Wrist Injuries

The wrist is a complex structure that takes significant stress in calisthenics—often in positions most people never trained before starting bodyweight training. Handstands, push-ups, L-sits, and planche work all demand wrist extension and load-bearing that the average person's wrists aren't prepared for. This chapter covers common wrist injuries and how to build resilient wrists.

Red Flag Warning: Seek immediate medical attention for: obvious deformity, complete inability to move the wrist, severe pain following a fall on outstretched hand, numbness in fingers that doesn't resolve, or significant swelling with inability to grip.

Wrist Anatomy Overview

The Wrist Joint Complex

The wrist isn't a single joint but a complex of joints working together:

Radiocarpal joint:

• Between radius and proximal carpal row
• Primary site of wrist flexion and extension
• Bears the majority of load in push-up positions

Midcarpal joint:

• Between proximal and distal carpal rows
• Contributes to wrist motion
• Important for fine motor control

Distal radioulnar joint:

• Between radius and ulna
• Allows forearm rotation
• Critical for varied hand positions

Carpal Bones

Eight small bones arranged in two rows:

• Proximal row: Scaphoid, lunate, triquetrum, pisiform
• Distal row: Trapezium, trapezoid, capitate, hamate

The scaphoid is particularly important—it's the most commonly fractured carpal bone and crosses both rows.

Key Soft Tissue Structures

Triangular Fibrocartilage Complex (TFCC):

• Stabilizes the ulnar (pinky) side of the wrist
• Acts as a cushion
• Commonly injured in calisthenics

Ligaments:

• Multiple ligaments stabilize the carpal bones
• Scapholunate ligament is commonly injured

Tendons:

• Flexor tendons (palm side)
• Extensor tendons (back of hand)
• Tendon sheaths can become inflamed

Common Wrist Injuries in Calisthenics

Wrist Pain from Extension Loading

What it is: Pain during weight-bearing on extended wrists—the most common wrist issue in calisthenics.

How it happens:

• Handstand training on unprepared wrists
• Push-ups, planche leans, and L-sits
• Sudden increases in floor-based training volume
• Insufficient wrist preparation and conditioning

Symptoms:

• Pain on the back of the wrist during weight-bearing
• Stiffness after training
• Pain may be diffuse or localized
• Usually worse with more extension angle
• May improve with warm-up, then worsen with volume

Contributing factors:

• Limited wrist extension range of motion
• Weak wrist extensors
• Training too much too soon
• Insufficient warm-up
• Poor hand positioning

TFCC Injuries

What it is: Damage to the triangular fibrocartilage complex on the ulnar (pinky) side of the wrist.

How it happens in calisthenics:

• Repetitive loading with wrist extended and ulnar deviated
• Falls onto outstretched hand
• Rotational forces through the wrist
• Planche and handstand training with poor positioning

Symptoms:

• Pain on the pinky side of the wrist
• Clicking or catching sensation
• Pain with gripping and rotating
• Weakness in grip
• Pain pressing on the ulnar side of wrist

Types:

• Traumatic tears (from acute events)
• Degenerative tears (from chronic wear)
• May occur with or without instability

Ganglion Cysts

What it is: Fluid-filled sacs arising from joint capsules or tendon sheaths—common in people who stress their wrists repeatedly.

Characteristics:

• Firm, round lumps typically on the back of the wrist
• May appear suddenly or gradually
• Can fluctuate in size
• Sometimes painless, sometimes painful
• May cause weakness or discomfort

Treatment:

• Often resolve on their own
• Aspiration (draining) is an option but recurrence is common
• Surgical removal for persistent symptomatic cysts
• Generally don't require stopping training if painless

Tendinopathies

De Quervain's tenosynovitis:

• Affects tendons on the thumb side of the wrist
• Pain with thumb movements and gripping
• May occur from high-volume grip work

Extensor tendinopathy:

• Pain on the back of the wrist
• From repetitive extension loading
• Similar symptoms to general extension loading pain

ECU (extensor carpi ulnaris) tendinopathy:

• Affects tendon on ulnar side of wrist
• Pain with wrist extension and ulnar deviation
• Can sublux (slip out of groove) in some individuals

Carpal Instability and Ligament Injuries

What it is: Damage to ligaments that hold carpal bones in proper alignment.

How it happens:

• Falls onto outstretched hand
• Sudden high loads through extended wrist
• Repetitive stress over time

Types:

• Scapholunate ligament injury: Most common carpal ligament injury
• Lunotriquetral injury: Ulnar-side instability

Symptoms:

• Deep wrist pain
• Clicking or clunking
• Weakness
• Pain with certain movements or positions
• May feel like wrist "gives way"

Important note: Significant ligament injuries may require surgical consultation. Don't ignore persistent instability symptoms.

Stress Reactions and Fractures

What they are: Bone stress from repetitive loading, ranging from bone marrow edema (stress reaction) to actual fracture.

How they happen:

• Excessive handstand training
• Rapid volume increases
• Training through significant pain
• Can affect radius, ulna, or carpal bones

Symptoms:

• Localized pain that worsens with activity
• Pain with weight-bearing
• May have point tenderness
• Doesn't improve with typical rest periods

Red flag: Suspected fractures require imaging. The scaphoid bone is notorious for fractures that don't show on initial X-rays.

Wrist Strengthening Protocols

Building Extension Capacity

The key principle: Build your wrist's ability to handle extension loads gradually.

Progressive loading sequence:

1. Wrist extension stretches (unloaded)

   • Prayer stretch
   • Floor stretch (fingers pointing forward)
   • Hold 30-60 seconds, gentle intensity

2. Loaded wrist extension prep

   • On all fours, rock forward over hands
   • Gradually increase load through hands
   • Work toward tolerance at increasing angles

3. Rice bucket training

   • Submerge hands in bucket of rice
   • Perform extensions, flexions, rotations
   • 2-3 minutes of various movements

4. Weighted wrist curls (reverse)

   • Light dumbbell, wrist extension
   • 3 sets of 15-20 reps
   • Build up weight gradually

5. Wrist push-ups

   • Push-ups on back of hands (with padding)
   • Builds extensor strength under load
   • Progress carefully

Building Flexion and Radial/Ulnar Strength

Wrist curls:

• Standard wrist curl for flexors
• 3 sets of 15-20 reps each direction

Radial and ulnar deviation:

• Hammer curls with offset weight (weight toward one end)
• Or specific radial/ulnar exercises with light dumbbell

Pronation and supination:

• Hammer rotation exercises
• Important for TFCC health

Grip Strengthening

For wrist support:

• Dead hangs (straight arm)
• Farmer's carries
• Towel hangs
• Crushing grip exercises

Strong grip supports wrist stability during training.

Prevention Protocols

Wrist Warm-Up Routine

Perform before any wrist-loading training (5 minutes):

1. Wrist circles: 10-15 each direction
2. Prayer stretch: 30 seconds
3. Reverse prayer: 30 seconds
4. Finger pulses on floor: 15-20 reps
5. Wrist rocks on all fours: 30 seconds
6. Fists on floor (back of hands): 15-30 seconds
7. Progressive loading: Gradually increase weight through hands

Training Modifications

For sensitive wrists:

Change hand position:

• Use parallettes to keep wrists neutral
• Use push-up handles
• Turn hands out slightly in push-up variations
• Use dumbbells for floor pressing

Reduce extension angle:

• Incline push-ups
• Elevated surface for planche leans
• Partial range handstand holds

Build volume gradually:

• Don't jump into high-volume floor work
• Progress time in extended positions over weeks
• Monitor for early warning signs

Movement Technique

Push-up hand position:

• Spread fingers wide
• Grip the floor actively (don't collapse)
• Weight toward heel of hand and fingers, not just base of palm
• Experiment with hand angle (slight turnout may help)

Handstand hand position:

• Spread fingers
• Active grip (fingers create balance)
• Load through whole hand
• Avoid collapsing wrist toward palm

L-sit and planche:

• Can be done on parallettes if wrist extension is limited
• Build flexibility and strength before attempting floor versions
• Progress gradually

Treatment Approaches

For General Wrist Pain from Loading

Phase 1: Reduce irritation

• Modify training to reduce pain
• Use parallettes/handles temporarily
• Continue mobility work if pain-free
• Ice after training if helpful

Phase 2: Build capacity

• Wrist strengthening program
• Gradually reintroduce extension loading
• Progress floor work slowly
• Continue warm-up protocol

Phase 3: Return to training

• Gradually increase volume
• Maintain strength and mobility work
• Monitor for recurrence

For TFCC Issues

Conservative management:

• Avoid provocative positions (ulnar deviation under load)
• Bracing or taping may help
• Gradual strengthening
• Often improves over 6-12 weeks

When conservative fails:

• May require imaging (MRI arthrogram)
• Some tears benefit from surgery
• Others can be managed with modification

For Ganglion Cysts

Options:

• Observation (many resolve)
• Aspiration (temporary relief)
• Surgery (if persistent and problematic)

Training:

• Usually can train around them
• Avoid direct pressure if painful
• Don't "bible bump" them (old myth—risks injury)

Return-to-Training Guidelines

After Wrist Pain or Tendinopathy

Criteria to progress:

• Pain-free in daily activities
• Full range of motion
• Completed strength-building program
• Able to tolerate light loading

Protocol:

• Start with neutral wrist positions (parallettes)
• Gradually reintroduce floor work
• Increase volume before intensity
• Continue wrist prep as permanent habit

After More Significant Injury

TFCC, ligament injuries, or fractures:

• Follow medical provider's guidance
• May require imaging to confirm healing
• Progress may be slower (months)
• Some modifications may be permanent

When to Seek Professional Help

See a healthcare provider if:

• Pain doesn't improve after 2-3 weeks of modification
• There was significant trauma (fall, acute event)
• There's clicking, catching, or instability
• Numbness or tingling in fingers
• Visible swelling or deformity
• Pain is localized and point tender (possible fracture)

What to expect:

• Physical examination
• Possible X-rays (may miss some injuries)
• Possible MRI or CT for persistent issues
• Treatment plan based on diagnosis

Key Takeaways

1. Wrists need progressive conditioning—don't jump into high-volume extension work
2. Warm up is non-negotiable—5 minutes can prevent months of pain
3. Parallettes and handles are valid tools—not crutches
4. Strengthen all directions—extension, flexion, rotation, grip
5. Hand position matters—spread fingers, grip actively, experiment with angles
6. Don't ignore TFCC symptoms—ulnar-side pain needs attention
7. Build capacity before demands—strength and mobility before high-volume skills
8. Falls are a risk—if you're doing skills where you might fall, wrist preparation is extra important