Sprained Wrist

Sprained Wrist

A sprained wrist is characterised by damage to the soft tissue (tendons, ligaments, muscles etc.), rather than the bone. It’s usually associated with a trauma to the wrist, such as an awkward fall or sudden twisting motion, rather than with overuse injuries.

Typically we classify a wrist sprain into three categories, depending on the severity of the injury:

Grade 1

This is a mild sprain where there hasn’t been significant damage to the ligaments of the wrist, but they will have been stretched to near their limits. The wrist will likely be sore for a couple of weeks but there is lots you can do at home to help (see the “How can I treat a mild wrist sprain?” section below).

Grade 2

This type of sprain may include some structural damage to the ligaments, but no true instability. The job of the ligament is to hold the joints together and, in a grade 2 sprain, they are likely to still be able to do that job. However there will be more pain and restriction than in a grade 1 injury. Symptoms will typically last around six weeks and some form of splinting may be required. After the pain has settled some joint stiffness is common.

Grade 3

This is where structural damage to the ligaments has occurred. There may be some instability in the joint as that structural support has gone. A ligament injury in the hand can be serious so you may require the input of a hand and wrist consultant surgeon.

An initial physiotherapy assessment usually lasts for up to 60 minutes. The first part will be a subjective assessment, where you’ll discuss how you got the injury, if you’ve had anything similar before and if there are any patterns to the pain. This will inform the physiotherapist more about which structures have been affected.

Next will be an objective assessment, where your physiotherapist will perform various checks and tests to gain a more complete picture of which structures have been injured and to what extent. Should your physiotherapist have any concerns at this point, that you have sustained a more serious structural injury, you will be advised on seeking further medical assessment.

An example of an objective assessment is “resisted testing”, where the muscle is tested without letting the joint move. If you get pain without the joint moving, it could indicate the issue is with the muscle. Whereas if your wrist joint is moved by the physiotherapist, without your muscles joining in, and you get pain, it could mean the issue is around the joint.

If you’re experiencing mild discomfort from a suspected wrist sprain, then there are several things you can do to help. The “PRICE” method is a great place to start in the 48 hours following a mild injury:

Protect
Rest
Ice
Compress
Elevate

If you feel like your symptoms aren’t improving or if think they’re more severe, you should seek the help of your local GP, physiotherapist or hand and wrist consultant.

Your physiotherapy assessment includes a full background to the injury, which your physiotherapist will use to eliminate other causes of your symptoms. Conditions such as carpal tunnel syndrome and other nerve related injuries will have very specific symptoms, like pins and needles for instance.

The first step is to try and decrease the main symptoms, including pain, swelling and bruising. Initially an ice pack is recommended to reduce the swelling.

Your physiotherapist will also give advice on how to manage your wrist to make sure you don’t injure it further over the coming days.

Once the initial phase is over, we will recommend gentle exercises to keep your wrist moving. At this stage a heat pack can be beneficial as it can help to relax tight muscles and allow stiff joints to stretch further. Heat is not used in the initial period as it can encourage swelling.

Following on from gentle exercises, your treatment plan will then tailored according to what difficulties you are still experiencing. This could include hands on joint mobilisations, weight bearing stretches and strengthening exercises using resistance bands.

The aim is to get back to a full range of movement, but these exercises should only be carried out when recommended by your physiotherapist if you have a grade 2 or 3 injury. For a grade 1 injury you should not be carrying out exercises or activities which cause pain, although slight discomfort is not unusual.

The recovery time will depend on the extent of your injury and your suggested treatment plan. However, estimated recovery times for each grade of injury are shown below:

  • Grade 1 – approximately two weeks
  • Grade 2 – around six weeks
  • Grade 3 – can take three months.

You may then be referred to a hand and wrist specialist, who may recommend other treatments such as targeted injections or surgery.

If you would like to book an assessment with an expert physiotherapist at Circle Rehabilitation, please call 0118 922 6980 or complete the booking form. A member of the team will then get in touch as soon as possible.

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