How to Treat Common Hand & Wrist Injuries in Athletes

Hand and wrist injuries are a common occurrence for many athletes from basketball to baseball, as well as solo sports like golf and tennis. We spoke with HOI-affiliated hand and wrist surgeon Nicholas Rose, MD, who shared insight into common hand and wrist injuries and how to treat them.

Q: What are the most common hand and wrist injuries in athletes?

Common athletic hand and wrist injuries include muscle strains, tendon or ligament injuries, and fractures. Some hand and wrist injuries are especially common with certain sports. This includes finger sprains and fractures with basketball, thumb ligament injuries with skiers, wrist ligament injuries in tennis players, elbow ligament injuries in baseball players and, of course, the common maladies of golfers elbow and tennis elbow.

Q: How are hand and wrist injuries typically treated?

While some more serious hand and wrist injuries may warrant urgent surgical treatment (certain fractures, tendon or ligament injuries), most hand and wrist injuries are initially treated without surgery. Non-operative treatment includes rest, icing, nonsteroidal anti-inflammatory medications, bracing, casting and physical therapy. In some cases, cortisone injections or platelet-rich plasma (PRP) injections might be an option. When symptoms persist in spite of non-operative measures or tissue injuries fail to heal on their own, surgical intervention may be indicated.

Q: If an athlete is experiencing hand and wrist pain, when should they seek care?

In general, an athlete should seek care sooner rather than later. Certain injuries (e.g. some finger fracture/dislocations, wrist scaphoid fractures that may feel like a minor sprain) may seem minor to an athlete but could necessitate urgent treatment or surgery. While presenting to a hand surgeon initially is optimal and will minimize wait time between diagnosis and appropriate care, one should at least seek out their primary treating physician or go to an urgent care if early access to a hand surgeon is not available.

Q: When is surgery typically needed for a common hand/wrist injury?

Surgery is emergently needed (within hours) for some more serious athletic injuries (e.g. open fractures, certain dislocations, muscle compartment syndrome). Surgery is also urgently needed (within days or 1-2 weeks) for certain other hand and wrist injuries including displaced fractures, tendon ruptures and some finger or wrist ligament injuries. If a particular injury fails to improve with nonoperative treatment for several months, surgery may be indicated.

Q: What are some exercises or preventative measures athletes should incorporate into their regimen to avoid injury?

The importance of stretching and warming up before engaging in exercise or sports cannot be understated, particularly in the older athlete. Also, wearing recommended protective equipment (e.g. wrist guards for mountain bikers, forearm guards in lacrosse players, hand and elbow padding for hockey players) is another protective measure that athletes can take to minimize the risk of athletic injuries to the hand or wrist

Q: What is the benefit of seeing a hand and wrist specialist for your injury?

The hand and wrist is the most complex instrument in the human body. Some benign-appearing injuries may actually warrant urgent, appropriate bracing or surgical intervention (e.g. occult wrist scaphoid fractures, finger tendon lacerations or ruptures). Some injuries may be missed by a primary treatment doctor or an urgent care physician, as they typically lack the specialty training necessary to diagnose certain more complex hand and wrist injuries.

Nicholas E. Rose, MD, FACS, is a Hand & Upper Extremity Surgeon with Hoag Orthopedic Institute and California Orthopaedic Specialists.