Wrist pain during push ups/ handstands | Physiotherapy |Physio Evangelist

- Follow or contact me on Instagram: @movewithjustinyee
https://www.instagram.com/movewithjustinyee/
- visit sharehalves.com
to support Malaysian home sellers for home made food and drinks.
- come find me at Regen physio and sports rehab if you love near Petaling Jaya.
Video intro credit to Logan Paul, may Vine rest in peace
There are tons of videos out there giving advice on how to reduce the pain when performing the activity, like engaging your fingers or lat mobility and what not. Those are good, and might just be the solution to your problem. However in this video we are going to look at what could be happening in your wrist itself and how to deal with it.

Before I explain what those conditions mean, lets look at how a perfect wrist moves in wrist extension activities.
These bones, called the scaphoid and lunate are 2 bones in the wrist responsible for a lot of the stability in the wrist. To palpate for the scaphoid, this thing that sticks out, and the bone you feel inside this triangle youre now holding your scaphoid, the bone next to that would be the lunate. When we extend our wrist, the 2 bones turn to face up and then glides downwards. If the wrist continues into slight radial deviation, these bones then turn to face the radial or thumb side and glide towards the ulnar or pinky side. Muscles that lend stability to these 2 bones during wrist extension and radial deviation are abductor pollicis longus APL, extensor carpi radialis longus ECRL and flexor carpi ulnaris FCU. They work to supinate the midcarpal bones tightening the volar scaphoid-distal row stabilising the scaphoid.
Occult dorsal ganglion cyst - Occult means hidden, dorsal means back of the wrist, ganglion in this case means an abnormal NON cancerous swelling on the ligament, and cyst means a sac containing liquid. So basically a hidden water balloon in the back of your wrist. Although sometimes, ganglion cysts can be visible.
How is this tested?
Finger extension test. Hold your wrist in a flexed position, actively push or extend your ring and middle finger against resistance, this loads the radiocarpal joint, if it reproduces your pain, then it is a positive test and there is a high chance that you have an occult dorsal ganglion cyst causing your wrist pain.
The second on the list was scapholunate ligament partial tear or attenuation. Scapho-lunate refers to the joint between these 2 bones, ligament connects bone to bone, partial tear is when the ligament is injured, possibly from trauma, attenuation means the ligament has over stretched and is loose, no longer giving the joint sufficient stability. Which will affect the perfect movement of the wrist bones, and potentially cause pain during wrist extension.
To test for this, we do the watsons test.
Treatment
Treatment. Our goal is to help the wrist bones move correctly during wrist extension and improve stability. That is to help the scaphoid and lunate bones face up while gliding downwards towards the palm. Second would be to use the tendons to stabilise, specifically the flexor carpi radialis, extensor carpi radialis longus, flexor carpi ulnaris and abductor pollicis longus. These tendons essentially stabilise the scapho-lunate joint and do this motion, the dart throwing motion.
So, to help the bones move properly, get some rigid tape, tape the scaphoid and lunate down, helping it glide down. Then to stabilise with exercise, get either a long PVC pipe, a hammer or a light weight. Rest your arm on a surface, then do this motion as I showed before. Start light and in shorter ranges. As it gets easier with time, you can give it more challenge and increase range, bringing the weight lower.
You will feel these muscles along your radius working. This exercise is to be done 2-3 sets, 6reps. Every 2nd day, meaning 48 hours in between each session. For this is the time required for a tendon to recover.
Then, whenever you are not doing the exercise, you can put a wrist brace on, allowing the wrist to heal in a stress free environment. You can do this for 2 - 6 weeks.
Then you can start doing some proprioceptive work. That would be to throw and catch balls, or catch a weighted bag like this, then progress to doing it with your eyes closed.
For problem 1, an occult dorsal ganglion cyst, aka the water balloon, you can consider seeing a doctor to get your wrist aspirated. That's where the doctor sticks a fine needle into your cyst and pulls the liquid out.
For problem 2, an attenuated or damaged scapholunate ligament, you can see a physiotherapist to receive shockwave therapy. Shockwave therapy works to cause inflammation in the ligament, resulting in laying down of collagen fibres, hence increasing the load capacity or stability of the ligament. After you have done these, you can still do the rehab I have suggested above to further rehab your wrist.

Видео Wrist pain during push ups/ handstands | Physiotherapy |Physio Evangelist канала Physio Evangelist