Thursday, May 4, 2017

Protect your wrists!

As an acrobat, cyclist, and bodyworker I am no stranger to wrist pain.  That being said, over the years I have come up with several self care routines to help mitigate this experience and would like to share with you what I have learned along the way.  This blog will focus on strength, flexibility, tolerance, and self-care to help keep your wrists in top form so you can do what you love with minimal pain.

Strength:   Gotta have it!  A few of our favorite exercises include:

  • Flashlights to strengthen finger flexors (strength in these muscles will help decompress your carpal bones and support your wrist).  Open fingers wide, then close.  Repeat quickly 30x in various shoulder/arm positions.  You should feel the Bern (or at least the burn).

Close into a tight fist
Open fingers wide


  • Isometrics to strengthen all sides of the wrist:  my two preferred methods are wrapping a theraband around the knuckles of my fingers during my shoulder warm up, or holding a kettle bell with the bell up during get-ups or shoulder exercises.


  • Table top knuckle "push ups" (changing how close your knees are to your hands changes intensity; can do in plank)


Flexibility:  You need sufficient wrist extension to tolerate standing on your hands.  See below for a simple test for functional wrist extension.  If you don't pass this test - use the exercises listed below in the "tolerance" section to help get the range you need.


From table top:  keep the palm flat on the ground and lean forward so that your shoulders pass your your wrists.  You should be able to get the shoulders just past your finger tips with base of palm flat on the ground.
Please note:  if you have pain during this test, stop, gently shake out your hands and arms, and try again.  If you still have pain, you may be injured -  get help ASAP as wrist pain can exacerbate quickly.

Tolerance:  Weight-bearing through the hands is often uncomfortable at first, but with practice and patience eventually you will build your tolerance.  The most important thing to remember is to progress slowly and back off if you experience pain.  Below are a few positions we utilize as a warm up before starting our hand balancing practice.  

Working wrist extension with turnout 

When working on building your tolerance for wrist extension - find the edge of what is comfortable for you, back off a bit, then stay in that position for 10-15 slow relaxed breaths.  Over time your tolerance to these positions should improve.


Self care:  As I get on in my years, I am less drawn to ice, and more drawn to heat.  That being said, during the middle of my work week when I am waking up in the morning with "pumped" forearms, I will draw myself an ice bath in the kitchen sink by doing the following:
  • Fill the sink with water, empty 2 trays of ice cubes, add several ice blocks and let it sit for 5 minutes to get nice and cold.  
  • Submerge forearms, wrists and hands - making sure the water is deep enough to cover elbows - soak for 1-2 minutes.  This usually coincides with obnoxiously loud deep breathing and a few guttural noises because sound healing is the best.  
We've also been known to dunk our forearms into cold streams as shown below.

Stanley icing his forearms somewhere in CA
Other helpful strategies include: cupping the wrist flexors and extensors, mobilizing the pecs with a lacrosse ball, acupuncture, chiropractic care, and good old fashioned rest (not my strong suit but I'm working on it, and it helps).

Pain:  If it hurts - in general - stop what you are doing and reassess.  How is your alignment through your wrists, elbows and shoulders?  Is your core engaged?  Are you dehydrated or tired?  If you are able to go through all these mechanical (and physical) stressors and still have pain, you may be injured.  Do yourself a favor and get it attended to sooner rather than later.  Unless you are a unicorn, magic likely won't fix your wrist pain.

Consider your shoulders:  If you do not have full overhead shoulder elevation, chances are you are compensating somewhere else in your body... possibly your wrists.  Read the following case study to see how this situation may play out.

Case study:  I am currently working with a high level acrobat who injured herself falling out of hand to hand several years ago.  While this fall was certainly a catalyst in her wrist pain, upon further investigation we discovered that she has a fairly significant deficit in overhead shoulder elevation.  In order to maintain her line over her base, she is compensating at her wrist, which is preventing her strain from getting better.  We have focused on addressing her shoulder mobility and strength deficits, while allowing her wrist to rest and recover.  Her exercises include:  using a lacrosse ball to increase the extensibility of her lats, posterior rotator cuff and pecs; strengthening her scapular stabilizing muscles with bands and weight shifting exercises; and isometrics for the wrists.  For a review of shoulder exercises, see my previous blog.

Summary
:  The hands and wrists are fairly complex, with at least 27 bones, multiple nerves (some say there are 48 named nerves including motor and sensory branches), over 120 ligaments, and ~34 muscles.  Our hands are how we interact with the world - please take good care of yours so you can continue to do amazing things with your body.

Keep training, keep it safe, and we hope to see you soon!


Upcoming events with Precision Acrobatics:
Pelvic Floor and Bladder Control with Liz:  May 21st, Oakland
Semi-private coaching:  June 6th, San Francisco
Master's Handstand Workshop with Ariel:  June 20th, San Francisco
AcroLove Festival: June 30th-July 2nd, San Diego
Divine Play Festival:  October 7th-9th, Portland, OR