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LEARNING OBJECTIVES
Discuss common injuries and conditions that occur to the wrist.
Demonstrate the ability to apply taping, wrapping, bracing, and padding techniques for the wrist when preventing, treating, and rehabilitating injuries.
Explain and demonstrate appropriate taping, wrapping, bracing, and padding techniques for the wrist within a therapeutic exercise program.
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INJURIES AND CONDITIONS
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Acute and chronic injuries and conditions to the wrist may result from compressive forces, excessive range of motion, and repetitive stresses. Normal range of motion and stability of the wrist are required for participation in most athletic, work, and casual activities. Loss of range of motion, as a result of contusions, sprains, fractures, dislocations, and overuse injuries and conditions, can be caused by compressive forces, a fall on the outstretched arm, excessive range of motion, and/or repetitive stresses. Sprains, fractures, and dislocations can occur due to excessive range of motion and shearing forces, and can result in loss of wrist stability. Common injuries to the wrist include:
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While uncommon, contusions to the wrist do occur; they may be caused by compressive forces. Athletes participating in sports that utilize a stick can be injured as a result of being struck on the wrist by an opponent. Although mandatory gloves normally protect the wrist, an ice hockey forward, for example, can be struck with a stick during a shot on goal.
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Sprains to the wrist are common in athletic and work activities, and are caused by several mechanisms. A fall on the outstretched arm, rotary forces, and abnormal ranges of motion can result in injury to the ligamentous and capsular tissues of the distal radioulnar and radiocarpal joints (Illustration 10–1). For example, a wrestler may sprain his wrist during a takedown, when he lands on the outstretched arm and hyperextends his wrist.
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Triangular Fibrocartilage Complex (TFCC)
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Injury to the TFCC can be caused by a fall on the outstretched arm, rotary stress, and excessive range of motion. Athletic participation with the upper extremity in a closed kinetic chain position increases the risk of injury.24 Excessive forces and abnormal ranges of motion placed on the wrist during gymnastic floor exercises, for instance, can contribute to a TFCC injury.
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Fractures to the distal radius can be the result of a fall on the outstretched arm. A fall on the outstretched arm and shearing forces can cause fractures of the scaphoid and hamate.
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