Thursday, February 7, 2019

Wrist pain: how it happens, how to assess it and how to fix it. -Dr. Scott Glidden

Wrist pain: how it happens, how to assess it and how to fix it.
By Dr. Scott Glidden, DC

Wrist pain is incredibly common these days.  Texting, computer use, or even just grabbing stuff too much can lead to wrist pain or even hand numbness. The problem is generally not “IN” the wrist but in the forearm muscles that cross the joint—specifically those that flex the fingers.  These muscles all start near the medial (inner) part of your elbow and go into your hand and control wrist and finger flexion. If you want to “feel” them, all you have to do is put your other hand on your forearm and move your fingers around. If you go poking around and they feel firm or tender, that’s a really strong sign that they are overused.

How bad is it?
The fun thing about wrist health is that you can fairly easily get an estimate of how healthy your wrist is by yourself and with a friend you can figure out EXACTLY how dysfunctional those muscles are. All you need is a phone with a level app (like the iHandy level app) and a buddy to hold the phone while you do the assessment.

31.9 degrees from vert=59.1 to parallel
What is full function?
Full function of these muscles means that you will be able to extend your fingers 60 degrees (AND with no tension) below parallel to the floor, and scoring is a straight scale from there.  A score of 30 degrees would be 50% function. What is important here is the NUMBER primarily and the FEELING secondarily.

What should I do?
If your score is 80% or better, some stretching or foam rolling/mobilizing the forearm muscles with a lacrosse ball would be a good place to start.  If your score is less than 80% or mobilizing/stretching doesn’t seem to work, a doctor who has expert knowledge in assessing these problems.  The most likely reason you are experiencing restriction is adhesion (or scar tissue).  When these muscles are overused adhesion develops and acts like glue, limiting the range of motion and strength of whatever it is stuck to.  More overuse leads to more adhesion, which leads to more symptoms. Rest, ice, stretching, strengthening, dryneedling, cupping or voodoo will not get rid of adhesion; expert treatment does.

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