Wrist and Hand

Pick a Body Problem

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Skier’s Thumb (Gamekeeper’s thumb)

Skier’s Thumb is caused by a traumatic force on the thumb that forces it out (radial deviation is the anatomical direction). It often occurs with skiing and football.

Signs and symptoms include pain in the knuckle of the thumb, swelling, and an unstable joint. X-rays often show a small fragment of the metacarpal that has been pulled off by the ligament (called an avulsion fracture).

Treatment usually consists of bracing or splinting of partial tears and in some cases, surgical repair if the tear is complete.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Electrotherapeutic Modalities
  • Hand Active Range of Motion
  • Wrist Active Range of Motion
  • Wrist Joint Mobilization
  • Wrist Passive Range of Motion
  • Wrist Resistive Range of Motion
  • Isometric Exercise
  • Physical Agents

Possible Treatment Goals

  • Decrease Risk of Reoccurrence
  • Improve Function
  • Improve Muscle Strength and Power
  • Optimize Joint Alignment
  • Improve Proprioception
  • Self-care of Symptoms
  • Improve Safety
  • Improve Tolerance for Prolonged Activities

Additional Resources

Carpal Tunnel Syndrome

Carpal tunnel syndrome is a compression of the median nerve within the carpal tunnel. There is pain, tingling, and in severe cases, numbness in the thumb, index middle and ½ of the ring finger. It is typically caused by repetitive tasks involving the hand and wrist. Typing with the wrists resting on hard surfaces can result in this problem.

It is often worse at night or with driving and can lead to loss of grip strength and coordination. As the problem progresses, atrophy (muscle wasting) of the thumb muscles may occur.

Treatment typically consists of splinting the wrist in a neutral position (no bend in the wrist in either direction), anti-inflammatory medication, and most importantly, activity modification such as wearing a padded glove during cycling. Surgical release of the transverse carpal ligament is often performed before muscle wasting occurs. Physical therapy follows to help restore range of motion, strength, and to educate the patient of factors that can lead to a reoccurrence of the problem.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Soft Tissue Mobilization
  • Stretching/Flexibility Exercise
  • Wrist Active Range of Motion
  • Wrist Joint Mobilization
  • Wrist Passive Range of Motion
  • Wrist Resistive Range of Motion
  • Isometric Exercise
  • Physical Agents

Possible Treatment Goals

  • Decrease Risk of Reoccurrence
  • Improve Function
  • Improve Muscle Strength and Power
  • Decrease Nerve Compression
  • Increase Oxygen to Tissues
  • Improve Range of Motion
  • Improve Relaxation
  • Self-care of Symptoms
  • Improve Safety
  • Improve Tolerance for Prolonged Activities

Guyon’s Canal Syndrome (Handlebar Palsy)

Like Carpal Tunnel Syndrome, this condition is often seen in cyclists when the ulnar nerve is compressed in its canal over the wrist. Resting the palms of the hands on bicycle handlebars is typically the cause.

Treatment is similar to that for Carpal Tunnel Syndrome – activity modification, such as wearing a padded glove during cycling, rest, splinting, hand therapy – including ultrasound/iontophoresis, exercise, and less often, surgery.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Electrotherapeutic Modalities
  • Hand Active Range of Motion
  • Iontophoresis
  • Soft Tissue Mobilization
  • Stretching/Flexibility Exercise
  • Wrist Active Range of Motion
  • Wrist Joint Mobilization
  • Wrist Passive Range of Motion
  • Wrist Resistive Range of Motion
  • Isometric Exercise
  • Physical Agents
  • Proprioceptive Neuromuscular Facilitation (PNF)

Possible Treatment Goals

  • Decrease Risk of Reoccurrence
  • Improve Muscle Strength and Power
  • Decrease Nerve Compression
  • Increase Oxygen to Tissues
  • Improve Range of Motion
  • Self-care of Symptoms
  • Improve Relaxation
  • Improve Tolerance for Prolonged Activities

De Quervain’s Tenosynovitis

This is a common condition in which the tendons that extend or straighten the thumb and their surrounding sheaths (extensor pollicus brevis and abductor pollicus longus) become inflamed. Pain is located at the base of the thumb and wrist.

De Quarvain’s tenosynovitis is common with repetitive work activities such as wringing and scissoring tasks. Treatment includes rest, splinting, and rehabilitation to restore flexibility, reduce inflammation and modify tasks and activities. Surgery is rarely indicated, but a steroid injection is occasionally neccessary.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Electrotherapeutic Modalities
  • Hand Active Range of Motion
  • Soft Tissue Mobilization
  • Stretching/Flexibility Exercise
  • Wrist Active Range of Motion
  • Wrist Joint Mobilization
  • Wrist Passive Range of Motion
  • Wrist Resistive Range of Motion
  • Isometric Exercise
  • Physical Agents

Possible Treatment Goals

  • Improve Function
  • Improve Muscle Strength and Power
  • Improve Relaxation
  • Increase Oxygen to Tissues
  • Self-care of Symptoms
  • Improve Range of Motion
  • Improve Safety
  • Improve Tolerance for Prolonged Activities

Fractures of the Forearm/Wrist

Fractures of the wrist and hands are commonly named for their anatomical location, how they occurred, or a doctor that discovered or studied the given type of fracture.

The fingers are susceptible to fracture in household mishaps, recreational injuries and work-related trauma.

Most hand fractures are stable and do not require surgery. However, occasionally, fractures will not heal without appropriate surgical intervention. Internal support or “hardware” is necessary to stabilize fractures. The therapist may apply a form fitting, custom thermoplastic splint to protect the fracture during healing. These splints may be removed for exercise and hygiene.

Most therapy programs commence days to 3 or 4 weeks post op, to regain motion, decrease pain, and reduce swelling. Rehabilitation may continue for weeks or months to restore range of motion (ROM) and strength.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Hand Active Range of Motion
  • Wrist Active Range of Motion
  • Wrist Joint Mobilization
  • Wrist Passive Range of Motion
  • Wrist Resistive Range of Motion
  • Isometric Exercise
  • Physical Agents

Possible Treatment Goals

  • Improve Function
  • Improve Muscle Strength and Power
  • Decrease Postoperative Complications
  • Improve Range of Motion
  • Self-care of Symptoms
  • Improve Wound Healing

Distal Radius Fracture Colles, Smith Fractures

These fractures often result from a fall onto an outstretched hand or because of a direct blow. Pain, tenderness, and deformity are common. X-rays are used to rule in/out a fracture.

Treatment for a fracture involves “closed reduction” in which the bones are moved back into alignment.

If the bones cannot be moved back into the proper position manually, open reduction and often internal fixation is used. This means that the bones are surgically positioned next to each other and might be pinned, screwed or wired together.

Early intervention/rehabilitation is helpful to reduce pain, increase range of motion, and ultimately restore strength and function. Wrist supports and custom splints are helpful to protect the area so optimal healing can occur.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Hand Active Range of Motion
  • Wrist Active Range of Motion
  • Wrist Joint Mobilization
  • Wrist Passive Range of Motion
  • Wrist Resistive Range of Motion
  • Isometric Exercise
  • Physical Agents

Possible Treatment Goals

  • Improve Function
  • Improve Muscle Strength and Power
  • Increase Oxygen to Tissues
  • Self-care of Symptoms
  • Improve Range of Motion

Scaphoid Fracture

This is a common carpal wrist bone fracture. Often wrongly diagnosed as a wrist sprain, there is tenderness or pain where the base of the thumb meets the wrist, an area called the anatomical snuffbox. It usually occurs in the adolescent or young adult with a fall on the outstretched hand or with high velocity wrist injuries (like motorcycle accidents).

Treatment for a scaphoid fracture can be difficult. If there is just a crack in the scaphoid bone, it requires a thumb splint for 6 weeks or until healed. If the bone is completely broken apart, it will require surgical fixation. Because of the unusual blood supply, the fracture may not heal completely (delayed union) or avascular necrosis (death of the bone because of loss of the blood supply) may result.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Electrotherapeutic Modalities
  • Hand Active Range of Motion
  • Wrist Active Range of Motion
  • Wrist Joint Mobilization
  • Wrist Passive Range of Motion
  • Wrist Resistive Range of Motion
  • Isometric Exercise
  • Physical Agents

Possible Treatment Goals

  • Improve Function
  • Improve Muscle Strength and Power
  • Self-care of Symptoms
  • Improve Range of Motion

Fracture of the Hook of Hamate

This is a fracture of a small region on the palm of the hand opposite the thumb. It typically occurs when the golf club impacts the ground. Signs and symptoms consist of point tenderness and pain in the palm of the hand. X-rays are used to rule this in/out.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Hand Active Range of Motion
  • Wrist Active Range of Motion
  • Wrist Joint Mobilization
  • Wrist Passive Range of Motion
  • Wrist Resistive Range of Motion
  • Isometric Exercise
  • Physical Agents

Possible Treatment Goals

  • Improve Function
  • Improve Muscle Strength and Power
  • Self-care of Symptoms
  • Improve Range of Motion
  • Decrease Nerve Compression
  • Decrease Postoperative Complications
  • Improve Wound Healing

Mallet (Baseball) Finger

This fracture results from a trauma to tip of the finger forcing it into flexion (rapidly bending it down toward the palm) and avulsing the extensor tendon. This injury commonly occurs in baseball and basketball when attempting to catch a ball. Signs and symptoms include pain, swelling, and an inability to straighten out the last digit of the involved finger.

Treatment includes splinting of the finger in the straight position for 6-8 weeks. In some cases, surgical pinning of the finger in a straight position along with splinting is necessary.

Possible Treatments

  • Cryotherapy or Cold Therapy
  • Isometric Exercise
  • Physical Agents

Possible Treatment Goals

  • Improve Function
  • Improve Muscle Strength and Power
  • Self-care of Symptoms

Additional Resources

  • Skier’s Thumb (Gamekeeper’s thumb)

    Skier’s Thumb is caused by a traumatic force on the thumb that forces it out (radial deviation is the anatomical direction). It often occurs with skiing and football.

    Signs and symptoms include pain in the knuckle of the thumb, swelling, and an unstable joint. X-rays often show a small fragment of the metacarpal that has been pulled off by the ligament (called an avulsion fracture).

    Treatment usually consists of bracing or splinting of partial tears and in some cases, surgical repair if the tear is complete.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Hand Active Range of Motion

    The movement of the hand, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Active Range of Motion

    The movement of the wrist, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or wrist joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Wrist Passive Range of Motion

    The movement of the wrist, by the patient or therapist, through a range of motion without the use of the muscles that “actively” move the joint(s).

    Wrist Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Decrease Risk of Reoccurrence
    • Improve Function
    • Improve Muscle Strength and Power
    • Optimize Joint Alignment
    • Improve Proprioception
    • Self-care of Symptoms
    • Improve Safety
    • Improve Tolerance for Prolonged Activities

    Resources

  • Carpal Tunnel Syndrome

    Carpal tunnel syndrome is a compression of the median nerve within the carpal tunnel. There is pain, tingling, and in severe cases, numbness in the thumb, index middle and ½ of the ring finger. It is typically caused by repetitive tasks involving the hand and wrist. Typing with the wrists resting on hard surfaces can result in this problem.

    It is often worse at night or with driving and can lead to loss of grip strength and coordination. As the problem progresses, atrophy (muscle wasting) of the thumb muscles may occur.

    Treatment typically consists of splinting the wrist in a neutral position (no bend in the wrist in either direction), anti-inflammatory medication, and most importantly, activity modification such as wearing a padded glove during cycling. Surgical release of the transverse carpal ligament is often performed before muscle wasting occurs. Physical therapy follows to help restore range of motion, strength, and to educate the patient of factors that can lead to a reoccurrence of the problem.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Soft Tissue Mobilization

    Therapeutic massage of body tissue, performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.

    Stretching/Flexibility Exercise

    Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

    Wrist Active Range of Motion

    The movement of the wrist, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or wrist joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Wrist Passive Range of Motion

    The movement of the wrist, by the patient or therapist, through a range of motion without the use of the muscles that “actively” move the joint(s).

    Wrist Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Decrease Risk of Reoccurrence
    • Improve Function
    • Improve Muscle Strength and Power
    • Decrease Nerve Compression
    • Increase Oxygen to Tissues
    • Improve Range of Motion
    • Improve Relaxation
    • Self-care of Symptoms
    • Improve Safety
    • Improve Tolerance for Prolonged Activities

    Resources

  • Guyon’s Canal Syndrome (Handlebar Palsy)

    Like Carpal Tunnel Syndrome, this condition is often seen in cyclists when the ulnar nerve is compressed in its canal over the wrist. Resting the palms of the hands on bicycle handlebars is typically the cause.

    Treatment is similar to that for Carpal Tunnel Syndrome – activity modification, such as wearing a padded glove during cycling, rest, splinting, hand therapy – including ultrasound/iontophoresis, exercise, and less often, surgery.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Hand Active Range of Motion

    The movement of the hand, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Iontophoresis

    Medications are propelled through the skin by an electrical charge. This modality works on the physical concept that like charges repel each other, therefore, a positively charged medication will be repelled through the skin to the underlying tissues by the positively charged pad of an iontophoresis machine. Iontophoresis is usually prescribed for injuries such as shoulder or elbow bursitis.

    Soft Tissue Mobilization

    Therapeutic massage of body tissue, performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.

    Stretching/Flexibility Exercise

    Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

    Wrist Active Range of Motion

    The movement of the wrist, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or wrist joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Wrist Passive Range of Motion

    The movement of the wrist, by the patient or therapist, through a range of motion without the use of the muscles that “actively” move the joint(s).

    Wrist Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound
    Proprioceptive Neuromuscular Facilitation (PNF)

    Performed in diagonal patterns that mimic functional movements. Initially this technique was used in developmentally and neurologically impaired patients. Today, PNF (or a variation of it)is commonly used for almost every aspect of neuromuscular retraining. It can be used on the professional athlete or someone in a nursing home.

    Goals

    • Decrease Risk of Reoccurrence
    • Improve Muscle Strength and Power
    • Decrease Nerve Compression
    • Increase Oxygen to Tissues
    • Improve Range of Motion
    • Self-care of Symptoms
    • Improve Relaxation
    • Improve Tolerance for Prolonged Activities

    Resources

  • De Quervain’s Tenosynovitis

    This is a common condition in which the tendons that extend or straighten the thumb and their surrounding sheaths (extensor pollicus brevis and abductor pollicus longus) become inflamed. Pain is located at the base of the thumb and wrist.

    De Quarvain’s tenosynovitis is common with repetitive work activities such as wringing and scissoring tasks. Treatment includes rest, splinting, and rehabilitation to restore flexibility, reduce inflammation and modify tasks and activities. Surgery is rarely indicated, but a steroid injection is occasionally neccessary.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Hand Active Range of Motion

    The movement of the hand, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Soft Tissue Mobilization

    Therapeutic massage of body tissue, performed with the hands. Soft tissue mobilization may be used for muscle relaxation, to decrease swelling, to decrease scar tissue adhesions, and for pain relief.

    Stretching/Flexibility Exercise

    Exercise designed to lengthen a muscle(s) or soft tissue. Stretching exercises are usually prescribed to improve the flexibility of muscles that have tightened due to disuse or in compensation to pain, spasm or immobilization.

    Wrist Active Range of Motion

    The movement of the wrist, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or wrist joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Wrist Passive Range of Motion

    The movement of the wrist, by the patient or therapist, through a range of motion without the use of the muscles that “actively” move the joint(s).

    Wrist Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Improve Function
    • Improve Muscle Strength and Power
    • Improve Relaxation
    • Increase Oxygen to Tissues
    • Self-care of Symptoms
    • Improve Range of Motion
    • Improve Safety
    • Improve Tolerance for Prolonged Activities

    Resources

  • Fractures of the Forearm/Wrist

    Fractures of the wrist and hands are commonly named for their anatomical location, how they occurred, or a doctor that discovered or studied the given type of fracture.

    The fingers are susceptible to fracture in household mishaps, recreational injuries and work-related trauma.

    Most hand fractures are stable and do not require surgery. However, occasionally, fractures will not heal without appropriate surgical intervention. Internal support or “hardware” is necessary to stabilize fractures. The therapist may apply a form fitting, custom thermoplastic splint to protect the fracture during healing. These splints may be removed for exercise and hygiene.

    Most therapy programs commence days to 3 or 4 weeks post op, to regain motion, decrease pain, and reduce swelling. Rehabilitation may continue for weeks or months to restore range of motion (ROM) and strength.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Hand Active Range of Motion

    The movement of the hand, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Active Range of Motion

    The movement of the wrist, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or wrist joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Wrist Passive Range of Motion

    The movement of the wrist, by the patient or therapist, through a range of motion without the use of the muscles that “actively” move the joint(s).

    Wrist Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Improve Function
    • Improve Muscle Strength and Power
    • Decrease Postoperative Complications
    • Improve Range of Motion
    • Self-care of Symptoms
    • Improve Wound Healing

    Resources

  • Distal Radius Fracture Colles, Smith Fractures

    These fractures often result from a fall onto an outstretched hand or because of a direct blow. Pain, tenderness, and deformity are common. X-rays are used to rule in/out a fracture.

    Treatment for a fracture involves “closed reduction” in which the bones are moved back into alignment.

    If the bones cannot be moved back into the proper position manually, open reduction and often internal fixation is used. This means that the bones are surgically positioned next to each other and might be pinned, screwed or wired together.

    Early intervention/rehabilitation is helpful to reduce pain, increase range of motion, and ultimately restore strength and function. Wrist supports and custom splints are helpful to protect the area so optimal healing can occur.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Hand Active Range of Motion

    The movement of the hand, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Active Range of Motion

    The movement of the wrist, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or wrist joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Wrist Passive Range of Motion

    The movement of the wrist, by the patient or therapist, through a range of motion without the use of the muscles that “actively” move the joint(s).

    Wrist Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Improve Function
    • Improve Muscle Strength and Power
    • Increase Oxygen to Tissues
    • Self-care of Symptoms
    • Improve Range of Motion

    Resources

  • Scaphoid Fracture

    This is a common carpal wrist bone fracture. Often wrongly diagnosed as a wrist sprain, there is tenderness or pain where the base of the thumb meets the wrist, an area called the anatomical snuffbox. It usually occurs in the adolescent or young adult with a fall on the outstretched hand or with high velocity wrist injuries (like motorcycle accidents).

    Treatment for a scaphoid fracture can be difficult. If there is just a crack in the scaphoid bone, it requires a thumb splint for 6 weeks or until healed. If the bone is completely broken apart, it will require surgical fixation. Because of the unusual blood supply, the fracture may not heal completely (delayed union) or avascular necrosis (death of the bone because of loss of the blood supply) may result.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Electrotherapeutic Modalities

    Possible Treatments

    • Neuromuscular Electrical Stimulation
    • Transcutaneous Electrical Nerve Stimulation (TENS)
    • Iontophoresis
    Hand Active Range of Motion

    The movement of the hand, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Active Range of Motion

    The movement of the wrist, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or wrist joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Wrist Passive Range of Motion

    The movement of the wrist, by the patient or therapist, through a range of motion without the use of the muscles that “actively” move the joint(s).

    Wrist Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Improve Function
    • Improve Muscle Strength and Power
    • Self-care of Symptoms
    • Improve Range of Motion

    Resources

  • Fracture of the Hook of Hamate

    This is a fracture of a small region on the palm of the hand opposite the thumb. It typically occurs when the golf club impacts the ground. Signs and symptoms consist of point tenderness and pain in the palm of the hand. X-rays are used to rule this in/out.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Hand Active Range of Motion

    The movement of the hand, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Active Range of Motion

    The movement of the wrist, by the patient, through a range of motion against gravity. AROM is usually prescribed for arthritis, initial recovery of joint motion and/or gentle strengthening without trauma to joints.

    Wrist Joint Mobilization

    Hands-on therapeutic procedures intended to increase soft tissue or wrist joint mobility. Mobilization is usually prescribed to increase mobility, decrease joint stiffness, and to relieve pain. There are many types of mobilization techniques including Grimsby, Maitland, Kaltenborn, Isometric Mobilizations, etc.

    Wrist Passive Range of Motion

    The movement of the wrist, by the patient or therapist, through a range of motion without the use of the muscles that “actively” move the joint(s).

    Wrist Resistive Range of Motion

    Exercises that gradually increase in resistance (weights) and in repetitions. PRE is usually prescribed for reeducation of muscles and strengthening. Weights, rubber bands, and body weight can be used as resistance.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Improve Function
    • Improve Muscle Strength and Power
    • Self-care of Symptoms
    • Improve Range of Motion
    • Decrease Nerve Compression
    • Decrease Postoperative Complications
    • Improve Wound Healing

    Resources

  • Mallet (Baseball) Finger

    This fracture results from a trauma to tip of the finger forcing it into flexion (rapidly bending it down toward the palm) and avulsing the extensor tendon. This injury commonly occurs in baseball and basketball when attempting to catch a ball. Signs and symptoms include pain, swelling, and an inability to straighten out the last digit of the involved finger.

    Treatment includes splinting of the finger in the straight position for 6-8 weeks. In some cases, surgical pinning of the finger in a straight position along with splinting is necessary.

    Treatments

    Cryotherapy or Cold Therapy

    Cold therapy is used to cause vasoconstriction (the blood vessels constrict or decrease their diameter) to reduce the amount of fluid that leaks out of the capillaries into the tissue spaces (swelling) in response to injury of tissue. Ice or cold is used most frequently in acute injuries, but also an effective pain reliever for even the most chronic pain. Cold therapy may be administered by using a cold pack or an ice massage as seen in the above video.

    Isometric Exercise

    An isometric exercise is a muscle contraction without joint movement. Isometrics are usually prescribed for gentle nerve and muscle reeducation. They are typically used for strengthening with arthritis patients, post-surgical patients, or as an introductory muscle strengthening exercise. A usual progression is from isometrics to active and resistive exercises that involve joint movement.

    Physical Agents

    Possible Treatments

    • Cryotherapy or Cold Therapy
    • Heat Pack
    • Ultrasound

    Goals

    • Improve Function
    • Improve Muscle Strength and Power
    • Self-care of Symptoms

    Resources