1. Common Injuries of the Wrist and Hand

2. Wrist and Hand Anatomy The hand including the wrist consists of 27 bones 8 carpals make up the wrist 5 metacarpals form the structure of the hand 14 Phalanges are the bones of the fingers

3. Wrist and Hand Anatomy 8 muscles create movement at the wrist 3 Muscles move the hand 8 muscles move the thumb 9 muscles move the fingers

4. Did you know… Injury to the thumb ligament is one of the more common skiing injuries. It ranks second only to knee sprains.

5. Fractures of the Wrist and Hand Finger fractures- can involve any of the three phalanges (bones) in each finger (two in the thumb)  Most finger fractures can be treated with a finger splint, but if the fracture is severe may be necessary to use pins, wires or screws Boxers fracture – break in the 5 metacarpal leading to the little finger  Often the result of slamming a clenched first against a solid object

6. Fractures of the Wrist and Hand Baseball Finger- an injury to the finger resulting from tearing of the finger tendon and damage to the cartilage  Occurs when a ball or other object strikes the tip of the finger bending it beyond its normal range of motion Scaphoid fracture – a break in the scaphoid bone in the thumb  The most commonly fractured bone in athletics – often occurs from falling onto an outstretched hand

7. Tendonitis Inflammation of tendons caused by overuse or repetitive stress deQuervains Tenosynovitis- tendonitis originating at the base of the thumb

8. Tendonitis – Signs and Symptoms Ache or pain at the wrist Worsens with forceful gripping, rapid wrist movements or moving the wrist and fingers to an extreme position

9. Tendonitis – Treatment Rest Ice – Ice bath or Ice Massage Anti-Inflammatory medications

10. Carpal Tunnel Syndrome Carpal Tunnel is a passageway that runs from the forearm through the wrist, the median nerve runs through here Median nerve – supplies feeling to the thumb, index and ring fingers Carpal Tunnel Syndrome – an inflammatory disorder caused by irritation of the tissues and nerves around the median nerve

11. Carpal Tunnel Syndrome Women are three times more likely than men to get carpal tunnel syndrome Certain conditions can increase your risk:  Diabetes  Gout  Hypothyroidism  Rheumatoid arthritis  Pregnancy  Sprain or fracture of the wrist

12. Carpal Tunnel Syndrome – Signs and Symptoms Pain, numbness and tingling in the wrist, hand and fingers May experience sense of weakness and develop a tendency to drop things May have trouble fastening buttons

13. Carpal Tunnel Syndrome – Signs and Symptoms May feel that hands are swollen even though there are no visible signs of swelling May lose a sense of heat and cold Symptoms occur both when the hand is being used and when at rest

14. Carpal Tunnel Syndrome - Treatment Affected hand and wrist should be rested for at least 2 weeks Wear a wrist splint or brace to keep the wrist from bending Ice massage or ice bath Strengthening exercises

15. Carpal Tunnel Syndrome - Treatment If carpal tunnel syndrome is left untreated the muscles on the thumb side of the hand can atrophy (shrink and waste away)

16. Rheumatoid Arthritis A disorder that causes inflammation of the lining of the joints. The body is mistakenly attacked by its own immune system. It is a chronic disorder that can worsen over time and may never go away.

17. Rheumatoid Arthritis Affects about 1% of the US population Usually occurs between the ages of 30 and 60, but can also affect younger and older individuals. Occurs three times more often in women than men. Cigarette smoking and family history increase the likelihood of developing rheumatoid arthritis.

18. Rheumatoid Arthritis Signs and Symptoms Pain, warmth and swelling at the joint Joint pain usually occurs on both sides of the body at the same time. Joint stiffness that usually occurs in the morning or after periods of inactivity. Ongoing fatigue and low grade fever.

19. Rheumatoid Arthritis Signs and Symptoms Inflammation of the lining of the joints can destroy cartilage and bone which can cause deformity of the joints. As the condition progresses joints can develop considerable pain and loss of function.

20. Rheumatoid Arthritis X-Ray

21. Juvenile Rheumatoid Arthritis The most common type of arthritis in kids. Causes joint inflammation, stiffness and damage Can affect a child’s growth.

22. Rheumatoid Arthritis - Treatment There is no known cure for rheumatoid arthritis. Goal of treatment is to reduce inflammation and pain. Moist heat, paraffin bath, acupuncture and regular exercise (avoid high impact activities) have been shown to help with symptoms related to rheumatoid arthritis.

23. Wrist and Hand Strengthening Exercises Squeeze a stress ball  Firmly squeeze the ball 20 times rest for 30 – 45 seconds and repeat Wrist Stretch  Extend hand away from the body  Pull fingers towards the ground  Hold the stretch for 20-30 seconds

24. Wrist and Hand Strengthening Exercises Wrist Flexion  Hold a dumbbell and bring arm over the edge of a table with palm towards ceiling  Bring hand up towards ceiling and lower back down – repeat 15-20 times Wrist Extension  Hold a dumbbell and bring arm over the edge of a table with palm towards floor  Bring hand up towards ceiling and lower back down – repeat 15-20 times

25. Preventing Overuse Injuries Read the following article (click on hyperlink)  Write a 300 word summary of the article (can be written or typed  Create 3 questions for a class discussion (print a copy of the article if you want to refer to it during the class discussion) Preventing Overuse Injuries