Wrist Injuries with Dana Ranahan

Mark: Hi, it’s Mark from TLR. I’m here with Dana Ranahan of Body Works Physiotherapy in North Vancouver, body-works.ca. And we’re going to talk about fooshing injuries. Did I get that right? Fooshing

Dana: Pretty close. Hi Mark. They’re actually called Foosh. So the acronym is F O O S H. So you can kind of imagine if you slip on ice, like it’s like a whoosh or a FOOSH, but effectively that’s like a fracture that you would have from falling with, you know, usually it’s a wrist fracture, so we call those FOOSH injuries. So you’re pretty close. Yeah. It’s a funny name, but not necessarily a fun injury to have.

Mark: So other than, you know, someone’s, let’s start with the easier ones where that’s not broken, but the wrist is sore. They can’t really hold things anymore without a lot of pain. What’s going on there? And what sort of the typical course of treatment?

Dana: Well, when they have a fall, typically it’s on the wrist is extended. So they’ve kind of fallen and landed on their wrist. So the wrist can get hyperextended or kind of jammed. So sometimes people can just sprain a couple of ligaments around there, or there’s a little disc inside the wrist that you can damage from the compressive forces.

So if it’s more of a sprain and not actually a fracture, it’s something that probably needs, first a little bit of rest and ice, but you do need to start moving it slowly while it’s healing so that it doesn’t become stiff and weak. And in those cases, those are people that we could probably help from the clinic fairly quickly, even in terms of guiding them and helping them understand what to do.

And if there’s something questionable, you know, we can palpate the bone and assess for potential fracture because you may have a mild fracture, just to crack in the bone, like a hairline fracture kind of thing that might not be noticeable. And if you don’t get it x-rayed, you wouldn’t know. So if there’s something like that happened, we might be able to help kick that out as well.

But the outcome for those are usually they would recover in a period of four to six weeks, typically depending on the severity of their sprain. And then they can hopefully get back an action. But if you don’t do anything about it, it might be a little slower to recover the mobility and strength back again.

Mark: So how soon after the injury, with guidance, would you start to move the wrist and get that happening. Because I know people want to just lay in bed and not move, oh, it hurts. Let me not do anything.

Dana: Well, I think that’s the problem is because it’s painful and swollen is that we don’t want to move it. So of course it would depend on the severity of the injury. But let’s say it’s a mild to moderate sprain that you have so not necessarily severe, but you need to start moving in as soon as you possibly can. Even if you’re just doing some simple movements, you know, if you can’t really stress the wrist through the full range of motion, sometimes it’s just doing some hand exercises to pump the muscles that helps to clear the swelling.

You can start doing some self massage to try to help clear swelling, and then introducing some gentle, active movement. Are we even do like active assisted movement where, let’s say it hurts for me to push back. So I might use my other hand to help guide it a little bit, just to help almost like wiggle the joints a little bit.

So in the early stages, we want to start really easy pain-free as best as we can movements to try to restore motion. And of course, we’re sure that there’s no fracture when we do this because we don’t want to, you know, move anything if there’s no underlying fracture. But typically the earlier the better.

Mark: So, is that fairly similar to how say someone’s broken their wrist and they’ve had it immobilized and it’s healed now. Is it the same thing? Like as soon as that’s healed time to make it move, basically.

Dana: Yes, definitely. And what happens and what we probably don’t realize is we think if we break the bone and you put it in a cast, let’s say for six weeks, and then you take it off, the bone has healed, but the joint has not moved or the joint in the wrist, there is multiple joints in the hand, sometimes that are mobilized also. And in the forearm that allows us to turn our arm up and down. So it can be multiple joints that really haven’t moved for that six weeks. And so what we get is what we call a post immobilization stiffness in the joints.

So that is really important for us, typically, we would do more manual hands-on techniques to help the joints move a bit better to restore the mechanical movement in the joint. And then people will take their exercises and hopefully be able to gain motion better. Sometimes it’s hard to gain the movement back yourself fully because you don’t know which piece is not moving if you will. So you can try some of the active movements, but if certain parts of the joints aren’t moving, it’s hard for a person sometimes to restore full motion themselves. And that’s where we play as physiotherapists a very important role.

Mark: So what about preventing these kinds of injuries? What would be your advice there?

Dana: Well, one of the biggest things is I think sometimes people will, you know, run down their stairs or down the sidewalk they’re in a rush to go to the store to work or whatever. And they, you know, slip out before they realize it. So I think the biggest thing is noticing the conditions and if the temperature sometimes either cooled or hovering around the zero mark, you know, there’s the potential for ice. And in the lower mainland and the North Vancouver area, we do get a lot of rain coupled with snow sometimes. So it has a tendency to have a little bit of black ice almost on the sidewalks or roads. So I think knowing those conditions and being aware is really key. And I think then you can be a little bit more preventative, you know, either getting like some crampon type things you can slip onto the bottom of your boots to give you some traction underneath you. Be sure you’re wearing good footwear. Take your time and take little, maybe baby steps. If you’re striding out, it’s easier for you to slip out. So those are key things, I think in terms of preventing the injury.

I mean, sometimes it happens quickly and you’re going to react. And when that happens, it’s already too late. So if you can stop it before it gets to that risk stage, then I think that’s the best way of preventing.

Mark: So if you’ve had an injury, a wrist injury or any kind of injury, basically, and you want to get better quickly, you need a physiotherapist to really help you understand what’s going on and get the proper course of treatment. So you get back moving as fast as possible and fully, not just in a restricted kind of not proper way of moving and limited for the rest of your days. You want it all fixed properly and a physio will help you. Body Works Physiotherapy. Many time winners of best physios in North Vancouver are the people to see. You can reach them at 604-983-6616 to book your appointment. Or check out the website, body-works.ca. Thanks, Dana.

Dana: Thanks so much Mark. Take care.