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  • Sports-Related Wrist and Hand Injuries

    Image for wrist and hand injuries While hand and wrist injuries are very common, some athletes never seek treatment. However, delaying the diagnosis and treatment may result in long-term problems or even a permanent disability. Here is a list of some of the most common hand and wrist injuries that athletes experience.

    Sprains

    Sprains are damage to ligaments. A ligament is a type of tissue that connects bone to bone. There are different grades of sprain from minor tear to complete rupture. Treatment and recovery time will depend on grade of sprain.

    Thumb Sprains

    Breaking a fall with the palm of your hand or taking a spill on the slopes with your hand strapped to a ski pole, could leave you with a painful thumb injury. The ulnar collateral ligament may be sprained. This ligament acts like a hinge and helps your thumb to function properly. If you sprain your thumb, you could lose some or all of your ability to grasp items between your thumb and index finger or to grasp well with the entire hand.

    Wrist Sprains

    When you fall forward, as when you trip running or rollerblading, your natural response is to put your hands out in front of you to catch yourself. Unfortunately, this natural response causes you to land on your palm, bending your wrist backwards, and possibly stretching or tearing the ligaments connecting the bones in your wrist. The resulting injury is a wrist sprain.

    Injuries to the Bone

    Bones can be fractured and dislocated. A fracture is a crack or break in a bone. It is commonly referred to as broken bone. A dislocation is when a bone is pushed out of place so that they no longer line up correctly at the joint. This can decrease the ability to move and cause pain.

    Hand Fractures

    Fractures of the metacarpals (the bones in your hand just before your knuckles) and your phalanges (the bones between the joints of your fingers) are also common sports injuries. The most common fracture of the metacarpals is a boxer’s fracture. A boxer’s fracture usually occurs when you strike an object with your closed fist. With a boxer’s fracture, the fifth metacarpal joint (the one at the base of your littlest finger) is depressed and the surrounding tissue is tender and swollen.

    Wrist Fractures

    Scaphoid fractures account for many wrist fractures . The scaphoid bone is one of eight small bones that make up the wrist.
    Wrist fractures are common both in sports and motor vehicle accidents. The break usually occurs during a fall on the outstretched wrist. The angle at which the wrist hits the ground may determine the type of injury. The more the wrist is bent back (extension), the more likely the scaphoid bone will break. With less wrist extension it is more likely the lower arm bone (radius) will break.
    Scaphoid fractures are not always immediately obvious. Many people with a fractured scaphoid think they have a sprained wrist instead of a broken bone because there is no obvious deformity and very little swelling.

    Dislocations of the PIP Joint

    One of the most common injuries to an athlete’s hand is an injury to the joint above the knuckle, the proximal interphalangeal (PIP) joint. Injuries to the PIP joint occur when the finger is either hyperextended (forced backwards) or forced into flexion (downward into a bent position). Injuries to the PIP joint may include fractures, dislocations, and fracture dislocations.

    Soft Tissue and Closed Tendon Injuries

    Tendons are a type of connective tissue that attaches muscle to bone. A common injury of the tendon is called tendonitis, an irritation of the tissue.

    DeQuervain’s Syndrome

    DeQuervain’s syndrome is a common injury in racquet sports and in athletes who use a lot of wrist motion, especially repetitive rotating and gripping.
    The overuse of the hand may eventually cause irritation of the tendons found along the thumb side of the wrist. This irritation causes the lining around the tendon to swell, making it difficult for the tendons to move properly.

    ECU Tendonitis

    Extensor carpi ulnaris (ECU) tendonitis is another common sports-related closed tendon injury. ECU tendonitis is an inflammation of the tendon that runs along the back of the wrist and is caused by repetitive twisting and backward flexion of the wrist. It is most commonly seen in basketball players and those playing racquet sports.

    Baseball Finger

    Baseball finger (or mallet finger) is an injury that commonly occurs at the beginning of the baseball season. It occurs when a ball hits the tip of your finger, bending it down. Normally, the tip of your finger can bend toward the palm of your hand about 60-70 degrees. However, add the force of a ball that has been batted through the air, and it can push your finger beyond that limit, tearing the extensor tendon that controls muscle movement in the affected finger. If the force is great enough, it may even pull tiny pieces of bone away, as well.

    Jersey Finger

    Jersey finger is the opposite of mallet finger and occurs when the fingertip, usually the ring finger, is forcibly extended, such as if your finger gets caught in an opponent’s jersey. This causes the flexor tendon, which bends the fingertip, to be pulled away from the bone and will leave you unable to bend your finger without assistance.

    Boutonnière Deformity

    Boutonnière deformity is an injury to the tendons that straighten your fingers. It occurs when your finger receives a forceful blow when it is bent. Several tendons, running along the side and top of your finger, work together to straighten the finger. If the tendon on the top that attaches to the middle bone of the finger (the central slip of tendon) is injured by a forceful blow, it can sever the central slip from its attachment to the bone, in some cases, even popping the bone through the opening. The tear looks like a buttonhole ("boutonnière" in French). If you have a boutonnière deformity, the middle joint of your finger will bend downward and the fingertip end joint bends back. People with a boutonnière deformity cannot fully straighten their finger.

    Preventing Sports-Related Hand and Wrist Injuries

    The best ways to prevent sports-related hand, wrist, and upper extremity injuries include:
    • Wrist guards: If your sport is rollerblading, street hockey, or skateboarding, wrist guards may help protect you from bone fractures and hand scrapes if you fall or slide.
    • Gloves: Use gloves to protect your hands, particularly if you are a bicyclist or skateboarder. The gloves will help protect your hands if the palm suffers a direct blow. In addition to protecting your nerves, gloves can protect your skin from direct wounds and cuts.
    • Warm-up : Before playing sports, include a warm-up routine where you focus on stretching and improving your flexibility.

    RESOURCES

    American Academy of Orthopedic Surgeons http://www.aaos.org/

    American Council on Exercise http://www.acefitness.org/

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org/

    Health Canada http://www.hc-sc.gc.ca/index%5Fe.html/

    References

    Aronowitz ER, Leddy JP. Closed tendon injuries of the hand and wrist in athletes. Clin Sports Med. 1998;17(3):449-467.

    Brown HC. Common injuries of the athlete’s hand. Can Med Assoc J. 1977;117(6):621-625.

    Flexor tendon injuries. American Academy of Orthopedic Surgeons (AAOS) website. Available at: http://orthoinfo.aaos.org/fact/thr%5Freport.cfm?Thread%5FID=392&topcategory=Hand . Updated January 2011. Accessed May 21, 2012.

    Hand fractures. American Academy of Orthopedic Surgeons (AAOS) website. Available at: http://orthoinfo.aaos.org/fact/thr%5Freport.cfm?Thread%5FID=265&topcategory=Hand . Updated October 2007. Accessed May 21, 2012.

    Luby LK. Common hand injuries in the athlete [Abstract]. Orthop Clin North Am. 1980;11(4):819-839.

    Mastey RD, Weiss AP, Akelman E. Primary care of hand and wrist athletic injuries. Clin Sports Med. 1997;16(4):705-724.

    McCue FC III, Baugher WH, Kulund DN, et al. Hand and wrist injuries in the athlete. Am J Sports Med. 1979;7(5):275-286.

    Sprained thumb. American Academy of Orthopedic Surgeons (AAOS) website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00022 . Updated May 2010. Accessed May 21, 2012.

    Women's Heart Foundation. Stretching exercises for women. Women's Heart Foundation website. Available at: http://www.womensheart.org/content/Exercise/stretching%5Fexercise.asp. Accessed May 21, 2012.

    Wrist sprains. American Academy of Orthopedic Surgeons (AAOS) website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00023 . Updated September 2010. Accessed May 21, 2012.

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