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Early management of hand/wrist sprains and strains

Minor injuries to the knee, such as a mild sprain or strain should settle with time and can be managed at home.

A sprain or strain to the knee may result in the following:

  • Pain
  • Swelling
  • Bruising
  • Stiffness and loss of function

The pain can be particularly strong in the first three weeks as this is the inflammatory phase of your body healing itself. Typically, these injuries last 4 to 6 weeks depending on the severity.

Painkillers like paracetamol will ease the pain, but need to be taken regularly in order to control the pain. Always follow the instructions on the packet.

Anti-inflammatories like ibuprofen can help with swelling, and therefore help you move more freely. Follow the instructions on the packet and discuss using them safely with a pharmacist, especially if you have any underlying health conditions

However, you should not take ibuprofen for 48 hours after an initial injury as it may slow down healing.

Up to date guidelines can be found on the NHS website:

Ibuprofen

Paracetamol

Go to an urgent treatment centre or A&E if you:

  • have severe pain
  • feel faint
  • are dizzy or sick from the pain
  • heard a snap, grinding or popping noise at the time of the injury
  • are not able to move your wrist or hold things
  • have a wrist that’s changed shape or colour, such as blue or white

These could be signs of something more serious.

You can also call 111 for advice or go 111.nhs.uk.

Speak to a GP or physiotherapist if:

  • the pain is severe or stopping you doing normal activities
  • the pain is getting worse and/or keeps coming back
  • the pain has not improved in any capacity after treating it at home for 2 weeks
  • you have ongoing symptoms of giving way or locking
  • click here to self-refer to a physiotherapist.

 

How to manage a sprain or a strain

Day 1 – Early Management

Protect by minimising use of the affected area and initially avoiding stretching the area which could cause further injury. You may require the use of a walking aid to offload pressure on the affected side. You may find it easier to go upstairs leading with good leg first, and downstairs with the affected leg first.

Rest can be beneficial in the very early stages of the injury (days 1-4). Complete rest, however, is not advisable. In the early stages, gentle active movements and specific exercises can help decrease pain and swelling, they also promote good tissue healing with less unwanted scar tissue and joint stiffness. It is important to make sure you keep your hip and ankle moving as able, so they do not stiffen up.

Ice pack/frozen peas wrapped in a damp cloth, placed on the swollen area for up to 20 minutes at a time, 3 times a day. So long as there is swelling you will need to continue ice therapy, often beyond the third week.

  • Please note only use ice if you have normal skin sensation
  • Check the skin regularly
  • Stop if there is excessive pain, numbness or tingling
  • Do not put ice directly on to the skin as this may cause a burn.

Compression of the knee can be achieved by using a tubigrip or crepe bandage. It should compress firmly but not restrict blood flow and create a tourniquet.  Remove if there are signs of poor circulation, or if you start to experience pins and needles or numbness.

Elevation. If you have swelling in your knee, try to keep it level or slightly higher than your hip. You can help achieve this with use of pillows.

Click here for a video of how to manage a sprain or strain at home.

WEEK 1 – Early Mobilisation and Recovery

After 72 hours is important to start using your wrist and hand normally again. Start to do normally everyday activities. You should also try doing these exercises 3 – 4 times a day. Repeat each one 10 times. 

Hand and wrist exercises

1. Rest your forearm on a table with your hand over the edge. Using your wrist only, move your hand down towards the floor, and then back up towards the ceiling the ceiling in a patting motion.

2. Rest the palm of your hand on a table. Without moving your forearm, slide your hand one way and then the other. 

3. Bend your elbow and tuck it into your side. Turn your palm as far as possible upwards, without moving your elbow, now turn the hand back over again as far as possible.

4. Touch your thumb to the tip of each finger. 

5. Support your elbow on a table make a fist bend your fingers into your palm as tightly as you can and feel them stretching. Now stretch your fingers as wide as you can and feel them stretching.

6. Hold your hand with the palm of your hand facing upwards. Touch your thumb to the base of your little finger. Now stretch the thumb out the opposite way.

As you start to do these exercises you may feel there is some discomfort, however, this is normal and you should continue. If you have discomfort and pain for more than 2 hours after these exercises, then you shoulder reduce the number and gradually build up again.  

Recovery time and returning to activity 

It usually takes 6 weeks to heal from this type of injury; however everyone recovers from injuries at different rates. You may be back to normal in 2 weeks however in some cases it can take up to 3 months. 

Returning to work – Gradually build up your strength and function, practice similar tasks at home that you would do at work. Start doing this little and often ensuring there is no pain or swelling. 

Returning to hobbies/sport – it is advised not to return to these activities until you have full strength and range of movement without pain or swelling. If you play sport that involves different actions of the wrist and hand, practice the specific activities such as throwing a ball and build this up before returning.

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