If you’ve ever felt wrist pain when doing exercises such as pushups, planks and other hands-on-the-floor moves, you’ve likely either pushed through the discomfort or stopped doing the move altogether.
There is, however, a third option: addressing the root issue. That way, you can reap the benefits of those exercises without your wrist hurting.
Here, physical therapists and rehabilitation experts share the most common causes of wrist pain during exercise, modifications to relieve pain and training tips to keep your wrists healthy over the long term.
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Why Do My Wrists Hurt During Pushups?
The delicate structure of the wrists can make some people more susceptible to injury there, explains Dr. Joanne Y. Zhang, a hand, wrist and elbow surgeon with Hoag Orthopedic Institute in Southern California.
“The human wrist is not supposed to bear the brunt of your body weight (or more) in a fully extended position, despite this position being the most common method that pushups are done in,” she says. “Our wrist ligaments are placed under high load in this position, making them prone to wear and tear. Ultimately this can lead to changes in the biomechanics of your wrist, leading to pain, ganglion cysts (or fluid-filled lumps) and arthritis.”
A single traumatic event, such as a fall or a break, can also lead to chronic wrist pain, says Marino Bucci, a physical therapist in sports medicine with the Ohio State University Wexner Medical Center in Columbus. Overuse injuries that worsen over time or the development of an underlying condition can contribute to burgeoning pain in the region as well.
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Reasons Behind Wrist Pain During Exercise
Exercise-induced wrist pain comes down to either functional and structural issues, says Nick Occhipinti, a chiropractic physician with Monmouth Pain and Rehabilitation in Monmouth County, New Jersey.
For example, it’s possible that you have tight or weak muscles in and around your wrist. Many people’s wrist flexors (the muscles that move your palms toward the inside of your forearms) are tight, which can make it difficult to get in a hands-flat-on-the-floor position. If, during exercises like planks, you feel a “widespread, pulling discomfort near the wrist on the palm side or on the front of the forearm, muscle tightness is likely the case,” Occhipinti says.
A lack of strength in the wrist extensors (the muscles that move the back of your hands toward the back of your forearms) can also commonly contribute to discomfort, Occhipinti notes. In a pushup position, for example, these muscles help your wrist joints support a large percentage of your body weight. If they’re lacking some strength, your wrist can experience excess stress.
Dr. John T. Knight, director of the Hand and Wrist Institute in Dallas, adds that “extending the wrist or bending it backward when doing pushups or plank position increases the force or stress to the thumb side of the wrist, making the wrist more susceptible to injury.”
Exercise is also prone to causing wrist pain with any other structural issues, such as arthritis, carpal tunnel syndrome or a history of wrist sprains, says Sam Becourtney, a physical therapist and certified strength and conditioning specialist in New York City.
What the Location of Pain Means
Where you feel pain offers some clues about the cause, Zhang says. Pain that runs in a relatively straight line from the wrist up the forearm with pushups might indicate tendonitis or tight tendons and muscles, she explains. If you experience a pinching sensation over the back of your wrist with pushups, a ganglion cyst or a ligament injury could be the culprit.
Becourtney adds that “the formation of ganglion cysts on the wrist and hand is a debated topic” and it’s not clear whether exercise causes them.
“Some researchers believe that repetitive micro-trauma or repetitive motions may cause the development of these cysts in the hand,” he explains. “That said, there are more people in the world who do pushups without ever developing a cyst than there are those who do develop cysts. While exercise alone is unlikely to cause a ganglion cyst, it can certainly cause discomfort if you already have one.”
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10 Ways to Ease Wrist Pain During Exercise
While pain can arise from a number of causes, there are several strategies you can use to help alleviate it or avoid it all together. Try these expert tips for both short-term relief during exercise and to address any functional mobility and strength deficits.
— Ramp up slowly.
— Adjust your elbows.
— Raise your hands with a cushion.
— Fan out.
— Stretch.
— Strengthen.
— Grab dumbbells.
— Rest and ice.
— Keep moving: A body in motion wants to stay in motion.
— Ask for help.
Ramp up slowly
Wrist pain often occurs “when we attempt to do something we are not prepared for,” Bucci says. So, you need to build up slowly to new exercises to avoid injury.
“Sometimes, we are capable of doing a movement once or twice, but we might not be able to perform it repetitively while exercising,” he says. “It’s important that we begin with movements and workloads that we know we can handle and gradually progress the exercise in a stepwise manner.”
Start out small by doing just a few repetitions of a new movement, and gradually increase the reps over subsequent training sessions. Or, start with a very light weight and gradually add more weight as you get stronger. “Preparing ourselves for movements or activities is a great way of preventing injuries due to those activities,” Bucci says.
And be sure to warm up before any exercise, Zhang adds. “Making sure you are using good form, warming up and cooling down adequately is essential to staying safe during workouts,” she says.
Adjust your elbows
“When our wrists are in an extended position for a prolonged period (like on the floor or other flat surface), we tend to hyperextend the elbow,” Becourtney says. “This ends up putting more pressure on the wrists, specifically the eight small carpal bones. These bones are not designed to bear the weight of our full body, and by hyperextending the elbow and underutilizing the shoulder protractors, we tend to just let our weight ‘rest’ in the wrist joint.”
So, the next time you’re in a pushup position, try locking and unlocking your elbows. During straight-arm exercises, the goal is to have your elbow extended but not fully locked out. In the correct position, the folds of your elbows should face each other.
Raise your hands with a cushion
Cushioning your hands can take multiple forms, but they all work to lessen how far you need to extend your wrists during exercise and the amount of stress you place on the joints.
When working out at home, try placing a small, folded hand towel or another piece of fabric under your hands at the base of your palms (aka the heels of your hands). You can also use a couch cushion or AIREX pad, according to Occhipinti.
Or, if you have access to a barbell and squat rack and want to work on pushup or plank exercises, secure the barbell low in the rack, place your hands on the bar and do your exercises from there. “Being that your hand is not flat on the floor, you can focus on keeping your wrist in a neutral (rather than extended) position,” he says.
Zhang adds that you can also use your fists to keep your wrists straight instead of extended.
Fan out
“With floor work, it’s important to fan the fingers out and make sure your weight is evenly distributed between the arms,” Knight says. By fanning out your fingers, you create a wider base for your upper body. This approach can help alleviate putting too much weight on any one specific area while doing pushups.
Stretch
Find out if you have tight wrist flexors with the forearm wall stretch. Place one palm flat on a wall at shoulder height with your fingertips aiming down toward the floor. If you feel a stretch in this position, you could likely benefit from stretching both before exercise and on a daily basis.
Your goal: Hold this stretch comfortably for one to two minutes per side, Occhipinti says. (Never push to pain.) As your flexibility improves, try doing the stretch with your hands a few inches higher on the wall.
Zhang also recommends two particular stretches to loosen things up:
— Example 1: Hold your arm out straight in front of you, palm facing up, and extend your wrist. Use your other hand to gently pull your fingers back towards you until you feel a stretch down the palm side of your wrist and the underside of your forearm.
— Example 2: Again, hold your arm out straight in front of you, this time with your palm towards the floor and wrist hanging downwards. Use your other hand to gently pull your fingers back towards you until you feel a stretch over the top of your wrist and forearm.
Strengthen
While you stretch one side of your wrist, you need to strengthen the other.
To do so, Occhipinti recommends exercises like wrist extension curls (hold light weights and draw the backs of your hands to the backs of your forearms).
You can also try resisted finger expansions, starting in a fist and extending your fingers as far as comfortable. For resistance, try a rubber band, stretchy hair band or finger extension bands. The finger extension bands (which you can search for online) are the most user-friendly option and won’t slip or fling off your fingers mid-rep.
Bucci adds that “grip-strengthening exercises for the muscles of your hand and other exercises for your elbow may help as well, as they also help strengthen the joints above and below our wrists.”
Grab dumbbells
Perform troublesome movements with your hands gripping the handles of two vertically positioned dumbbells, Becourtney recommends. Other options include parallel bars and pushup handles.
Whichever tool you choose, it will let you keep your wrist in a neutral position to reduce pressure on the joint.
For example, when setting up for a plank, set two dumbbells or bars on the floor, and spread shoulder-width apart with the grips running the same direction as your body. With straight arms, grab both handles and then step your feet back. Ensure the equipment is either heavy enough or creates enough friction against the floor so that it won’t move mid-exercise.
Zhang also recommends substituting other exercises “to target the same muscles, such as bench presses, dumbbell chest presses, using a TRX setup for including pushups” and so on. TRX is a form of resistance training that uses straps anchored to a wall to leverage your body weight for strength training.
A certified personal trainer or physical therapist can help you find the most beneficial modifications or exercises.
Rest and ice
If you develop pain in the wrists after working out, “rest, use ice, a brace and nonsteroidal anti-inflammatory drugs — medications like Advil or aspirin,” Knight says. “If the pain subsists, it’s important to transition back slowly with a rest day between sessions with icing immediately after a session.”
Icing after workouts that involve the wrists can help keep inflammation from becoming recurrent. Ice is one of the most effective and least expensive anti-inflammatory techniques.
As with any kind of exercise, more isn’t always necessarily better, Knight adds. “It’s important to give muscles and joints a rest day while working on other areas of the body, such as cardio, core or lower extremities,” he explains.
Keep moving: A body in motion wants to stay in motion
Bucci notes that keeping your wrists moving is important to maintain a full range of motion and ensure your wrists stay healthy. Using modifications to your exercises such as the ones listed above can help. He also recommends decreasing the intensity by completing fewer repetitions or using lighter weights, decreasing the volume and changing how you execute the exercise.
“For pushups, for example, we could use a table or wall instead of the floor and progress to the floor over time as we get more comfortable with the movement,” he says.
Ask for help
If pain persists, it’s best to visit with a health care provider to get to the bottom of the problem and figure out how to correct it. Physical therapists or a hand and wrist specialist are particularly well suited to helping you learn how to alleviate wrist pain while keeping you moving.
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Protect Your Wrists and Relieve Pain During Floor Exercises originally appeared on usnews.com
Update 05/31/23: This piece was previously published at an earlier date and has been updated with new information.
