Wrist Tendonitis: Prevention & Treatment For Tennis Players

What Is Wrist Tendonitis?

To put it simply, wrist tendonitis is the inflammation of the tendons in your wrist. In tennis, especially, this injury is found abundantly because of the repetitive motions common in the sport. These motions cause the tendon to rub against the bone, thus causing inflammation.

Ulnar-sided tendon injuries mostly involve the extensor carpi ulnaris (ECU), which is the tendon lying across the edge of the wrist, pinky side. Not only can inflammation occur (tendonitis), but a tennis player can also meet subluxation (partial dislocation) of the tendon.

Tendonitis causes the tendons and nearby tissues to swell, resulting in swelling of the wrist and decreation of mobility. In most cases, the pain and swelling will travel to the hand and/or forearm. (Hand and forearm swelling usually occurs when a muscle is also injured and/or inflamed.)

Common Symptoms Of Wrist Tendonitis

In most cases, you can tell if you have wrist tendonitis if you experience pain and stiffness in the wrist, especially after you wake up in the morning. The area may also feel tender and sore when you put pressure on it. Additionally, you may also be able to self-diagnose wrist tendonitis if you’re experiencing these most common symptoms:

  • Pain – Pain in your wrist because of wrist tendonitis can occur suddenly or gradually. The pain will worsen when you use your wrist to do things such as serve, where you have to snap your wrist in a downward motion.
  • Reduced Strength – In most to all cases, you will have reduced strength in your wrist because of the inflammation and pain you’re also experiencing. The pain may start after playing tennis/doing an activity, or in some cases, the pain may remain constant while you’re active or even increase and become unbearable. 
  • Inability To Bear Weight – Easy tasks that could’ve been done before your injury may now be almost impossible. Doing push-ups or using your arms/wrist to get up may give you large amounts of pain.
  • Bruising & Warmth – With almost all injuries comes the duo of bruising and warmth. The tearing of your blood vessels around the tendon causes the bruising color and the rising blood flow will cause the warmth you’re experiencing. 
  • Tearing, Popping, and Snapping – Sometimes an active person can experience the “snapping wrist” which is the subsheath rupturing and causing the tendon to snap in and out of place. This causes the snapping or popping sensation when a wrist moves, and causes damage to the tendon itself over time, tearing it gradually.
  • Muscle Fatigue and Cramping – Cramping and muscle fatigue of the wrist and forearm are very common in almost all wrist injuries because of the stress your muscles are constantly under. Muscle spasms may also occur.
  • Stiffness / Swelling – Stiffness and swelling go hand in hand with injuries. Because of constant swelling in response to the inflammation of the tendon rubbing on the bone causes stiffness in the wrist. Physical therapy and band exercises can decrease the stiffness and increase your range of motion.

Less Common Symptoms

There are less common symptoms that may point to wrist tendonitis that are case dependent. These include:

  • Numbness – The loss of feeling in your wrist, forearm, or hand can occur if a nerve is pinched or irritated by the tendon. If this issue occurs longterm, you could be moving towards carpal tunnel syndrome. 
  • Pain at Rest – In some cases, the pain from wrist tendonitis could last 24/7, making it hard to get sleep at night. If this is the case, a long-term healing option such as surgery may be a better option for you.
  • Depression and/or Anxiety – On the mental side, you could experience symptoms such as depression or anxiety because of the injury or inability to play the sport you love. If you are dealing with this, seek professional help.

How To Prevent Wrist Tendonitis

Wrist pain is highly common in tennis players, from professionals to amateurs. Wrist injuries in this sport are due to chronic overuse, improper technique, and/or improper equipment (wrong size grip / improper string tension).

Hitting techniques when falling or hitting the ball may also play a part in acquiring wrist injuries. To decrease your risk of wrist tendonitis, here are some prevention methods:

  • Choose Your Equipment Carefully – A tennis player’s equipment should be chosen by age, size, and level of play to ensure injury safe matches.
  • Using Proper Technique and Grip – A proper playing technique and grip on your racket can greatly decrease your risk of injury. Recording yourself and looking over the film can help you catch bad habits you may have.
  • Increasing Mobility, Strength, and Flexibility – Increasing the mobility, strength, and flexibility of your wrists, hands, forearms, arms, and shoulders can all help reduce your risk of wrist tendonitis. Physical therapy exercises and band stretching can increase your mobility and help build muscle to absorb shock instead of your tendons. 

How To Treat Wrist Tendonitis Pain

There are many ways that wrist tendonitis is managed and treated. There are short-term things that can be done, such as a steroid shot, or long-term, such as surgery.

Like any injury, your doctor will look at your quality of life or the injury itself to determine which route they will take. 

Here are many common treatments:

Short Term

  • Rest 
  • Splints
  • Slings
  • Soft straps
  • Avoiding irritating activities 
  • Encouraging tendon repair (using your wrist intermittently to do small tasks)
  • Exercise (physical therapy – see below) 
  • Medications 
    • Non-Steroidal Anti-inflammatory Drugs (NSAIDs)
    • Steroids (tablets or shot injection)

Long Term 

  • Surgery
    • Open Surgeries such as tendon sheath release, tendon grafting, tendon transfer, tendon repair surgery, and tenosynovectomy are used to repair the damaged tendon due to overuse. This option is usually considered to not only repair the tendon but also the surrounding membranes, sheaths, and/or other structures.
    • Minimally Invasive Surgeries use small tubes and needles to help repair the tendon without large incisions. These surgeries include arthroscopic surgeries and tenotomies.

Physical Therapy Exercises For Wrist Tendonitis

Physical therapy exercises will help whether your choice is surgery or non-surgery injury treatment.

Here are some common physical therapy exercises to help treat wrist tendonitis. (Always remember weights should be added gradually the more progress you make.)

  • Wrist range of motion (flexion, extension, and side to side)
  • Wrist stretch 
  • Wrist extension stretch 
  • Wrist flexion stretch
  • Forearm pronation and supination 
  • Wrist flexion
  • Wrist extension
  • Grip strengthening 

Link to exercises: https://www.rickysinghmd.com/wrist-tendonitis/

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