Hand & Wrist Injuries

Proper management during the first 24-48 hours is imperative to expedite return after the injury as quickly and as safely as possible. Refer to the PEACE & LOVE Approach for acute care of the injury. If there is any noticeable deformity, seek out either Urgent Care or an Emergency Department, depending on severity (see Where Should You Go? page for more information). 

After any injury, follow up with your athletic trainer as soon as you can. 

Immediate Care

A couple of key takeaways from "PEACE & LOVE": 

• Ice and cold treatments are not necessary and can disrupt inflammation, angiogenesis, and revascularisation, delay neutrophil and macrophage infiltration as well as increase immature myofibers, potentially leading to impaired tissue repair and redundant collagen synthesis and prolonging return to sport

• Only take Tylenol/Acetaminophen for the first 24-48 hours as needed to manage pain

• Swelling is good so avoid NSAIDs like Advil/Motrin/Ibuprofen, Aleve/Naproxen Sodium, etc. until at least 48 hours post-injury

• Elevate the injured wrist & hand by placing it across the chest and holding your opposite shoulder

• Limit use and avoid testing range of motion for, at minimum, the first 24-48 hours post-injury

Wrist Injury Subsequent Care

After waiting 24-48 hours after injury, complete these stretches & exercises on your own for the recommended sets, reps, & frequency, provided you are pain-free or pushing yourself to a point of pain. If necessary, see the athletic trainer for more exercises or if exercises need to be modified. The descriptions of each phase are meant to be a guide and if the athlete is having difficulty or ease with completing the listed exercises, they can choose a different stage more appropriate.

Wrist Stretches - 4×/Day, 30 seconds each - Typically, wake-up, before practice, after practice, before sleep - Within Pain-free Range of Motion Limits

• Table Top Wrist Flexion Open-Hand Stretch:

  • Place your Elbow on the table and an open hand, push down on the back of your hand until you feel a stretch

• Table Top Wrist Extension Open-Hand Stretch: 

  • Place your Elbow on the table and an open hand, push down on the palm of your hand until you feel a stretch

• Table Top Wrist Flexion Closed-Hand Stretch: 

  • Place your Elbow on the table and a loosely closed fist, push down on the back of your hand until you feel a stretch

• Table Top Wrist Extension Closed-Hand Stretch: 

  • Place your Elbow on the table and a loosely closed fist, push down on the palmar side of your fist until you feel a stretch

• Straight Arm Wrist Flexion Open-Hand Stretch: 

  • With a straight Elbow and open hand, push on the back of your hand until you feel a stretch

• Straight Arm Wrist Extension Open-Hand Stretch: 

  • With a straight Elbow and open hand, push on the palm of your hand until you feel a stretch

• Straight Arm Wrist Flexion Closed-Hand Stretch: 

  • With a straight Elbow and a loose fist, push on the back of your hand until you feel a stretch

• Straight Arm Wrist Extension Closed-Hand Stretch: 

  • With a straight Elbow and loose fist, push on the palmar side of your hand until you feel a stretch

Stage 1 Exercises - 2×/Day - If there is pain in the end-range of normal range of motion

1. Unweighted Wrist Flexion/Extension in Pronation 3×10

   • Palm side down, flex and extend your wrist within pain-free range of motion

2. Unweighted Wrist Flexion/Extension in Supination 3×10

   • Palm side up, flex and extend your wrist within pain-free range of motion

3. Unweighted Pronation/Supination 3×10

   • In a wrist neutral position, rotate your hand over and back within pain-free range of motion

Stage 2 Exercises - 1×/Day - If pain-free with full range of motion for all normal wrist ranges of motion

1. Weighted Wrist Flexion Curls 3×10: https://youtu.be/mgfqzKNeajc 

2. Weighted Wrist Extension Curls 3×10: https://youtu.be/hOfHzWKlzH4 

3. Hammer Pronation/Supination Rotations 3×10: https://youtu.be/ODznghlBrCI 

Taping/Bracing

• If indicated, the Athletic Trainer can tape/wrap the injured area to assist with returning to your sport.  Please wear appropriate clothing as indicated by the Athletic Trainer. 

Thumb Injury Subsequent Care

After waiting 24-48 hours after injury, complete these stretches & exercises on your own for the recommended sets, reps, & frequency, provided you are pain-free or pushing yourself to a point of pain. If necessary, see the athletic trainer for more exercises or if exercises need to be modified. The descriptions of each phase are meant to be a guide and if the athlete is having difficulty or ease with completing the listed exercises, they can choose a different stage more appropriate.

Stage 1 Exercises - 2×/Day - If there is pain in the end-range of normal range of motion

Stage 1 Exercises #1-#3 are shown here: https://youtu.be/P4WPk5mUr8I 

1. Flexion/Extension 3×10

2. Abduction/Adduction 3×10

3. Opposition (touch each finger and just below the base of the pinky) 3×5

4. Thumb Circumduction (Clockwise & Counter-clockwise circles) 3×10 

Stage 2 Exercises - 1×/Day - If pain-free with full range of motion for all normal thumb ranges of motion

You will need a rubber band for these exercises. Full video: https://youtu.be/0fm-Htp4zj8 

1. Thumb Rockers 3×10: https://youtu.be/0fm-Htp4zj8?t=97 

2. Thumb Outward Bounds 3×10: https://youtu.be/0fm-Htp4zj8?t=184 

3. Thumb Twiddlers 3×10: https://youtu.be/0fm-Htp4zj8?t=195 

4. Thumb Reverse Twiddlers 3×10: https://youtu.be/0fm-Htp4zj8?t=225 

5. Thumb Touch Up Downs 3×10: https://youtu.be/0fm-Htp4zj8?t=294 

6. Thumb Overheads 3×10: https://youtu.be/0fm-Htp4zj8?t=336 

7. Thumb Adductors 3×10: https://youtu.be/0fm-Htp4zj8?t=350 

8. Thumb Swans 3×10: https://youtu.be/0fm-Htp4zj8?t=389 

9. Thumb Flys 3×10: https://youtu.be/0fm-Htp4zj8?t=423 

10. Thumb Hammocks 3×10: https://youtu.be/0fm-Htp4zj8?t=543 

Taping/Bracing

• If indicated, the Athletic Trainer can tape/wrap the injured area to assist with returning to your sport.  Please wear appropriate clothing as indicated by the Athletic Trainer. 

Hand/Finger(s) Injury Subsequent Care

After waiting 24-48 hours after injury, complete these stretches & exercises on your own for the recommended sets, reps, & frequency, provided you are pain-free or pushing yourself to a point of pain. If necessary, see the athletic trainer for more exercises or if exercises need to be modified. The descriptions of each phase are meant to be a guide and if the athlete is having difficulty or ease with completing the listed exercises, they can choose a different stage more appropriate.

Stage 1 Exercises - 2×/Day - If there is pain in the end-range of normal range of motion

Stage 1 Exercises #1-#3 are shown here: https://youtu.be/aUmUiGRO96E?t=36 

1. Finger MP Extenders 3×50: https://youtu.be/aUmUiGRO96E?t=36 

2. Finger PIP Flex/Ext 3×50: https://youtu.be/aUmUiGRO96E?t=68 

3. Finger DIP Flex/Ext 3×50: https://youtu.be/aUmUiGRO96E?t=89 

Stage 2 Exercises - 1×/Day - If pain-free with full range of motion for all normal thumb ranges of motion

1. Finger Abduction 3×10: https://youtu.be/4QsU3mnsVmM?t=297 

2. Finger Isometrics 3×10: https://youtu.be/4QsU3mnsVmM?t=418 

3. Finger Extension 3×10: https://youtu.be/4QsU3mnsVmM?t=576 

Taping/Bracing

• If indicated, the Athletic Trainer can tape/wrap the injured area to assist with returning to your sport.  Please wear appropriate clothing as indicated by the Athletic Trainer.