Better Rehabilitation, Faster Recovery

Wrist Rehabilitation 101

September 23rd 2019 in Physical Therapy

Your wrist connects your hand to your forearm. It is not composed of one large joint; instead it has several small joints. This makes it flexible and allows you to move your hand in different ways. The wrist has two large bones in the forearm and eight small bones known as carpals. It also has tendons and ligaments, which are connective tissues.


Tendons connect muscles to bones.


Ligaments connect bones to each other.


There are many types of wrist injuries and many different forms of wrist injury rehabilitation. Some wrist injuries, such as RSI (carpal tunnel syndrome and tendonitis), will heal themselves over time; others require that you wear a cast or splint on your wrist for a couple of weeks (breaks, fractures, sprains) before beginning any kind of therapy.

If you find daily tasks difficult to do because you suffer from stiffness, swelling, or pain in your hands, the right exercises can help get you back in motion. Many people have jobs that require them to work on a computer all day long or repeat the same motion, for forty hours each week. This much repetition and overuse can cause wrist issues.

Common wrist injuries and conditions:

  • Wrist breaks and fractures (broken bone)
  • Wrist strains and sprains (injuries to ligaments, muscles or tendons)
  • Wrist tendonitis (inflammation of a tendon, usually due to overuse
  • Other (such as cysts or Depuytren’s disease)

Therapists usually suggest specific exercises depending on the condition. Some will help increase a joint's range of motion or lengthen the muscle and tendons via stretching. Other exercises strengthen muscles around a joint to generate more power or to build greater endurance. These are helpful for inflammation of the tendons (tendinitis) and non-painful arthritis conditions.

No matter what kind of wrist injury you have, all injuries will benefit from wrist strengthening exercises at some point during your recovery.

However, you should only ever begin wrist physical therapy after your injury has fully healed and you no longer experience intense pain when moving the wrist joint. Once the injury is full healed, you can start regaining strength and movement in your wrist as part of your wrist physical therapy.

At first, your muscles, tendons and bones will likely be very weak. That is why is it important to start slowly and gradually build the intensity of your wrist physical therapy as you progress through your recovery.

The MIO solution consists of weekly wrist range of motion (ROM) assessments which establish weekly goals and a baseline for your ROM. The first two weeks will consist of stretching exercises, followed by two weeks of strengthening exercises.

Weekly Assessment - Range of motion exercises:


Range of motion exercises require simple movements of the wrist and are a good place to start when you begin wrist physical therapy. These types of exercises slowly take the wrist through its normal range of motion and should be done gently and carefully to avoid further injury:

  • Wrist flexion
  • Wrist extension
  • Wrist ulnar deviation
  • Wrist radial deviation

Two weeks – Stretching exercises:

Wrist stretching exercises are a step further in wrist physical therapy. As the name suggests, these types of exercises stretch out the muscles and tendons in the wrist and forearm, increasing circulation and overall flexibility. Below are four examples of simple, yet effective stretching exercises for wrist physical therapy:

  • Weighted wrist flexion
  • Weighted wrist extension
  • Grip strengthening

Two weeks - Strengthening exercises:

Once you can do all of the stretching exercises without feeling any pain, you can move on to strengthening exercises. Strengthening exercises are the final stage of your wrist physical therapy and will effectively strengthen the wrist joint for a longer-lasting, more effective recovery.

Stronger, healthier wrists are more flexible and resilient, and are less likely to incur injury in the future. Practicing regular strengthening exercises maintains muscle and joint health and so, it is recommended that you continue to practice the below exercises even after you have fully regained strength in your wrist:

  • Wrist stretch palm inwards and down
  • Wrist stretch palm inwards and up
  • Wrist stretch palm outwards
  • Palm press thumbs in
  • Palm press thumbs out

Always take care to never overexert yourself. If it hurts, take a break! It is advised that you seek medical attention if you experience severe pain or numbness after or during these exercises.

If your hand condition is painful or debilitating, it's best to get exercise advice from a physical therapist. All exercises should be done slowly and deliberately, to avoid pain and injury. If you feel numbness or pain during or after exercising, stop and contact your doctor.

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