Medically reviewed by Misty Seidenburg
Due to their intricate network of bones, joints, ligaments, and tendons, the hand and wrist are particularly vulnerable to injury. The physical demands of different athletic activities and fitness programs can damage these structures, causing pain and affecting performance. This article shares information about common injuries in the hand and wrist as well as strategies for preventing, managing, and rehabilitating sports-related hand injuries, helping you improve function and alleviate discomfort.
A study of college athletes revealed that one-quarter of acute and chronic sports injuries affect the hand or wrist.
Our hands and wrists are constantly used throughout the day on and off the court and field, increasing the risk of overuse injuries. Repeating the same motions, like passing a lacrosse ball or pitching a baseball every day for hours at a time without sufficient recovery, can overstress the structure of the hands and wrists.
Direct trauma to the hand, wrist, or arm is another frequent cause of these injuries, particularly in contact sports where players collide with equipment, the ground, and other players. For example, if we’re about to fall, we may instinctually extend our arms to cushion the impact, resulting in what is known as a fall on an outstretched hand, or FOOSH. This is a common mechanism of injury in sports and can lead to shoulder, elbow, forearm, wrist, and hand fractures.
Hand and wrist injuries can also occur due to systemic degenerative conditions like rheumatoid arthritis and osteoarthritis, which weaken joint structures, heightening the risk of pain and injury. Individuals with these conditions can and should stay active but should choose gentle, low-impact activities like yoga, Tai Chi, and water aerobics, which offer the benefits of exercise without the risk of high-impact sports.
Now that we have a better idea of how and why common sports hand and wrist injuries occur, let’s examine these conditions, their symptoms, and treatments more closely.
A hand or wrist strain occurs when a muscle or tendon—the tissue connecting muscle to bone—is injured. In contrast, a sprain affects the ligaments, which are the tissues connecting bones at the joints. Sprains and strains are common in sports with repetitive wrist movements over time, like basketball, tennis, golf, and baseball. They also occur from a single event, like a fall or player-to-player collision.
Sprain and strain symptoms can include:
Most hand and wrist strains and sprains respond well to conservative treatment, including rest, elevation, compression, and physical therapy.
Blunt force impact from falls and contact sports can result in one or multiple broken bones in the hand or wrist. If you experience direct trauma, look for signs of a possible fracture: pain, swelling, tenderness, depressed knuckle, a shortened finger, and problems with your grip.
Treatment and recovery for hand or wrist fractures depend on the location and severity of the break. Splinting or casting followed by physical therapy may be effective for simple breaks, while complex fractures often require surgery to realign and stabilize the bone(s.) Post-surgery physical therapy helps to restore full function and range of motion in the hand and wrist, offering a clear path to recovery and a return to play.
Tendinopathy refers to injuries and conditions affecting the thick cord-like tendons that attach muscle to bone throughout the body. Tendons can become painful or inflamed (tendinitis), and the collagen fibers within them can break apart (tendinosis), causing them to weaken.
Possible signs of tendon injuries include pain, stiffness, and tenderness in the wrist and hand that increase with certain hand movements.
Tendon hand and wrist injuries often occur from repeating specific movements for extended periods, like swinging a golf club, tennis racquet, or pickleball racquet. As we age, the body also produces less collagen, resulting in weaker, thinner tendons that are more vulnerable to damage and take longer to heal. Older adults who want to stay fit and play the sports they love can consult a physical therapist for tips on staying safe and avoiding injuries.
Splinting, elevation, and rest are generally the first line of treatment for tendinopathy. Once cleared for activity, physical therapy gently introduces exercise and stretching to regain range of motion, mobility, and strength in the fingers and wrist. Hand and wrist therapy may also include manual treatments to reduce pain and inflammation and promote tissue recovery.
Dislocations are joint injuries when the ends of two bones separate at the joint, typically from extreme force, like a direct blow or forceful overstretching of the joint. Most sports-related finger dislocations happen in basketball and football. While fingers and shoulders are most frequently affected in athletes, dislocations can also occur in the hips, knees, and elbows.
A dislocated finger may appear mishappen or crooked. Other symptoms include bruising, swelling, numbness, and tingling. Movement can be difficult or impossible.
Immediate medical attention is crucial for a dislocation. Healing can be delayed without prompt care, and the injury may permanently affect function. While simple dislocations can often be quickly realigned to restore function, mild soreness in the joint may persist in the months following injury.
Nerve compression is pressure on any of the peripheral nerves that run throughout the body, carrying messages to and from the brain and spinal cord. It is a leading cause of nerve damage and limb pain.
Carpal tunnel syndrome is the most common type of nerve compression. It affects the median nerve, a motor and sensory nerve that provides sensation and controls movement in the hand and fingers. Repeated use of the hands and wrists for activities that require prolonged gripping or grasping can cause nerve compression within the carpal tunnel passageway surrounding it.
Carpal tunnel syndrome is most common in sports like:
After taking a break from these activities, therapeutic exercise and stretching with physical therapy can help improve strength and flexibility and alleviate wrist pain and pressure.
In addition to targeted movement therapy, physical therapists offer manual therapies to relieve painful tissues and ergonomic tips to protect the hands and wrists during training and games. If nonsurgical treatments do not provide relief, surgery may be recommended, so it’s important to monitor your condition and seek treatment if it does not improve.
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Now, let’s focus on the proactive measures you can take to prevent these painful conditions from affecting your hands and wrists.
Take frequent breaks. Whatever your sport of choice, periodic breaks are essential if you use your hands and wrists. Aim for 5-10 minute breaks every 30-60 minutes if possible. Also, switch up your training to ensure you are not overstressing any single area of the body.
Stretch and strengthen often.Hand and wrist stretches are incredibly beneficial before and after participating in sports (and hobbies and jobs) that involve repetitive hand and wrist movements. You can also exercise the forearm muscles, which control wrist movement. Not only do these movements improve mobility and function—but they also feel amazing!
Harness the power of physical therapy. Physical therapy offers a comprehensive approach to preventing, managing, and treating hand and wrist pain without surgery. By incorporating everything from stretching and exercises to hands-on therapies and education, physical therapists address all of the factors that cause discomfort and dysfunction.
They are licensed experts who provide sport-specific guidance on form and mechanics to help athletes of all ages and abilities move more efficiently. After an injury, Your physical therapist creates a personalized rehabilitation plan to build hand and wrist strength so you can safely return to the game you love.
One final word of advice: always pay attention to your body when it comes to hand and wrist injuries. Persistent pain or difficulty with wrist movements can quickly escalate. If something doesn’t feel right, find a physical therapy clinic near you to schedule a sports injury evaluation today.
