Weightbearing Pains with Wrist in Extension: – Self Treatment

If get pains in wrist in extension – especially with pressure – then a strap self-mobilization technique could help.

Man Ther. 2013 Dec;18(6):568-72.
Short-term effects of self-mobilization with a strap on pain and range of motion of the wrist joint in patients with dorsal wrist pain when weight bearing through
the hand: A case series.
Choung SD, Kwon OY, Park KN, Kim SH, Cynn HS.
http://www.ncbi.nlm.nih.gov/pubmed/23830868

• Dorsal wrist pain with weight bearing through the hand
• Causes include:
  distal radius stress injuries,
  scaphoid impaction syndrome
  dorsal impingement

Technique:

• Squat by a table that you put wrist on so can straighten up as you extend wrist later
• Put hand on a table with wrist in neutral position, shoulder at 90 degrees  flexion and elbow in extension
• Put strap “on the dorsal surface of the proximal carpal bones, just below the distal end of the radius”
• Pull strap down with other arm but not enough to hurt
• Gardually bent wrist up until it starts to become uncomfortable
• distract wrist at this point by pulling arm upward and maintain for 10 seconds
• do ten trails with 20 second rest in between

• Took 15 cases of dorsal wrist impingement on extension, worse with weightbearing
• strap was a commercial shoelace (1 cm wide and 125 cm long)
• did 5 sessions over 1 week

Results:  pain dropped from 6.5/10  to 2.8/10 on extension:

Comment – Would have been nice if they specified the impingement. Does sound like too far gone for a simple manipulation ( hold wrist and elbow with separate arms and jerk wrist into distraction).  Does not deal with instability issues that could be a factor. Nonetheless, is simple enough for patients to do at home and seems safe.