Patient Education and Home Instruction for Wrist Tendinopathies

Rehabilitation experts generally consider patient education as a unique and critical piece to rehabilitation.

Education is unique in that it is ongoing and critical because without proper patient understanding of the insulting activities, it is likely that the patient will relapse with the symptoms or cause a delay in healing time. More specifically, the literature supports ergonomic modifications and the following points of emphasis specific to tendinopathies.

• Rest from activities that increase tendon loading and aggravate pain. Your therapist will guide you in the proper loads and timing of those loads to ensure proper healing. In the meantime use your other hand.
• Avoid repeated wrist, forearm or elbow movements although do not avoid all upper limb motions as this will further reduce the tendons ability to take load. Rather use both arms.
• When exercising, make sure the exercises do not increase your pain as this might be a signal that the load is too much. Be particularly mindful of stretching. Pain of 3/10 is normal during and after the exercise but 24/24 later is not.
• Use larger handles on utensils, tools, keyboard and mouse. You may also use a gel mouse pad for further support.
• Make modifications to your work area to promote good posture. The following should also be considered:
  1. Don’t maintain fixed postures for long periods of time. Consider setting a timer every 30 minutes to stand up and do your exercises.
  2. A headset with microphone and dictation software to ease the load of computer work.
  3. A vertical mouse to promote a more neutral wrist posture.
  4. Use a lumbar roll for your chair at work if slumping is a problem.
• Consult a trainer in your sport to help correct faulty mechanics or make appropriate adjustments in equipment that you use.
• Avoid palm down lifting; instead always try to lift with your palm up.
• Avoid injections for pain management. Patients receiving multiple corticosteroid injections as a treatment modality typically fair worse in function and pain management in the long term.