Wrist Supports: Types, Proper Application, and Care

How Do You Put a Wrist Support On?

Proper application of a wrist support is crucial for its effectiveness, ensuring optimal stabilization, compression, and comfort without impeding circulation or causing further irritation. The method varies slightly depending on the type of support, but generally involves aligning the support with the wrist joint, securing it snugly but not tightly, and ensuring full freedom for the fingers and thumb (unless specifically designed for thumb immobilization).

Understanding Wrist Supports: Purpose and Function

Wrist supports, often referred to as wrist braces or wraps, are designed to provide external stability, compression, and support to the wrist joint and surrounding structures. Their primary functions include:

• Stabilization: Limiting excessive or painful movements of the wrist, which is particularly beneficial during recovery from sprains, strains, or fractures.
• Compression: Reducing swelling and inflammation, and providing proprioceptive feedback, enhancing the body's awareness of the joint's position.
• Pain Relief: By immobilizing or supporting the joint, they can alleviate pain associated with conditions like Carpal Tunnel Syndrome, tendinitis, or arthritis.
• Injury Prevention: In activities involving repetitive wrist movements or heavy lifting, supports can reduce stress on the joint and surrounding tissues.

From a biomechanical perspective, supports work by altering the forces acting on the wrist, distributing stress, and maintaining the joint in a more neutral or optimal alignment, thereby reducing strain on ligaments, tendons, and nerves.

Types of Wrist Supports and Their Application Nuances

The way you put on a wrist support largely depends on its design and intended function:

• Elastic Wraps/Bands: These are long strips of elastic material, often with a thumb loop and hook-and-loop closure. They offer adjustable compression and support, commonly used for weightlifting or mild sprains.
• Sleeve Supports: Simple, pull-on designs that offer mild compression and warmth. They are ideal for general support or minor aches.
• Braces with Stays/Splints: These feature rigid or semi-rigid components (e.g., metal or plastic splints) to provide significant immobilization. They are typically secured with multiple straps and are used for more serious injuries like Carpal Tunnel Syndrome, fractures, or post-surgical recovery.
• Thumb Spica Braces: A specialized type of brace that extends to immobilize the thumb joint (e.g., for De Quervain's Tenosynovitis or thumb sprains), while still supporting the wrist.

Pre-Application Checklist: Ensuring Optimal Use

Before applying any wrist support, consider the following:

• Clean Skin: Ensure your skin is clean and dry to prevent irritation and allow the support to sit properly.
• Correct Size and Type: Verify that you have the appropriate size and type of support for your specific hand and wrist, and for the condition you are addressing. An ill-fitting support can be ineffective or even harmful.
• Inspect the Support: Check for any tears, frayed edges, or damaged fasteners that could compromise its integrity or comfort.
• Understand the Injury/Need: Be aware of the specific area requiring support and any movements you should avoid.

Step-by-Step Guide to Applying Common Wrist Supports

While specific designs vary, these guidelines cover the most common types:

General Principles for All Types:

• Neutral Wrist Position: For most applications, position your wrist in a neutral or slightly extended (dorsiflexed) position. Avoid extreme flexion or extension, as this can exacerbate some conditions.
• Finger and Thumb Freedom: Unless it's a thumb spica brace, ensure your fingers and thumb can move freely and comfortably.
• Avoid Wrinkles: Smooth out any wrinkles in the fabric as you apply it to prevent skin irritation or pressure points.

1. Applying an Elastic Wrist Wrap (e.g., for lifting or mild support):

1. Locate Thumb Loop: If present, slide your thumb through the loop. Position the beginning of the wrap at the base of your palm, just above the wrist joint.
2. Initial Wrap: Wrap the elastic band around your wrist, starting from the side of your hand (pinky finger side) and moving towards the thumb side.
3. Overlap and Secure: Continue wrapping in a spiral fashion, overlapping each previous layer by about half. Ensure the wrap covers the wrist joint effectively.
4. Adjust Tension: Pull the wrap firmly but not so tightly that it restricts circulation. You should be able to comfortably move your fingers, and your hand should not feel cold, numb, or tingly.
5. Secure End: Use the hook-and-loop fastener to secure the end of the wrap.

2. Applying a Sleeve Wrist Support:

1. Slide On: Simply slide the sleeve over your hand, pulling it up your forearm until the main body of the support covers your wrist joint.
2. Position Correctly: Ensure the top and bottom edges are evenly distributed and the support is centered over your wrist.
3. Smooth Out: Adjust and smooth out any bunched-up fabric to ensure a comfortable and even compression.

3. Applying a Brace with Stays/Splints (e.g., Carpal Tunnel Brace):

1. Identify Orientation: Most braces are hand-specific (left or right) and have a distinct top and bottom. The splint typically runs along the palm side of the forearm and hand.
2. Position Hand: Slide your hand into the brace, ensuring your palm aligns with the splint and your fingers are free (unless it's a full hand brace). The splint should extend from your forearm to just below the knuckles of your palm.
3. Secure Straps (Bottom-Up or Top-Down):
   • Common Method (Forearm First): Begin by securing the strap(s) around your forearm, just below the elbow. This anchors the brace.
   • Wrist Strap: Next, secure the strap(s) directly over your wrist joint.
   • Hand Strap: Finally, secure any strap(s) around the hand or palm area.
4. Adjust Snugness: Tighten each strap individually until the brace feels snug and supportive, but not uncomfortably tight or restrictive of circulation. The splint should hold your wrist in a neutral or slightly extended position.
5. Check Comfort and Fit: Ensure there are no pressure points, pinching, or excessive gaps.

4. Applying a Thumb Spica Brace:

1. Identify Orientation: Similar to other braces, identify the correct hand (left/right) and ensure the thumb portion is correctly oriented.
2. Position Hand and Thumb: Slide your hand into the brace, carefully guiding your thumb into its designated slot or pocket. The thumb should be cradled and slightly abducted (moved away from the palm).
3. Secure Straps: Fasten the straps, usually starting with the forearm straps, then the wrist straps, and finally the strap(s) that secure the thumb itself.
4. Ensure Thumb Immobilization: The brace should restrict most movement of the thumb's base joint (CMC joint) and potentially the MP joint, while still allowing the tip of the thumb to bend if designed to do so.

Achieving Proper Fit and Comfort: Key Considerations

• Snugness vs. Constriction: The support should feel firm and supportive, but never cause numbness, tingling, increased pain, coldness, or discoloration (blue/purple) in your fingers or hand. These are signs of impaired circulation, and the support should be loosened immediately.
• Range of Motion: While some supports aim for complete immobilization, others allow for controlled movement. Ensure the support permits the necessary range of motion for your activity while restricting unwanted movements.
• Wrinkle-Free Application: Any wrinkles or bunching can create pressure points that lead to discomfort, skin irritation, or even pressure sores, especially with prolonged wear.
• Trial and Error: It may take a few attempts to find the perfect fit and tension. Don't hesitate to readjust until it feels comfortable and effective.

When to Use a Wrist Support and When to Seek Professional Advice

Wrist supports can be highly beneficial for:

• Acute Injuries: Sprains, strains, or post-fracture stabilization.
• Overuse Injuries: Tendinitis (e.g., De Quervain's), Carpal Tunnel Syndrome.
• Chronic Conditions: Arthritis, joint instability.
• Activity-Specific Support: Weightlifting, gymnastics, or jobs involving repetitive wrist movements.

However, a wrist support is a tool, not a cure. Always consult a healthcare professional (doctor, physical therapist, kinesiologist) if you experience:

• Persistent or worsening pain.
• Numbness, tingling, or weakness in the hand or fingers.
• Significant swelling or bruising.
• Inability to move your wrist or fingers.
• Symptoms that do not improve with conservative management.
• Suspected fracture or dislocation.

A professional can provide an accurate diagnosis, recommend the most appropriate type of support, and guide you on its proper use as part of a comprehensive treatment plan.

Maintenance and Care for Your Wrist Support

Proper care extends the life of your wrist support and maintains its hygiene:

• Cleaning: Most supports can be hand-washed with mild soap and cold water. Avoid harsh detergents or bleach.
• Drying: Air dry thoroughly. Do not machine dry, as high heat can damage elastic materials, plastic stays, and hook-and-loop fasteners.
• Storage: Store in a clean, dry place away from direct sunlight.
• Replacement: Replace the support if it loses its elasticity, the straps no longer hold securely, or the splints become bent or broken.

Conclusion

Mastering the correct application of a wrist support is fundamental to maximizing its therapeutic benefits and ensuring your safety and comfort. By understanding the different types of supports, following a meticulous application process, and paying close attention to fit and comfort, you can effectively leverage these tools for injury recovery, pain management, and performance enhancement. Remember that a wrist support is often just one component of a broader management strategy; always seek professional guidance for persistent issues or serious injuries.