Today we’re talking about hand and wrist cooperation and wrist pain.

So I’d like to go through with you a fairly complicated regime today because one of the questions that I constantly get is, “Doc, I get wrist pain every time my wrist is in extension,” this is called extension, “Doing push-ups, doing stuff in the gym. I go in this position and it hurts.”

Now, I said in the beginning that we’re talking about wrist and hand cooperation.

So the easiest way for us to understand this is to think about basic anatomy.

If you’ve never looked at the anatomy of this area of the body it’s relatively complicated, but we’re going to simplify it this way. If you start in your forearm, slide your fingers down on both sides you’re going to come to a point basically on the thumb side and the little finger side. Those points represent the end of the long bones, the radius and the ulna.

Now if you then go just past those points, and wrap your index finger and thumb in that area and go, move your wrist back and forth you can probably going to feel a lot of cracking and popping because you have a number of what are called carpals in here. Carpals are the small bones of the wrist.

Sometimes what happens when people are having issues with wrist extension is the rhythm between the radius and ulna and the carpals gets disturbed probably because of a prior injury, a fall.

So what I’m going to do is show you a quick way to test your own wrist against your forearm, or hand against your forearm to see if there is a specific type of tractional movement that you can perform that decreases your pain. All right?

That’s why I’m kneeling, I have not fallen.

So what we’re going to do is we’re going to find a chair. This is a bench obviously.

What I’m going to ask you to do to begin with is get in this position, palm facing down, spread your fingers, lock your elbow, and then you’re going to roll your body forward until you come to the end of your wrist extension. All right? So this is going to be your test position.

Now, if I go fully into this, because my wrist is in pretty good shape, I have a lot of extension available, so I’m going to be working right about here. You can work at this level, you can work at this level, I don’t care what your level of restriction is because what we’re going to do now is we’re going to start creating some leverages.

So, what I need you to do for our first one is I need you to find on the thumb side, find the point of the long bone and then you’re going to take the web of your hand and you need to go just below that toward the thumb.

Now in this position you’re going to lock your elbow and you want to push into this row of bones. You’re going to try and actually move that row of bones toward your little finger.

All right? So I’m going to come in here, I’m going to push toward my little finger while keeping my wrist in place. As I’m pushing I’m going to roll forward and I’m going to see if that decreases my discomfort or increases my range of motion. All right?

So, that’s step one.

Step two is to pull.  We’ve pushed, now we’re going to pull.

So we’re going to go into the same area on that little finger side. So I’m going to grab it with my index finger and thumb and I’m now going to be pulling this way toward the thumb in that row of carpals. So pull it. You’re going to hold and continue to pull as you move forward, once again seeing what your range of motion feels like and what the level of discomfort feels like.

So for me, pushing toward my little finger increased wrist discomfort. Pulling toward my thumb decreased it. So for me, already I know what direction do I need to move these bones in order to have my hand and wrist cooperate more.

Now we have a couple of other options. This time instead of focusing on this row of bones we want to come up to the two long bones and we’re going to imagine that these long bones can be either wrapped this way so we can essence grab our wrist and try to pull these bones back. So we’re going to wrap them toward themselves, pulling back as I come forward into that extension position. That also feels pretty good.

My other option would be to push them forward. So now I’m going to have to use my thumb, little finger, push them forward however you can manage the leverage. Push as you come forward. For me that’s terrible, but occasionally you’ll run into people who actually need that.

So again, what you’re trying to figure out is does one direction of movement do best for you? Does two directions of movement do best for you?

In my particular case what I found was pulling toward my thumb and actually wrapping these bones this way gave me the most benefit.

So now I’m going to try to combine those. So I’m going to pull the bones toward my thumb, at the same time try to create some wrapping traction around my wrist, do all of that as I come forward and for me that feels fantastic.

I know it’s a little bit complicated. You’re going to have to play around with your hand placements. Sometimes you can do this with a band or some kind of a belt, attaching it to things out to the side to just help you create the pressure. But again, the goal is using the pressure, move into your range of motion, do it very slowly, very carefully. Use about 10% of the force that you think you need in the beginning because this is a very delicate area. You don’t want to do anything that would hurt yourself.

So if you’ve got issues in your wrist that you haven’t had evaluated by a healthcare professional, do that first before you start playing with these particular mobilizations. But very often what we’ll find is if you can identify one or two directions that improve you, a few reps of that every couple of hours through the course of a few days and all of a sudden you’ll be doing push-ups without pain.

Give this a shot.

If you have questions about it let us know, and please, please, please go carefully.

Thanks.