some discomfort.

    Day-to-day activities that cause discomfort are things like applying pressure while holding something with my right hand - ie, washing dishes manually, for example, during which I would usually scrub with my right hand, or opening jars, tight bottle caps, etc, which I would usually do with my right hand but have switched on occasion to grip the bottle/jar with my right hand and use my left to twist the cap. I will note that when doing this, the act of gripping does still cause some discomfort in my right wrist - but gripping a wider object seems to cause less discomfort than gripping the narrower bottlecap, for example.

    I will note here that I am using the word "discomfort" rather than pain because honestly, it seems fairly minor, but obviously it has been going on some time now, and does not seem to be really getting better on it's own so obviously it's something I need to address.

    Previously I had been weightlifting semi-regularly but have not done any lifting since this injury. Push-ups are also out and cause too much wrist discomfort (actually I would say to attempt a push-up would cause actual pain in my right wrist, not just discomfort - maybe this is the best example of a movement which causes definite pain and is my ability to do is significantly reduced) although I find I AM able to do push-ups on my fists, possibly also with push-up bars, although I am not sure if this is sensible or good for the injury as it still does not feel 100% right, but the discomfort or pain is minimal.

    I have attempted pull-ups and chin-ups, and found that actually my ability to do these seems to be relatively unaffected, the limiting factor is still the strength/endurance of whatever other musculature is involved in these movements more-so than my wrist - but I do feel a "pulling" sensation of some kind in my right wrist while doing pull-ups or chin-ups which also makes my doubt the safety of these exercises with this current injury.

    So my questions, essentially are:

    1) What is likely to have happened, and what can I do about it to speed recovery?

    2) What exercises CAN I do, and what exercises should I avoid?

    (I guess this is a good time just to focus on cardio type exercise, ie, running, etc, but I am wondering if there is any light weight/bodyweight stuff I could still work in - are fist-push-ups, chin-ups, pull-ups that I mentioned a bad idea, or likely OK or perhaps just helpful in moderation somehow?)

    Thank you in advance for any assistance anyone can offer!

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  2. #2
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    Re: Wrist sprain (possible hyperextension) that does not seem to be healing over time

    Aircast Airselect Short Boot
    Hi Xenith and thanks for your informative post. I suppose my first thought might be that if this was me I would have gone for a simple wrist x-ray/scan to rule out any fracture of the smaller bones (metacarpals) of the hand. These are often injured when falling in the way you describe and the resultant symptoms might just be a deep aching sensation. I'd want to rule out any issue with the scaphoid bone and although your pain is on the outside of the wrist the change in position of the bones could possible lead to that scenario.

    If you did fall more laterally onto the wrist you might have sprained the Triangular Fibrocartilage. This can lead to generalise instability and can be an annoyance, something especially noticeable in people who play tennis and have to grip and hit under load. You might try purchasing a simple wrist wrap and seeing how the wearing of that affects your symptoms. It can be a useful and simple supportive aid to wear for a while to support the carpal bones as a group while the soft tissues heal.

    See if you can action either or both of the above and let us know where you end up and we can provide some more insights.
    regards
    PB

    Aussie trained Physiotherapist living and working in London, UK.
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