From bbc.co.uk
Modern life is ruining our wrists. We can all do something about it, but it helps to start early
It began with a dull ache. Over the course of a summer, it rapidly progressed to an arm-juddering pain, radiating through my left hand every time I struck a tennis ball or even attempted to open a door.
I was 18 at that point, and playing competitive tennis was an important part of my life, but I'd just experienced an injury that would plague me for years. Now, nearly two decades later, it could increase my risk of developing wrist arthritis. Such problems are surprisingly common in mid to later life.
Our wrists are remarkably adaptable. They have the strength to allow us to lift heavy objects (including the World Record of 2,422 kg (5339 lbs)), the flexibility to enable us to hit rogue balls during racquet sports, and the fine control to make tasks like painting possible.
From typing to holding a coffee cup, functional wrists are essential to normal everyday life. But they are easily damaged, and we all need to start thinking about them earlier in life than you’d expect. Here's how to protect yours, so you can continue taking them for granted for years to come.
(Image credit: Getty Images)
A fragile balance
We may think of the wrist as a single joint, but it is actually a complex, comprising multiple smaller joints. These are formed of eight small bones known as the carpal bones, the two long bones of the forearm, and the bases of the five metacarpal bones within the palm.
"Every ligament and every bone in the wrist that connects it to your forearm bones are really in a very finely-tuned balance," says Andrew Abadeer, an assistant professor at the University of South Florida. "When that goes awry, that's when wrist arthritis starts to develop."
Injuries, combined with the effects of ageing, can disrupt this fragile equilibrium.
Simply avoiding arthritis is a major reason for maintaining your wrist health. There are many different kinds, but it typically takes one of three forms: rheumatoid arthritis, osteoarthritis, or post-traumatic arthritis. The latter two ailments occur when the cartilage cushioning the small bones within the wrist becomes damaged, or the bones become misaligned. Both are linked to the long-term effects of injuries to the ligaments and bones within the wrist, or lingering inflammation due to overuse through repetitive manual tasks.
Sara Larsson, a researcher who studies wrist rehabilitation at Lund University, explains that this trauma may be as simple as a repetitive twisting movement or tripping and falling on an outstretched hand. "I see many people who had an injury when they were young, everything appeared to be fine again, and then 20 years later, they develop problems."
Arthritis of the wrist has been estimated to affect as many as one in seven Americans. It is not only highly painful, but makes it harder for people to dress themselves and cut their own food, with the psychological burden being linked to depression.
Abadeer describes the wrist as being a "sentinel joint" which can reflect early signs of declining health within the rest of the body. About half of all patients who develop rheumatoid arthritis first feel the effects the disease in their wrist before it progresses to other joints. Because the brain devotes a large region of the cortex, known as the cortical homunculus, to mapping the hands, wrist and fingers, grip strength can reflect brain structure and cognitive health.
But people who reach their sixties with their wrists in better shape – typically assessed in the form of grip strength – tend to have better health overall. Those people are not only less frail and less vulnerable to falls, bone fractures and osteoporosis – a condition that weakens bones. But they are less likely to lose their independence in older age.
Setting yourself up
Before we get started, Jaehon Kim, an orthopaedic surgeon at the Ichan School of Medicine at Mount Sinai, New York, recommends considering your diet. Foods high in calcium and other minerals, such as small, bony fish (sardines work well for this) and dairy products can help to mitigate against the development of osteoporosis. In addition, while weight might not seem particularly related to wrist health, shedding excess body fat can improve the overall biomechanics of the wrist joint.
But overall, Larsson says that the best preventative measure is to do a few simple home-based workouts which can help make your wrist more resilient and stave off problems further down the line. For each of the below exercises, she recommends performing three sets of 10 repetitions (this means performing the exercise 10 times, resting, performing it again 10 times, resting, and doing it another 10 times), three or four times per week.
If you have any pre-existing conditions or injuries, it's important to seek medical advice before starting a new exercise regime. And if you feel pain at any point, stop and seek medical help.
1. Build your shoulder muscle strength
The main muscles in your shoulders are known as the deltoids. While they may appear unrelated to wrists, Larsson says that strengthening the muscle groups across the whole arm can greatly benefit your wrist as they work together like a chain.
"You don't just use your hand, you use the whole arm," says Larsson. "And if you're weak in your shoulders, then you put more load on the wrist. But if you are strong, then you can protect and unload the wrist."
One easy method of training your shoulder muscles is simply to stand with your arms out to the sides, with your arms either straight or slightly bent. Slowly raise your arms up to the ceiling and then bring them down again slowly. Repeat this ten times.
2. Strengthen your grip
Grip strengthening exercises can improve wrist stability by conditioning groups of forearm muscles known as flexors and extensors, which attach to your fingers across the wrist joint, allowing you to grip objects. Studies have previously shown that this can also help people with existing wrist pain.
"All your forearm muscles connect into your hand on both sides of your wrist in a pulley system," says Abadeer.
To work these muscles, you ideally want a hand therapy ball or therapeutic putty – a silicone-based material which you can squeeze in your hand – but a tennis ball will do.
Even healed wrist injuries can lead to problems decades later (Credit: Getty Images)
Hold the ball or putty in the palm of your hand and squeeze it as hard as you can for five to 10 seconds. Release the grip and relax your hand for another five seconds and then squeeze again. Repeat ten times in each hand. (Read more from the BBC about how grip strength can predict your chances of living to 100.)
3. Gently load and flex the wrist
According to Kim, another key means of reducing the stress on the wrist joints and tendons is exercises that flex and extend the wrist, using some form of mild weight or resistance as a load.
This can also strengthen bones in the wrist, which could have longer-term health benefits, particularly when it comes to preventing a type of osteoporosis known as disuse osteopenia. "When they're loaded, these bones strengthen and start to remodel, adding more strength to the wall of that bone," says Abadeer.
To do this, start by sitting and resting your forearm on a table with your hand hanging off the edge and holding a small weight, between 3 and 7kg (5 and 15lb). For a flexion exercise, have your palm facing upwards and curl your wrist up toward your body before lowering it back down again. For an extension exercise, have your palm facing downwards while holding the weight, and lift your hand up towards the ceiling before lowering it down again.
If you don't have weights, Larsson suggests using a resistance band instead. Fix one end of the band under a table leg and hold the other end across your wrist so you're experiencing some resistance while carrying out the exercises.
Repeat both flexion and extension ten times. "I think this can go a long way in terms of helping the joints in your wrist, especially if you're typing and writing a lot," says Kim.
4. Supinate and pronate
Lastly, there are supination and pronation movements. These can improve the range of motion of your wrist and its overall functionality. Like the flexion and extension exercises, they can be carried out over a table with a small weight or resistance band.
Begin with your hand over the edge of the table with your thumb pointing up. Then slowly turn your wrist so your palm faces down, then return to the starting position, and rotate the other way so your palm faces up. Repeat this ten times.
Abadeer says that such exercises are becoming increasingly important as we now live in what he describes as "a pronated world", where our hands spend many hours of the day in a fixed position, either due to typing on a laptop or a phone.
As with all our joints, strong, flexible wrists are something that we often take for granted. But as I found myself when my wrist was out of action for many months, it's only when you lose something that you realise its true importance.
* All content within this article is provided for general information only, and should not be treated as a substitute for the medical advice of health care professionals.
https://www.bbc.co.uk/future/article/20260904-how-to-future-proof-your-wrists
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