Make Loading An Injured Wrist Feel Safe.
Loading a painful wrist can be scary for athletes, especially if there's been an acute episode they remember.
It gets more complicated if that episode happened while on the wall.
If making a move results in pain, the brain now connects (literally on a cellular level) that move with pain. So even though a single moment rarely creates an injury, it certainly feels like it does.
I often hear from clients the idea that they need to "feel it" when doing rehab. This general idea that you need to feel the pain to demonstrate appropriate loading isn't accurate. Pain reduction is why most clinicians start by using isometric movements. They're simple, safe, and an effective place to begin building confidence.
When I provide support for an athlete with a sensitive pain complaint, I bias towards the overcoming type. The overcoming isometric applies force through a joint to a perceived intensity for time. How intense depends on an athlete's strength, confidence, and understanding. This loading style gives the athlete complete control over the stress put on the painful tissue.
Because perception (also pain) limits force output, building confidence is priority 1. If we give an athlete too little of a load, often they'll feel "more injured" than they are. If we give an athlete too heavy of a load, they'll also feel "more injured" than they might be. The regular loading habit always influences the athlete's perception, and in this case, pain.
I often use the analogy of loading into a box with the fist for the initial rehab:
In this neutral position (straight wrist, thumb up, elbow at 90-degrees), the athlete can load the wrist isometrically in all directions under their control. As a result, we can maintain recruitment and build confidence quickly.
Try it:
3-5 sets in each direction
20-30-seconds time under tension to a perceived intensity
2-min rest between sets
Key takeaways:
Under-loading AND over-loading can make you feel more injured than you are.
Feeling like you can control stress builds back confidence.
You have to start somewhere, and only you know where that is!