Trigger thumb

PROBLEM: Pain in the wrist that is aggravated by any pressing exercise, such as bench presses, shoulder presses, and pushups.

TRIGGER: It's usually the result of using a very wide grip (more than twice shoulder-width, or to where it's uncomfortable) on overhead pressing exercises and Olympic weightlifting variations such as a power snatch or overhead squat. It can also come from letting your wrists bend back too far on flat or incline bench presses.

DIAGNOSIS: If the wrist is a little sore or swollen, it's probably just a simple wrist sprain. However, the wrist is a tricky joint, and what initially looks like a sprain can really be a fracture of the scaphoid, one of the small wrist bones.

WHAT YOU SHOULD DO NOW: AS with any acute injury, RICE it. RICE stands for Rest, Ice, Compression, and Elevation. Ice the wrist for 20 minutes every two hours for the first 48 hours to prevent the injury from getting worse. (It won't stop the swelling, as you may have heard, but it does put the damaged tissue in a kind of suspended animation.) Wrap the wrist in an Ace bandage to give the joint extra support (it also keeps people from bumping into your wrist and can score you some sympathy), and keep your wrist elevated above your heart to limit the swelling. Monitor the wrist for excessive swelling, changes in your level of pain, and decreases in range of motion. If the pain gets worse, go to the emergency room.

WHAT YOU SHOULD DO LATER: If there's no improvement after a day or two, get to an ER. It's either a more severe sprain than you initially thought or a potential fracture of the scaphoid or one of the eight other wrist bones. If you're on the fence about going to the ER, here are two tests you can run on yourself to see how bad it is: First, grip anything tightly--flit hurts, you may have a fracture. Second, make the thumbs-up sign with your injured hand. You'll see two tendons pop up on the thumb side of the wrist. Now push on the bone in between the two tendons--if it hurts like hell, a bone may be broken and you need to see a doctor.

WRIST OK FOR NOW: Keep it that way. To avoid excessive wrist extension during pressing exercises, keep the bar positioned toward the heel of your hand rather than toward your fingers. If you're going to perform overhead exercises that require a wider grip, start with a grip width that's comfortable for you and progressively widen it as you get more accustomed to the position.

MF adviser Bill Hartman is an expert in the rehabilitation of sports injuries.

COPYRIGHT 2005 Weider Publications
COPYRIGHT 2005 Gale Group