The Wrist

The wrist is a jigsaw of bones making up the joints. Eight small bones bridge the gap between the end of the radius, one of the long forearm bones, and the metacarpals in the hand. Together, the 'jigsaw' bones are known as the carpus. These joints allow a lot of movement so that, for example, we can fold our hands around objects to grip and do delicate finger movements.

Each bone is tied to the next with strong ligaments and tiny muscles. They are bound together with 'fascia' (a kind of natural taping system) which gives the shape and lines on the palms.


*Ligaments of the wrist, seen with the palm uppermost.*	*Tendons of the wrist, seen with the back of the hand uppermost.*

Sometimes the joints can be affected by conditions like arthritis and damage to the tiny bones can occur with a fall onto the hand.

We can treat common wrist or hand problems with mobilisation and strengthening techniques following strains or injury in sport or at work. If you fracture a bone and need a plaster we can show you rehabilitation exercises after the cast is removed to get things going again.

Carpal Tunnel

The carpal tunnel is a band of 'fascia' (tape!) which binds down the tendons on the front of the wrist, as can be seen in the right-hand picture above. One nerve, the median nerve, goes under the carpal tunnel into the hand and when the tunnel becomes inflamed for any reason, it can cause compression on the nerve. This creates tingling into the middle and index fingers and the feeling of weakness in the hand. This is known as 'carpal tunnel syndrome' and is curable! Inflammation can occur during pregnancy, but it usually settles naturally. It can occur with rheumatoid arthritis or simply as a result of over-use of the tendons of the forearm. The best treatment can be a hydrocortisone injection given by your GP or a specialist, but physiotherapy can also be helpful in identifying the problem and resolving neck problems which are often present and need treatment too.

Tendinitis

Tendinitis can occur when repeated stress is put on a tendon or muscle. This leads to inflammation of the tendons, which are encased in tiny tubes. An area of swelling can be created between the tendon and its lining and a feeling of 'grating' can sometimes be felt here. As tendons exist through the whole body connecting muscle to bones, tendinitis can occur at any joint where movement occurs.

Physiotherapy can help this by addressing the activities causing the stress and looking at adapting more helpful postures or positions of joints. We can also treat the problem with various anti-inflammatory techniques like ultrasound, acupuncture, and passive mobilisation techniques.

The Wrist

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