Wrist stability exercise programme

Information for patients

NHS Lanarkshire Hand Therapy Department

PIL.WRSTAB.22_05779.L

Wrist stability exercise programme

Once you have enough movement in your wrist, and your pain has reduced, you need to improve the stability (strength) of your wrist.

Level 1:

1. Squeezing

Squeeze a foam block, soft stress ball or rolled up socks.
Hold for a couple of seconds, then release.

Do this in the 3 positions shown:

1. Palm up position

Upturned fist squeezing a block as a hand therapy exercise

2. Mid Position

Fist squeezing a block as a hand therapy exercise

3. Palm down

Closed fist squeezing a block as a hand therapy exercise

In exercises 2 to 5, use your other hand to stop the movements for up to 5 seconds:

2. Resisted supination (palm up):

Tuck your affected arm in to your side with your little finger nearest the floor. Make sure your elbow doesn’t leave your side.
Put your other hand over the top of your forearm. Try to turn your forearm to the palm-up position. Stop it from moving with your other hand.

3. Resisted pronation (palm down):

Stay in the same position and try to turn your palm towards the floor. Stop it from moving with your other hand.

4. Resisted wrist extension (up) and flexion (down):

Make a gentle fist with your hand and place your other hand over the back of it. Try to move your wrist up but stop the movement with your other hand.

Next, put your other hand underneath your affected hand. Try to move your wrist down but stop this movement with your other hand.

5. Resisted ulnar and radial deviation (side to side):

Put your other hand against the thumb side of your affected hand. Try to push your affected hand sideways but use your other hand
to stop the movement.

Now move your other hand to the side nearest the little finger of your affected hand. Try to push your hand sideways and use your other hand to stop the movement.

Closed hand cupped in other hand exercise

Level 2:

1. Resisted abduction/adduction:

Hold the theraband (stretchy band) at the ends, with your wrists in a neutral position (not too bent forwards or backwards). Keep your arms tucked in at your sides and then pull your arms apart. Hold for a couple of seconds and then slowly control the movement to the starting position.

2. Theraband Pronation (palm down)

Hold the theraband in your other hand or tie it to a closed door or a chair. Keep your elbow tucked in at your side.Hold the theraband with your palm facing up. Slowly rotate your arm to turn your palm down towards the floor. The theraband will give resistance and make the movement harder.

Exercise stretching a theraband across a table

3. Theraband Supination (palm up):

Keep your elbow tucked in at your side. Hold the theraband with your palm facing down. Slowly rotate your arm to turn your palm up towards the ceiling. The theraband will give resistance and make the movement harder.

8. Theraband wrist extension (up)/flexion (down):

Hold the theraband in your other hand or tie it around your foot.

Keep your elbow tucked in at your side. Either drape the theraband across the back of your hand or hold it in your closed fist (palm down).

Stretching a theraband vertically exercise

Slowly pull your wrist backwards and up towards the ceiling (extension).

Then turn your hand palm-upwards and bend your wrist towards you (flexion). Make sure it is just your wrist that is moving and not your whole arm.

9. Theraband wrist radial deviation and ulnar deviation (side to side):

Place the side of your arm (little finger side) on a table. Wrap the theraband around your hand. Pull the band up towards the ceiling. Keep your arm on the table so it is just your hand that is moving:

Stretching a theraband across a table at the joint of the elbow

Place your hand (palm down) on a table. Wrap the theraband around your hand. Pull the band towards your little finger. Keep your forearm still so it is just your hand that is moving.

Wrapping a theraband around the wrist and stretching it

Level 3:

10. Wrist movements with weights:

Hold on to a 1-2kg weight.
Have your forearm on a table with your wrist and hand off the edge of it.
Start with your palm facing upwards.
Let your wrist bend so you are lowering the weight towards the floor.
Take the weight out and slowly lift the wrist back up without resistance.
Repeat this with your palm facing inwards.
Then do the same with your palm facing down towards the floor.

Wrist curling exercise with a small weight

11. Powerball:

You might be asked to start using a Powerball if your therapist thinks this would be useful. You will probably have worked through the exercises in this booklet first.

What is a Powerball?

A Powerball is another way to exercise your hand and wrist. There are different types of Powerball. One is wound up like a spring and released (auto-start type) and one where you use a starter cord.

This website gives you more information about powerballs: http://powerballs.com

To use a Powerball:

You need to move a Powerball smoothly with no jerky or flicking movements.
Hold the Powerball and either use the starter cord to start, or wind up and release (your hand therapist can show you how). You must start moving the Powerball in your hand as soon as you let go.
Make smooth, slow, large circle movements with your wrist, like you are drawing a circle on the floor. Keep your forearm still and so all of the movement is coming come from your wrist.
Move your wrist in a clockwise direction for up to 1 minute. Then move your wrist in an anti-clockwise direction for 1 minute.
Do this 3 times every day, or follow the instructions from your hand therapist.
You can increase the length of time you use it and how quickly you use it once you start to improve. Make sure you do this gradually.