Wrist Sprains


Wrist sprains and strains occur more often. In particular, the wrist sprain occurs due to torn wrist ligaments. Therefore, if your tendon or muscle is overstretched or strained, the resulting injury is a sprain.

Wrist sprains are graded in relation to their impact on the ligaments. Grande 1 wrist sprain is mild with ligaments stretched a little bit but not torn. Grade 2 wrist sprain is moderate with ligaments partially torn. This type of sprain may cause loss of function. 

Finally, there is a grade 3 wrist sprain which is severe. With this grade of a wrist sprain, the ligament is stretched and pulled off of its original attachment to the bone. Also, the ligament is torn completely. 

Grade 3 wrist sprain causes significant injuries that need medical care or surgical treatment. In extreme cases, the ligament may tear away from your bone, taking with it small chips of bone. When this happens, an avulsion fracture occurs. 

Wrist Sprains Anatomy


Typically, your wrists act as a connection between your forearm and your hand. The wrist is simply a big joint consisting of several small joints. These numerous small joints make your wrist flexible. They also allow you to move your hand in any direction. 

The wrist comprises two large forearm bones and approximately eight small bones called carpals. In addition, the wrist has wrist ligaments and wrist tendons that act as connective tissues. 

Ligaments connect two or more bones to each other. Tendons, on the other hand, form a connection between muscles and bones. Injuries or damage to your wrist tendon and wrist ligament may lead to severe cases of sprains. 

If you suspect that you have a sprained wrist, reach out to Dr. Christopher R. Sforzo and Dr. Christopher L. Dillingham at Sforzo I Dillingham I Stewart  Orthopedic + Sports Medicines. These two medical professionals are board-certified orthopedic surgeons and fellowship-trained in hand, arm, and wrist surgery.

The doctors provide expert medical care to treat injuries involving the elbow, shoulder, forearm, and wrist. They use minimally invasive techniques that include arthroscopic rotator cuff repair, arthroscopic elbow and wrist surgical procedures, and endoscopic carpal tunnel release.

Causes of Wrist Sprains


Several causes are linked to wrist sprains. Common among them are bending, twisting, or exerting more pressure on your wrist. Accidents by falling and playing sports can also contribute to a torn ligament in the wrist or a torn tendon in the wrist. 

In rare cases, chronic repeated trauma on your wrist’s ligaments can lead to a sprained wrist. Individuals with loose-jointed are at a greater risk of developing sprains. Such people can take longer to recover fully than those who are not loose-jointed. 

The following factors can lead to wrist ligament tear, dislocated wrist, or wrist tendon injury:

  • Accidental falling on your outstretched hand/arm or contact forces the wrist to move to one side.
  • An abrupt twist and hyperextension
  • Sports such as racquet sports, hockey, golf, weight lifting, and boxing
  • Motor vehicle accidents
  • Diseases such as rheumatoid arthritis

Wrist Sprains Symptoms


Sprained wrist symptoms are often associated with painful and swollen regions around the wrist. You may also notice some bruising on your wrist. Here are some additional signs of a sprained wrist to watch out for:

  • Reduced range of motion
  • Stiffness
  • Tenderness and warmth around the injured wrist
  • Feeling a tearing or popping in the wrist
  • General weakness

Symptoms associated with wrist sprains are very similar. They often include swelling, pain, stiffness, and limited range of motion. Even though these symptoms are mild, it is wise to consult a physician for proper diagnosis, treatment, and aftercare. Waiting for too long could worsen your wrist sprain condition.

Risk Factors for Wrist Sprains

Sports and strenuous activities involving repetitive use of your wrist are some of the top risk factors for a strained wrist. Apart from that, repetitive stress such as playing new musical instruments, crutch walking, and over-use of your wrist (in fitness activities like push-ups and press-ups) in the non-dominant arm can also be a serious risk factor for your wrist ligament injury. 

Other known risk factors include:

  1. Individuals who are prone to accidental falls
  2. Prior wrist tendon or wrist ligaments injury
  3. New routines that lead to a sudden increase in the strenuous activities
  4. Performing activities that need repetitive motions or exertion of elbows, wrists, and hands

Wrist Sprains Diagnosis

Your doctor will perform different tests to rule out the possibility of other health conditions besides the wrist sprains. In this regard, the doctor will carry out the diagnosis by using an X-ray, Lab test, computerized tomography or CT scan, and magnetic resonance imaging (MRI). 

Below is a brief explanation of each diagnosis process:

  1. X-ray: Your doctor is likely to order an X-ray test to confirm that your wrist is sprained or injured. Even though the X-ray diagnosis may not show the wrist tendons and ligaments, it can possibly suggest a tendon or ligament injury. This is only possible with an X-ray test if your wrist bones are not lined up properly. Besides, an X-ray test can help your healthcare provider rule out broken or damaged bones, torn ligaments, and dislocated joints in your wrist.
  2. Physical Exam: May also help establish the presence of a torn wrist, a torn tendon, a dislocated wrist, or a wrist tendon injury through physical examination. During your initial appointment, your healthcare provider will examine you for signs of swelling, bruising, and tenderness around the affected wrists before deciding on the most appropriate wrist tendonitis treatment option. Other wrist instability tests are a scaphoid shift test, a ballottement test, and a grip strength test.
  3. Computerized tomography (CT) scan: In addition to X-ray and lab tests, your doctor may suggest computerized tomography (CT) scan test. CT scan creates images of your wrist ligaments and wrist tendons. Your doctor will use those detailed images to check and verify the severity of your sprained wrist.
  4. Magnetic resonance imaging (MRI): MRI is one of the invasive diagnostic tests for a sprained wrist. The test enables your doctor to detect wrist ligament injuries and other injuries associated with nerves, wrist joints, cartilage, and soft tissues.

With diagnostic tests in place, your healthcare provider will be able to determine the severity and grade of your wrist tendon and ligament injury. A damaged ligament will appear torn and elongated or torn with some bones attached to it. 

Wrist Sprains Treatments 

The main idea behind the treatment of wrist sprains is to restore function and reduce pain. In most cases, non-surgical treatment options are usually adequate. However, your caregiver may recommend surgery if the torn ligament on the wrist is severe and too complex for non-surgical treatments. 

Bear in mind that if you don’t access adequate treatment for the traumatic tendon and ligament injuries, you may end up getting osteoarthritis of the wrist.  

However, before you go for treatment, you must consider the following factors:

  • Condition of your wrist ligament
  • The healing capacity of the injured ligament
  • Status of structures around the injured wrist
  • Condition of cartilage
  • Your factors as a patient

Once you have considered all the above factors, your physician will recommend either non-surgical treatment or surgical wrist sprain treatment.

1. Nonsurgical Treatment

Non-surgical treatment should be the best option for mild wrist sprains. Common techniques used to relieve pain in the sprained wrist are:

The PRICE (Protecting, Resting, Ice therapy, compressing the wrist, and Elevating the wrist) protocol, Wrist splint, Non-steroidal anti-inflammatory drugs (NSAIDs), Physical therapy, Return to work or play.

2. Surgical Treatment

If non-surgical treatment options don’t work, you may consider surgical procedures. Different surgeries that treat injured wrists are available together. Depending on the severity of your wrist injury, the surgeon may perform arthroscopic surgery through an open surgical procedure or a small incision. 

More than one surgical procedure may be used during a single wrist sprain surgery. Some of these techniques consist of closed reduction and pinning, thermal shrinkage, capsulodesis, tenodisis, ligament reconstruction, proximal row corpectomy, arthroplasty, and arthrodesis.

Final Thought

Most wrist sprains are caused by sports activities, overexertion, and strenuous activities that entail repetitive motion of your wrists. These injuries are common in gymnasts, divers, basketball players, baseball players, skaters, skiers, inline skaters, and skateboarders, among others. A wrist sprain may also happen to you if you take a fall or get hit hard on your wrist. This condition usually heals quickly. With proper treatment and care, wrist sprains can take a few days or weeks to heal. Contact Sforzo | Dillingham | Stewart Orthopedics + Sports Medicine for more information about wrist sprains.