Rehabilitating Wrist and Hand Pain Part I
Dr Alexander Green
NOVA Headache & Chiropractic Center
In this post we will be focusing on rehabilitative strategies for the wrist and hand. These rehab exercises will be directed specifically at the muscles of the hand and forearm. Please check out our earlier post on wrist and hand pain prevention for the rationale behind the exercises that are being recommended.
As was discussed in the previous post, avoiding injury is all about maintaining optimal alignment, and achieving a balance between the opposing muscle groups that move that joint. For the purposes of this discussion, we will generalize a bit- there are muscles that flex the fingers (curl them), and muscles that extend the fingers (straighten them). Stringed musicians especially tend to be have a flexor dominance in their hand muscles. Imbalance in the flexors and extensors of the fingers creates instability, and that will lead to injury over time. To combat this situation, we will focus on activating and strengthening the extensors of the fingers. A simple way of doing this is with a specialized resistance band that can be found on Amazon. Click on the button below to buy the resistance bands on amazon:
Step 1: Place the rings of the resistance band around the first or second joint of the finger (NOT at the tip of the finger). It should be noted that the closer the band is to the tip of the finger, the more difficult the exercise will be.
Step 2: Allow the resistance of the band to bring the fingers closer together
Step 3: While keeping the fingers and the wrist perfectly straight, Spread your fingers as wide as possible and hold them in that position for a 1-3 Mississippi count (1-3 seconds)
Step 4: Resist the pull of the band and slowly allow the fingers to return to the starting position
**Start with 2 sets of 10 repetitions per day and work up from there, adding more sets and reps as your finger extensors get stronger. It is also recommended that you start with the lightest resistance first, and wait 2-3 weeks (with daily use of the band) before graduating to a stronger resistance.
A variation or progression of this exercise will include a tennis ball. The goal of this variant is to provide a greater challenge to the finger extensors in different ranges of motion, and to build independent control over each digit.
Step 1: Place the resistance band on the fingers as discussed in the last exercise.
Step 2: Place a tennis ball in that same hand
Step 3: Lightly squeeze the tennis ball. The pressure should be applied with the first and second joints of each finger NOT the tip of the finger.
Step 4: Straighten one finger, lifting up and away from the tennis ball, while maintaining your grip on the tennis ball with your other fingers
Step 5: Maintain the extended finger position, and begin moving the finger in a circle (first clockwise and then counterclockwise). Again, the other fingers should still be applying pressure to the tennis ball.
Step 6: Lower that finger back down to the tennis ball, and proceed with the same steps for the next finger
The purpose of the last exercise will be to strengthen the extensors of the wrist. The extensors of the wrist are the muscles that help to straighten the wrist. These muscles live on top of the forearm.
Step 1: Kneel at a chair or bench. Lay the forearm flat on whatever surface you are using. The wrist and hand should be unsupported (so that there is room for movement).
Step 2: Grasp a weight (preferably a dumbbell, though resistance bands can also be used) in the hand.
Step: Resist the weight as you slowly bring the hand down towards the floor. This will put the wrist in a flexed position.
Step 4: Straighten the wrist, bringing it into a neutral position.
Step 5: Extend the wrist (point the knuckles towards the ceiling).
Step 6: Repeat
**Note that the forearm should remain firmly in contact with the surface you are resting on throughout the entirety of the exercise. Start with 1 set of 10 reps and a LIGHT weight (no heavier than 1 to 2 pounds) to begin with. You may add weight and sets/reps in time, but take it slowly- focus more on performing the movement with good control, rather than how much weight you can use, or how many repetitions you can do.
