It is very common to see an injury during sports activities. Wrist and hand injuries can range from ligament sprains, muscle strains, and tendons to fractures and dislocations. There are numerous mechanisms for injuries but the most common is the “fall on the outstretched hand” (FOOSH) injury. It may be worse if the athlete is holding some sort of object such as a stick or ski pole. It is important to mention that this injury is very popular amongst the geriatric age group. Seniors will fall with their hands outstretched, but the bone density levels are lessened with age, thus resulting in sprains and fractures.

Overuse injuries are common in people performing repetitive movements such as gripping a tool (tennis racket), using the hand/wrist to perform an act (cashiering, volleyball) or to support ones body weight (gymnastics).

The wrist is made up of two forearm bones, the ulna and radius. The hand has 8 carpal bones, 5 metacarpals and 14 phalanges. The soft tissue comprises ligaments, tendons and muscles of the forearm, wrist and hand.

Common wrist and hand injuries and conditions that we treat include:

Arthritis – Arthritis refers to the variety of conditions that cause inflammation and the degeneration of the cartilage and lining of the body’s joints. It can occur at any joint, but is especially prevalent in the feet and ankles. Rheumatoid arthritis can occur at any age, causing severe deformities of joints, which restricts motion and causes pain. Osteoarthritis can be a result of a previous injury to the joint, or can result from normal “wear and tear”.

Wrist Sprain – This is the most common wrist injury. It can be a result of any abnormally forced movement of the wrist. Typically, a fall on a hyper extended wrist is the most common cause of a sprain, but violent flexion or torsion can also tear the supporting and soft tissue. Treatment should begin with ice and compression along with minimal stretching and strengthening. This will promote healing by reducing stiffness and atrophy.

Skiers’s Thumb – With ‘Skier’s Thumb’ the ulnar collageral ligament in the thumb is injured. It usually occurs while the person falls and the thumb is trapped by the ski pole, or hockey stick, thus forcing the thumb into hyper extension. There is the possibility that this mechanism can tear the ulnar ligament, or even fracture a small piece of bone, from the thumb joint. This is known as a Bennetts’s Fracture, which is more serious than Skier’s Thumb, but happens from the same mechanism of injury.

Schaphoid Fracture - The schapoid is a carpal bone at the base of the thumb between the radius and trapezium bone. This fracture requires special attention, as they are frequently missed and have a non-union healing tendency. Typical patient is a young adult, who has fallen on the outstretched hand (FOOSH). Sometimes it is initially dismissed as a sprain or strain. Sharp pain, tenderness, and swelling are usual signs and symptoms.