# Wrist sprains and fractures A wrist sprain is a stretched or torn ligament, and a wrist fracture is a broken bone, most often from a fall onto an outstretched hand, on a snowboard or a bike. After the medical care a break needs, or from the first visit for a sprain, we settle pain and swelling, restore movement, and rebuild grip and weight-bearing. Splints are moulded to your hand in clinic. ## Symptoms - Pain and swelling in the wrist after a fall onto the hand - Bruising around the wrist or the base of the thumb - Pain when you press on the wrist bone below the thumb - Trouble pushing up from a chair or the floor - A weak grip, or pain holding a pole, handlebar or tool - Pain when you turn your palm up or down - Stiffness after a cast or splint comes off ## Assessment We start with the fall: a snowboard edge that caught, going over the bars in the bike park, or a slip on ice in the village. We ask where it hurts and how fast it swelled. Then we examine the wrist: swelling, bruising, where it is tender along each bone and ligament, and how far it bends, straightens and turns. We test your grip, whether you can take weight through the hand, and the feeling in your fingers. The small wrist bone near the thumb (the scaphoid) gets its own check. A break there is easy to mistake for a sprain, and one that is missed can heal poorly. If our findings point to a break, we ask you to see a doctor or nurse practitioner for an X-ray. ## Treatment - **A sprain:** for the first few days we protect the wrist, settle pain and swelling, and keep the fingers, elbow and shoulder moving. Then the exercises build: movement, then strength, then grip and taking weight through the hand. - **After a cast or surgery:** we follow the plan from your doctor, nurse practitioner or surgeon. The first jobs are the swelling, the joint movement and the muscles that switched off while it was held still. Hands-on treatment (joint and soft-tissue mobilization) eases stiff joints, but the exercises matter most. - **Splints:** we mould splints in clinic from a plastic that goes soft when heated and sets firm as it cools (thermoplastic), shaped to your own wrist. They suit wrist and scaphoid injuries and protect a repair after surgery. See [splints and bracing](https://backinactionphysiotherapy.com/services/splints-and-bracing). - **Hand therapy:** a break or a repair that needs close rehab can be seen by a Certified Hand Therapist, certified by the Hand Therapy Certification Commission. It has roots in both physiotherapy and occupational therapy. See [hand therapy](https://backinactionphysiotherapy.com/services/hand-therapy). ## Getting back to sport Testing decides your return to work, study and sport, not the calendar. The wrist is ready when it has healed, moves fully and passes our tests: grip strength against the other side, and body weight through the hand without pain. After a break or surgery, the doctor, nurse practitioner or surgeon treating it also has to agree. Before that, we train what your sport asks of the wrist. On a snowboard, it is pushing up off the snow, over and over. In the bike park, it is holding on through rough trail and landing drops. For work, it is lifting, carrying and tool use. If you snowboard, wrist guards lower the chance of some wrist injuries. Wear them from the day you go back. ## When to come in Book an assessment if wrist pain, swelling or weakness has not settled after a fall, or if gripping a pole, handlebar or tool hurts. Come in once a cast or splint is off, or as soon as your surgeon clears you for therapy. If you fell at work, WorkSafeBC pays for physiotherapy once it accepts your claim and approves the treatment. See a doctor or nurse practitioner first if a break is possible and you have not had an X-ray. Signs are pain pressing on the wrist bone below the thumb, fast swelling, and not being able to push up on the hand. Go to the emergency department right away, or call 911, if any of these happen: - the wrist, hand or a finger looks out of shape - your fingers are numb, cold or pale - a deep cut to the wrist or hand - worsening pain, numbness or tightness under a cast or splint ## Who treats it - [Therese Leigh, Physiotherapist, BSc Physiotherapy, MHA, Dip Sport Physio, FCAMPT, GunnIMS](https://backinactionphysiotherapy.com/team/therese-leigh) - [Mike Conway, Physiotherapist, M. PT Sports, M. PT Manips, M. PT Studies, BSc Kin, CHT, GunnIMS, FCAMPT, CSCS](https://backinactionphysiotherapy.com/team/mike-conway) - [Bianca Matheson, Physiotherapist, BSc PT, Grad Dip PT Manips, Dip Sports Physio, FCAMPT, GunnIMS](https://backinactionphysiotherapy.com/team/bianca-matheson) - [Jian Soares, Physiotherapist, M ClinPhys, BSc PT, FCAMPT](https://backinactionphysiotherapy.com/team/jian-soares) - [Dana Elliott, Physiotherapist, MScPT, BSc](https://backinactionphysiotherapy.com/team/dana-elliot) - [Julie Charette, Physiotherapist, BSc PT, Cert. MDT](https://backinactionphysiotherapy.com/team/julie-charette) - [Emilie Noble, Physiotherapist, MSc PT, BSc Kines, AN-IMS](https://backinactionphysiotherapy.com/team/emilie-noble) - [Cameron Gant, Physiotherapist, BSc Physiotherapy, PG Cert Sports Physio](https://backinactionphysiotherapy.com/team/cameron-gant) - [Nicole Klopfer, Physiotherapist, B Physiotherapy (Hons) (UMelb), M Physiotherapy (Manips) (UWA), PGrad Cert Cont & PF Rehab (UMelb), GunnIMS](https://backinactionphysiotherapy.com/team/nicole-klopfer) - [Michael Pearce, Physiotherapist, BSc PT](https://backinactionphysiotherapy.com/team/michael-pearce) - [Kelsey Rey, Physiotherapist, MPT, BHK](https://backinactionphysiotherapy.com/team/kelsey-rey) - [Keeley Wentzel, Physiotherapist, BSc Physiotherapy (Hons)](https://backinactionphysiotherapy.com/team/keeley-wentzel) ## Services - [Physiotherapy](https://backinactionphysiotherapy.com/services/physiotherapy) - [Hand Therapy](https://backinactionphysiotherapy.com/services/hand-therapy) - [Splints and Bracing](https://backinactionphysiotherapy.com/services/splints-and-bracing) ## Frequently asked questions ### Is my wrist sprained or broken? Hard to tell. A break can feel like a bad sprain, and the two can look the same from the outside. An X-ray usually settles it, but the small bone near the thumb (the scaphoid) does not always show on the first one. If there is doubt, a doctor or nurse practitioner may protect the wrist like a break until a repeat X-ray or scan rules one out. ### Do I need a custom splint, or will a wrist brace from the store do? It depends. A store-bought brace can be enough for a mild sprain, where its job is comfort and a reminder to go easy. A ligament or bone that has to heal in one exact position needs a splint that holds it there. A splint moulded to your own hand is shaped to do that, and can be reshaped as the swelling goes down. We look at the injury and tell you which one it needs. ### My cast just came off, so why is my wrist so stiff? That is normal. Time in a cast leaves the joint stiff, the muscles weak and the skin dry and tender, and some swelling is common once the cast is off. It eases as the wrist starts moving again, and short bouts of exercise several times a day do more for it than one long session. If the wrist needs support in between, a moulded splint can protect it while it builds up. ### When can I snowboard or ride again after a wrist injury? No set date. A sprain and a break each heal at their own pace, and so does a repair after surgery. You go back when the wrist passes testing, and after a break or surgery, when the doctor, nurse practitioner or surgeon treating it agrees. Going back before then means the next fall lands on a wrist that is not ready to take it. *This page is general information, not a diagnosis or a substitute for an assessment. If you are unsure, see a health professional.*