Sports-Related Wrist and Hand Injuries
by Elizabeth Peterson, MFA
While hand and wrist injuries are common among all types of athletes, some 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 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.
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 acts like a hinge and helps your thumb to function properly. If you sprain your thumb, you could lose some or most of your ability to grasp items between your thumb and index finger, or to grasp well with the entire hand.
A wrist sprain occurs when you stretch or tear the ligaments that connect the bones in your wrist. This can happen when you break a fall by landing on the palm of your hand. This may result in an overextention of your wrist, causing a sprain.
Injuries to the Bone
Bones can be fractured and dislocated. A fracture is a crack or break in a bone. A dislocation occurs when a bone is pushed out of place and no longer lines up correctly at the joint. Both injuries decrease the ability to move and cause pain.
Fractures of the hand include breaking the bones of the hand between your wrist and knuckles, as well as your fingers. The most common hand fracture is called a boxer’s fracture. A boxer’s fracture usually occurs when you strike an object with your closed fist, injuring the long bone that connects the little finger to the wrist. This fracture also results in damage to the surrounding soft tissues.
Scaphoid fractures account for many wrist fractures. The scaphoid bone is one of eight small bones that make up the wrist. The scaphoid bone lies at the base of the thumb adjacent to the radius, one of two large bones that make up the forearm.
Wrist fractures are common both in sports and motor vehicle accidents. The break usually occurs during a fall on the outstretched hand. The angle at which the palm 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 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 forced backwards or forced 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. Tendon injuries may result from:
DeQuervain 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.
Extensor carpi ulnaris (ECU) tendinitis is another common sports-related closed tendon injury. ECU tendinitis 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 (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 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 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. 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:
American Council on Exercise
Ortho Info—American Academy of Orthopedic Surgeons
When it Hurts to Move—Canadian Orthopaedic Foundation
Flexor tendon injuries. Ortho Info—American Academy of Orthopedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/flexor-tendon-injuries. Updated January 2011. Accessed November 17, 2017.
Hand fractures. Ortho Info—American Academy of Orthopedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/hand-fractures. Updated October 2007. Accessed November 17, 2017.
Mallett finger. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115985/Mallet-finger. Updated June 5, 2017. Accessed November 17, 2017.
PIP joint dislocation. EBSCO DynaMed Plus website. Available at: http://www.dynamed.... Updated June 7, 2017. Accessed November 17, 2017.
Safe exercise. Ortho Info—American Academy of Orthopedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/staying-healthy/safe-exercise. Updated July 2012. Accessed November 17, 2017.
Scaphoid fracture. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T116698/Scaphoid-fracture. Updated October 26, 2016. Accessed November 17, 2017.
Sprained thumb. Ortho Info—American Academy of Orthopedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/sprained-thumb. Updated May 2010. Accessed November 17, 2017.
Wrist sprains. Ortho Info—American Academy of Orthopedic Surgeons website. Available at: https://orthoinfo.aaos.org/en/diseases--conditions/wrist-sprains. Updated September 2010. Accessed November 17, 2017.
Last reviewed November 2017 by EBSCO Medical Review Board Michael Woods, MD, FAAP
Last Updated: 11/17/2017
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