By Elena Voropay 

Think of it for a second – what is the most important joint in your body that lets you do daily activities? Whether it is eating, driving, switching the remote on your TV, picking up the phone, or just brushing your teeth, you always need your wrist. You probably don't even think of it, until it gets injured. Then, forget it all – gym and life downtime!

So, if your hands are working now, be grateful for you wrist muscles, bones, tendons and ligaments that you go to the gym and build the body you currently have. If it wasn't for your wrist, you would never be able to grip a water bottle and your favorite protein shake! And what's interesting, being one of the most essential joints, the wrist doesn't get all the attention it needs.

How does wrist strength relate to your big guns? Quite simply. It is actually the strength of your grip that sometimes dictates how much you can lift. Think of the times you have to pick up heavy weights for any set.

These may feel massive for your palms, but are weightless for the larger muscles. As a result, you may fatigue your palms before you get a pump in your back, chest, arms, legs, shoulders or whichever muscle you try to ramp up.

The tissues surrounding the wrist are most certainly the first ones to let you know when you are tired after a few repetitions of Bench presses, Lat-pulldowns, Tricep extesions, Bicep curls, and definitely Dumbbell squats. The issue is clear – stronger wrist means stronger body and more fulfilled life.

Anatomy of the Wrist

There are 27 bones in the wrist – eight carpals, five metacarpals and 14 nonsesamoid bones that comprise the phalanges or your fingers. These act dynamically to allow oppositional grip of any weight lifted. To make the connection from the end of the forearm to the hand, your body has decided to plant 15 bones so that your wrist is better supported and you can lift more.

All the related tendons and complex series of interosseous ligaments travel down the arm and into the hand. The wrist is complicated because every small bone forms a joint with its neighbor. Ligaments connect all the small bones to each other, and to the radius, ulna and metacarpal bones. A wrist injury, such as falling on the outstretched hand, can damage these ligaments and change the way the bones of the wrist work together.

On top of that, the joints are covered with articular cartilage that cushions the joints. In brief, the wrist is a collection of many joints and bones with one main purpose; to allow you to use your hands. The wrist has to be extremely flexible, mobile and strong at the same time so you can use it in any way you want.

Causes of Wrist Injury

Strains and Sprains

Let''s see, how could you possibly injure your wrist while lifting weights or doing cardio? Does the alphabet start with A? I mean, when you go to the gym, you probably train pretty much everything else, not the wrists. So, you think, the parts you train, or the joints where these connect, should be the ones to get stressed, tired, overused and ultimately injured, right? Absolutely, but all your training starts with the wrist, and being one of the omitted links of your strength training and stretching routines, it has a greater chance of getting out of its natural sync.

There are many things that can lead to Wrist Injury, and most of them can be the result of either one or both - sudden movement in the wrong direction or overuse.

As for acute symptom, you just need a strong push or pull on the wrist beyond its limitations. For example, when you fall forward, your natural response is to put your hands out in front to catch yourself. As you land on your palm, your wrist bends backwards, which can stretch and perhaps tear the ligaments and tendons that connect bone to bone within the joint. The resulting injury is a sprain or strain.

Overuse comes from regular consistent training. If you are not doing too many variations in your workout pitch and repetitions in the same direction are your mantra, then expect an injury coming. Repetitive motion disorders such as bursitis and tendonitis, and 'writer's cramp' - a condition in which a lack of fine motor skill coordination, ache and pressure in the fingers, wrist, or forearm is brought on by repetitive activity all come from using your hands. These are not the true sprains, so should be approached differently.

So, if previously you were ruled by “Use It or Lose It” moto and used your hands a lot in every imaginable way, now is the time to turn it into a “Use It and Lose It”...Well, maybe not to that extreme, but you get the idea. Moderation and balance, as in everything, are the best approaches.

Other Conditions

Besides strains and sprains, there are a few other conditions in the Wrist Injury department. Even if you don't embrace in becoming an anatomy professor, you may sharpen up your injury knowledge just for the heck of it. Who knows, maybe when your buddy starts complaining of wrist pain, you can shine with these terms and get some respect from the ladies:

• Wrist Contusion - bruising of skin and underlying tissues of the wrist as a result of ruptured capillaries when you hit something

• Wrist Dislocation – an injury and displacement of either wrist or forearm bones from a sprain

• Wrist Ganglion or Synovial Hernia or Cyst - a nodule directly over the tendon or joint capsule of the wrist from a sprain, a defect in the fibrous sheath of the joint or tendon, or irritation to the synovium – the tendon-lubricating stuff.

• Wrist Tenosynovitis - inflammation of the lining of a tendon sheath in the wrist. The lining secretes a lubricating fluid allowing the tendon to glide smoothly. When it gets inflammed, usually from overuse, infection, or a direct pressure

• Carpal Tunnel Syndrome – a nerve disorder from the pressure in the wrist joint from a sprain, dislocation, fracture, overuse, or other metabolic conditions.

While the first four are pretty self-explanatory, the Carpal Tunnel gets special attention here.

Carpal Tunnel Syndrome

Believe it or not, there really is a carpal tunnel in your body. It is a narrow, rigid canal running from the forearm to the wrist. Inside it, there is a very important median nerve that governs the thumb, index and middle fingers and the thumb side of the ring finger. Carpal tunnel syndrome occurs when the median nerve, which runs from the forearm into the hand, becomes pressed or squeezed at the wrist. Whenever you increase pressure on the median nerve and tendons in the carpal tunnel, you get the pain.

What is especially engaging is that unlike strains, sprains or fractures, Carpal Tunnel Syndrome mostly comes from genetics - the carpal tunnel is simply smaller in some people than in others. But instead of blaming your parents if they passed on narrow carpal tunnel genes, thank them for being born as a man - women are three times more likely than men to develop carpal tunnel syndrome, perhaps because the carpal tunnel itself may be more narrow in women than in men, so there is less space left for the median nerve and pinching it can be done easily. Persons with diabetes or other metabolic disorders that directly affect the body's nerves are also more susceptible to compression in the carpal tunnel.

If your wrists are healthy now, why do you care? Carpal Tunnel Syndrome is no longer just the nemesis of secretaries and computer geeks. It is now an equal-opportunity ailment, striking the gym rat pumping iron and the weekend duffer flailing away on the fairway. You can never know beforehand whether you will get Carpal Tunnel Syndrome and life is full of surprises.

Symptoms of Wrist Injury

In an overuse Wrist Injury, symptoms usually start gradually, with frequent burning, tingling, or itching numbness in the palm of the hand and the fingers, especially the thumb and the index and middle fingers. Even if your fingers stay in shape and don't balloon into kettlebells, you may still get the sensations of increased pressure or completely lose it altogether – can't use poor phalanges any longer.

Have you ever paid attention to your wrists when you sleep? If you are an average Joe Blow, you probably flex your wrists at night. This is the exact time when you are most likely to notice fist symptoms of Wrist Injury. And if you don't wake up at night to urinate all the by-products of your fast metabolism from the mega-dozes of protein and other stuff you shuffle down your stomach before shut-eye to assist muscle recovery, you may simply wake up feeling the need to "shake out" the hand or wrist.

At that point you know something is wrong with your wrist, and you don't have to go to the gym and grab weights to test it. Decreased grip strength may make it difficult to form a fist, grasp a supplement bottle, or even check your e-mail for the latest updates on bodybuilding techniques.

In brief, signs and symptoms of a Wrist Injury are:

• Swelling in the wrist

• Pain at the time of the injury and thereafter

• Bruising or discoloration of the skin

• Tenderness at the injury site

• A feeling of popping or tearing inside the wrist

• A warm or feverish feeling to the skin

If you don't treat the symptoms as soon as they arrive, you are risking to make it a chronic condition. This is where your muscles at the base of the thumb may waste away and you won't be unable to tell between hot and cold by touch. So, get the diagnosis asap.

Diagnosis and Treatment of Wrist Injury

Wrist sprains are graded, depending on the degree of injury to the tissues.

• Grade 1 or mild sprains occur when the ligaments are stretched, but not torn.

• Grade 2 or moderate sprains occur when some of the ligaments are torn. Grade 2 sprains may involve some loss of function.

• Grade 3 or severe sprains occur when there is a complete tear all the way through the ligament. These are significant injuries that require medical or surgical care to ensure recovery. As the ligament tears away from the bone, it may also take a small chip of bone with it, resulting in an avulsion fracture.

If there is no deformity and the pain is manageable with over-the-counter pain medication, you may want to wait 12-24 hours before deciding whether to call the doctor. But check that these pain-relievers are compatible with your supplement stack, or side effects will bring other pains, which you try to avoid at all costs and get your ass to the gym and work these muscles out. If symptoms persist after a day, see a doctor.

If you have any doubts about the severity of your injury, arrange to have a doctor examine your wrist. Sometimes, a sprain can have only mild swelling but still be serious enough to require surgery.

1. Your doctor will review your symptoms and ask how the injury happened. He or she will also ask about any numbness in your hand as well as about your medical and orthopedic history, especially any previous injuries to your hand or wrist. The physical exam will cover your entire arm and hand to ensure that there are no other injuries. Tenderness in certain areas may suggest a broken bone.

2. If a severe sprain is suspected, your doctor will likely order X-rays. In some cases, a magnetic resonance image (MRI) or computed tomography (CT) scan may also be ordered.

3. When it comes to Carpal tunnel syndrome, physicians can use specific tests to try to produce the symptoms of tingling and increased numbness. In the Tinel test, the doctor taps on or presses on the median nerve in the patient's wrist. The test is positive when tingling in the fingers or a resultant shock-like sensation occurs. The Phalen, or wrist-flexion, test involves having the patient hold his or her forearms upright by pointing the fingers down and pressing the backs of the hands together.

4. Often it is necessary to confirm the diagnosis by use of electrodiagnostic tests where the nerves are tested by placing electrodes on the hand and wrist. Small electric shocks are applied measuring the speed with which nerves transmit impulses. In electromyography, a fine needle is inserted into a muscle; electrical activity viewed on a screen can determine the severity of damage to the median nerve. Ultrasound imaging can show impaired movement of the median nerve. Magnetic resonance imaging (MRI) can show the anatomy of the wrist but to date has not been especially useful in diagnosing carpal tunnel syndrome.

5. If you have severe pain, deformity, numbness, or are unable to move your wrist, you should call your doctor for an immediate appointment, go to an urgent care clinic, or go to a hospital's emergency department.

Obvious deformity or severe swelling definitely means a broken bone or dislocation. No doubt you need a specialist to put it back in place in time so it can heal better.

Self-Treatment of a Wrist Injury

Mild wrist sprains can be usually be treated at home with the RICE protocol.

• Rest the joint for at least 48 hours.

• Ice the injury to reduce swelling. Do not apply ice directly to the skin. Use an ice pack or wrap a towel around the ice or a package of frozen vegetables. Apply ice for about 20 minutes at a time.

• Compress the swelling with an elastic bandage.

• Elevate the injury above the level of your heart.

You may also wish to take a pain reliever such as aspirin or ibuprofen. If pain and swelling persist for more than 48 hours, however, see a doctor. Moderate sprains may need to be immobilized with a wrist splint for 7 to 10 days. Severe sprains may require surgery to repair the fully torn ligament. Afterwards, you will need a period of rehabilitation and exercises to strengthen the wrist and restore motion. A wrist sprain can take anywhere from 2 to 10 weeks to heal completely, depending on the severity of the sprain.

Prevention of Wrist Injury

How do you keep your wrists strong, durable, mobile and healthy? Easy, just find the will-power and discipline to nurture these links daily.

• Take a break at least once an hour when you repetitive work

• Wear supportive weight-lifting gloves, a wrist brace or splint while working out with heavy iron at the gym

• Warm up, stretch and strengthen your tissues in the forearm. What's better, it may even give your arms a better-looking muscular look and definition – something deserved for the very special bodybuilders. Exercises such as reverse or hammer bicep curls, wrist flexion are terrific!

• Every time you work out your body with exercises where your wrist is likely to be bent, either flexed or extended, it is subjected to overload and stresses of repetitive moves. Hold your weight like a rock, with all the mighty power you've got to maintain a solid grip, and try keeping your wrist straight.

• Joint-supporting supplements Glucosamine, Chondroitin Sulfate, MSM (Methyl Sulfonyl Methane), Hydrolyzed Collagen Protein (Gelatin), Essential Fatty Acids (EFAs) are excellent supporters of healthy wrists. Try to match them to your current supplements and foods and enjoy a healthy vital skeleton for many years to come

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