Wristy Business…Is wrist pain interfering with your yoga practice or Pilates workout or Life?
Wrist Pain: Our hands, by design, were not intended for weight bearing, so it’s no wonder that many of us experience pain or discomfort when assuming those Pilates or yoga positions that require us to do just that -bear body weight on our hands. Discomfort may simply be a result of mild limitations in wrist range of motion, improper alignment of shoulders, arms and hands or reduced core and arm strength. Gentle and gradual stretching and strengthening exercises, along with proper body alignment and weight distribution may reduce your wrist discomfort in weight bearing positions. However, for some of us, even with good strength and proper form wrist pain persists. A close look at the anatomy of the hand reveals why.
Hand Anatomy: The hand is designed more for mobility than stability. It is composed of 27 small bones, muscles and ligaments that allow for a large amount of movement and dexterity, enabling us to perform a multitude of daily activities requiring fine precision and coordination. The two bones of the lower arm, the radius and ulna, meet at the carpal bones of the hand to form the wrist. Unlike the foot the hand does not have a large bone cushioned with a fat pad for bearing weight, but has small bones surrounded by soft tissue, including the nerve and blood supply. The median nerve crosses the wrist through the carpal tunnel. These soft tissues of the wrist, including the ligaments and tendons, are subject to strain when we are weight bearing on a fully extended wrist such as in a push-up position.
The Culprits: As a simplification, the common causes of wrist pain are grouped into 4 categories:
Overuse: too much repetitive movement or joint impact
Injury: wrist fractures, strains & sprains
Lack of conditioning: weak muscles, poor range of motion, improper form
Aging or Disease: arthritic changes in the joints, inflammation, diabetes etc.
Which category does your wrist pain originate from?
Overuse: One common cause of wrist pain is Overuse, clinically known as RSI – Repetitive Stress (or Strain) Injury. Long periods performing the same movements, such as typing on a computer, playing a musical instrument or doing sun salutations, can lead to RSI. Carpal Tunnel Syndrome (CTS) a leading cause of wrist pain is grouped in the RSI category.
What do you do about RSI?
An important first step in treating an overuse injury is to rest – stop doing what is causing you pain to allow healing time. The reality, however, is that many of our repetitive movements are related to our livelihood such as data input, graphic design, dental hygiene, massage therapist or fitness instructor, so to stop completely might result in a few bounced checks. If complete rest isn’t an option, two ways to decrease repetitive joint stress are through task and schedule modification.
Suggestion One: Modify Your Activity
Once you’ve identified the specific task(s) that’s aggravating your wrists (or other joints) look at how frequently or for what duration you’re performing this task.
Modify your Schedule: The objective of modifying your schedule is to reduce how often and how long you spend doing the pain inducing task. Urgent deadlines, productivity ratings or financial stress are real factors that contribute to overuse injuries. Many smart industries have implemented job rotation and other programs to reduce RSI in the workplace, thus saving money on workman’s compensation claims and lost productivity. Practical examples for modifying your schedule may include:
1) Part Time Work: a schedule of Monday, Wednesday and Friday will allow a day of rest in between.
2) Plan Ahead: instead of spending 6 hours banging out a report on the computer spread it out over 4 days for 1 ½ hour each day.
3) Set Time Limits: Break up the problem task into shorter time segments with rest and stretch breaks built into your day.
4) Job Sharing / Rotation: Can you recruit a co-worker to assist you or swap tasks with? Look at all options for creative scheduling.
Modify the Task: The objective here is to use an alternate method to accomplish the task, which may require a different set of muscles or reduce muscle tension and joint stress.
1) Change the Method: If you’re a fitness instructor with a wrist injury, give verbal directions instead of demonstrations. If you spend your day on the computer consciously reduce keyboard time by limiting your email correspondence – pick up the phone and make a quick call instead.
2) Change or Modify the Tool: Examples include using a track ball instead of a mouse, substitute an electric tool for a hand tool and increasing the diameter of the tool to open the grasp of the fingers and thumb.
3) Modify your Body Position: Use an ergonomic keyboard, set up your ‘work station’ optimally for your body and alternate standing with sitting.
4) Use your non-dominant hand: If your wrist pain is primarily in your dominant hand try to develop the skill to accomplish the task with your non-dominant hand. Start with something simple like stirring while cooking or dialing the phone then work towards using your computer mouse with your opposing hand. This may be challenging but is very useful and good for your coordination.
Suggestion Two: Incorporate frequent stretch breaks into your day.
Whether it’s an occupation or leisure pursuit that’s resulting in RSI, do strengthening and stretches that move your body, limbs and joints in the opposite direction of the repetitive motions you’re engaged in. Computer use is a big culprit of wrist pain, since many people now spend hours of their day at a keyboard and monitor. The typical computer posture takes its toll on your back, neck, arms and hands -possibly resulting in Carpal Tunnel Syndrome. Break up long hours at the computer by scheduling intermittent breaks to stand up, move around and stretch. Do these simple stretches several times a day in standing or from the comfort of your chair.
Hold each stretch for 3 to 5 deep breaths:
1) Stretch shoulder and arms: Reach back from the shoulder rotating the spine, straighten your elbow and rotate your palm up, extend the wrist slightly or keep neutral then straighten and spread the fingers apart. Deepen the stretch by rotating the neck so your face is turned away from your stretched arm. Repeat with the other arm.
2) Rotate both wrists several times clockwise then counter clockwise.
3) Stretch finger flexors: Extend fingers and place them together in a prayer position. Press fingers firmly together and spread them apart keeping fingers straight. To increase the stretch, gently pull the wrists apart 1 or 2 inches while keeping fingers together.
4) Stretch wrist in extension: Continue in prayer position with fingers and wrists pressed together. Start with your finger tips at your chin, and then slowly slide hands down towards your waist keeping the wrists pressed together. Go as far as you can comfortably & hold stretch for several breaths. If you feel discomfort in your thumbs simply cross them on top each other instead of pressing together.
5) Stretch wrist in flexion: Flip your hands over so the backs of your hands and fingers are touching and pointing down. Start with your hands at your waist and move slowly up to chest height keeping the backs of the hands pressed together. Fingers dangle loosely while the top of the wrist joints are stretched.
6) Gently shake shoulders, arms, wrists and fingers.
This series of stretches, each held for 5 deep breaths, only take a total of 3 minutes to do! A simple and healthy way to incorporate this routine into your day is to drink lots of water. Every time you get up for a bathroom break, do your stretches before resuming work.
Is wrist pain interfering with your fitness pursuits, work or life? If so, what’s the culprit? Too much keyboarding, weight bearing on your hands or other repetitive activity may be an underlying cause of your wrist pain. If you have an overuse injury – first try to rest! Next modify the activity through creative scheduling and use of alternative methods, tools or props. It’s also important to develop a stretching & strengthening program to counteract the negative effects of repetitive movements on muscles and joints. Our bodies were designed to move in a multitude of directions, so mix it up and bring some balance and variety into your weekly routine. You know what they say…Variety is the Spice of Life!
Disclaimer: If you have significant wrist pain resulting from a more serious issue such as joint inflammation, arthritis, carpel tunnel syndrome, previous fractures or surgeries of the wrist, it is essential that you consult your health care practitioner prior to beginning a wrist exercise program, Pilates or yoga practice.