Sports Physiotherapy for Scaphoid Fracture of the Wrist in Hockey Players

Scaphoid is one of the smallest bones in your wrist. Scaphoid bone located at the thumb-side of your wrist joint along with other wrist bones constitutes the highly flexible architecture and mobility of the wrist. Besides being flexible, our wrist joint is highly stable and strong and the scaphoid bones are the most susceptible for injuries chiefly due to falls with outstretched hands. It is because our wrist joint is a combination of mini joints formed by a number of small bones in that area. Scaphoid fractures usually occurs to people leading very active lifestyles during their younger ages and to people who are involved in playing hockey and soccer, snowboarding, or skiing. Youngsters participating in extreme sports such as motor racing, mountain biking and cycling without wearing protective gears are also most susceptible.

What are the symptoms of scaphoid fractures?

You may start to feel some pain and swelling in your wrist area but at most times the pain is not good enough to suspect for a fracture. Moreover, the pain usually subsides within a few days leaving you confident that it is just a sprain of the muscles. As a result, you may not always seek a medical advice. But weeks later, you start to feel that the pain is not completely settling and there is some reduced movement and functionality of the wrist.

How is scaphoid fracture diagnosed?

Your physio would be able to pin down to scaphoid area by physical examination of the wrist joint and observation of certain features known as anatomical snuffbox. A detailed description of exact events that lead to the pain and swelling in the scaphoid area would be most helpful to your physiotherapist. You may also experience pain when your wrist is put in motion in certain specific ways. To confirm your fracture, typical scaphoid x-rays would be needed. Certain minimal fractures would not be obvious in x-rays and MRI and CT scans are also used.

How is scaphoid fracture treated with physiotherapy?

At our physiotherapy center, you will receive assistance in reducing the pain and swelling in the affected area mostly by using icing, or heat, and rest. Since it’s a fracture, we need to keep your wrist under casting for 9-12 weeks provided you have appropriate bony alignment in that area and all of your blood vessels and nerves are intact. A specially designed cast called thumb-spica cast is used, which would prevent your wrist from catastrophic movements. The time that you may be required to wear the cast depends upon the ability of your bones to heal and the degree of fracture occurred. Once the fracture is showing complete healing radiographically, your cast will be removed. It is common to experience some sort of stiffness and lack of movement in the initial days after cast removal. However, our physios will design client-specific exercises that will include stretching and strengthening exercises to increase the flexibility and range of motion of your wrist. You will be taught a number of exercises that you can continue doing at home to increase the stability of your wrist.

How different is rehabilitation after surgery?

Had you suffered a very severe injury that leads to misalignment of the bone, vessels, and nerves, you might need to undergo a surgery before we can plan rehabilitation. Once your surgery is done, you will be placed in a splint for up to 12 weeks for the healing process to take place. Once we have confirmed that you have a completely healed scaphoid we will remove the splints and kick start your physiotherapy program. You may experience some level of stiffness and lack of functionality associated with some pain and swelling in the wrist during your initial days of physiotherapy. We will fittingly help you to recover from pain and swelling and will move on to strengthening and stretching exercises so that you can regain full functionality of the wrist. Some exercises that we will prescribe will help you to recuperate the motor neuron functionality back to normal. You may also want to be watchful at least for some weeks not to pick up extra weight using your injured hand.

 Call us at (08) 9272 7359 today so we can a design your physiotherapy program.