Wrist Strain

Injury to the muscles or tendons of the wrist. Muscles, tendons and attached bones comprise units. These units stabilize the wrist and allow its motion. A strain occurs at the weakest part of a unit. Strains are of 3 types:

• Mild (Grade I)- Slightly pulled muscle without tearing of muscle or tendon fibers. There is no loss of strength.
• Moderate (Grade 11)- Tearing of fibers in a muscle, tendon or at the attachment to bone. Strength is diminished.
• Severe (Grade III)- Rupture of the muscle-tendon-bone attachment with separation of fibers. Severe strain requires surgical repair. Chronic strains are caused by overuse. Acute strains are caused by direct injury or overstress.

Body Parts Involved

• Tendons and muscles of the forearm.
• Bones at the wrist, where the muscles and tendons attach.
• Soft tissue surrounding the strain, including nerves, periosteum (covering to bone), blood vessels and lymph vessels.

Causes

• Prolonged overuse of muscle-tendon until in the forearm.
• Single violent injury or force applied to the forearm.

Signs & Symptoms

• Pain when moving or stretching the wrist.
• Muscle spasm of forearm muscles.
• Redness and swelling over the injury.
• Loss of strength (moderate or severe strain).
• Crepitation ("crackling") feeling and sound when the injured area is pressed with fingers.
• Calcification of the muscle or tendon (visible with X-rays).
• Inflammation of the tendon sheath.

Treatment

First Aid

Continuing Care

If splints or a cast are used after injury or surgery, leave fingers free and exercise them regularly. If a cast or splints are not used:

• Use ice massage 3 or 4 times a day for 15 minutes at a time. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball.
• After the first 24 hours, apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments and ointments.
• Take whirlpool treatments, if available.
• Wrap the injured wrist and forearm with an elasticized bandage between treatments.
• Massage gently and often to provide comfort and decrease swelling.

Medication

• For minor discomfort, you may use:

Aspirin, acetaminophen or ibuprofen.

Topical liniments and ointments.

• Your doctor may prescribe:

Stronger pain relievers.

Injection of a long-acting local anesthetic to reduce pain.

Injections of corticosteroids, such as  triamcinolone, to reduce inflammation.

Home Diet

Eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity.

Diagnostic Measures

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• X-rays of the wrist and forearm to rule out fractures.

Prevention Tips

• Participate in a strengthening and conditioning program appropriate for your sport.
• Warm up before practice or competition.
• Tape the wrist area before practice or competition.
• Wear proper protective equipment.