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Sore Wrists During Push Ups? Let's Fix That.

November 14, 2013 3 min read

Think back to the last time you saw someone bust out a set of push ups: what did they do when they were finished?

There's a good chance it was something like this:

It's such a common reaction that many yoga and Pilates classes now regularly include the cue to "shake out the wrists" after push ups, chaturanga, or arm balances, as though pain in the wrist joint was a perfectly normal part of these exercises.

It isn't.

And when, perhaps, you complained to a trainer or therapist about your wrist pain, maybe they told you it was a weakness issue. Just strengthen those wrists (whatever that means) and the pain will subside! Well, did it?

[caption id="attachment_31073" align="aligncenter" width="259"]Doubtful. Doubtful.[/caption] That, or they offered you a modification so that you didn't have to worry about it, like bearing weight on your fists instead, or propped up on dumbbells. This will work in the moment, but it's still predicated on the idea that the only thing you can do with aching wrists is try to ignore them. Well, like the vast majority of joint aches you'll ever experience, wrist pain during weight bearing is a simple, mechanical issue that's actually pretty easy to fix.

The Problem

Here's your wrist in palmar flexion:

Photo 30-10-13 12 41 50 pm

This is palmar extension, or dorsiflexion . . . Photo 30-10-13 12 41 55 pm . . . which is, obviously, the position of your wrist while you're doing a push up. What you might not know is that, what looks like a pretty straightforward hinge has a significant component of rotation. In particular, dorsiflexion of the wrist requires (or causes, depending on which direction the force is traveling) internal rotation, or pronation, of the forearm.

Many thanks to the very patient but understandably confused waitress who agreed to take this picture. So, if your forearm isn't rotating enough, your wrist isn't dorsiflexing enough. And if your wrist isn't dorsiflexing enough, bearing weight on it feels awful.

The Solution

The Breakdown

This is a human hand: Photo 1-11-13 3 21 09 pm And these are the radius and scaphoid bones: Photo 1-11-13 3 25 59 pm This is the same human hand from a viewing angle rotated roughly 90 degrees to the right: Photo 1-11-13 3 27 18 pm Now, do you see that pointy bit at the end of the radius that looks kind of like an arrowhead pointing toward the fingers? Well, like any sharp, pokey thing, sticking it in the wrong place hurts. And that's why the scaphoid has a track built right into its contours that is perfectly tailored for the radius. Maybe you can see it there in the grooves etched into the bone. No?
Photo 5-11-13 10 25 30 am
How about now?
What you also might notice is that the point of the radius isn't, at the moment, directly pointing at the notch where it is so clearly intended to fit. Well, what would happen if you rotated that radius to the left a few degrees, you know, like in that video you just watched? aha_momentWith that rotation comes the freedom to dorsiflex the wrist as far as you please. Without it, the radius—with its hooked, sharpened end—is left to grind the surrounding soft tissues into pulp, which is roughly as pleasant as it sounds. What's more, dorsiflexion of the wrist is mechanically similar to dorsiflexion of the ankle, in that it provides the initial leverage which drives upper-body strength. In addition to ridding yourself of that unpleasant stabbing sensation, you'll be tapping into a whole new source of badass. [caption id="attachment_31065" align="alignnone" width="854"]You may remember these from last time. This one's a little harder to decipher, but it's the palm of your hand (with all the fingers removed) illustrating the leverage of the capitate and scaphoid bones over the rotation of the radius. You may remember these from last time. This one's a little harder to decipher, but it's the palm of your hand (with all the fingers removed) illustrating the leverage of the capitate and scaphoid bones over the rotation of the radius.[/caption] And we haven't even talked about tendons or muscles yet! You can be sure, though, that their shape, position and function are all based on this structural relationship.

Side note

Be aware that, as you're experimenting with this, a lot of new, interesting things will happen in the elbow and shoulder. Keep the focus on the wrist for a bit and just try to make things comfortable. Remember: one thing at a time! Feel free to share your experiences in the comments.  

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