Week 4 and beyond : Hold for 30 seconds. Repeat 5 times. Do 2-3 times daily. Increase the resistance.
After week 4, slowly increase the hold time each week until you can manage 30 seconds. You can also increase the amount of resistance by pushing slightly harder with your good arm. At this point you can progress to the strengthening exercises described next.
2) Strengthening Exercise - Wrist Extension
Sitting down, put your painful arm on a table with palm down, and let your wrist hang over the table edge. Use a small hand weight or a water bottle to start with (approx 0.5 - 1kg) or yellow resistance band tied to a broom handle. If using a hand weight, slowly raise the weight upwards towards the ceiling, hold for a second and then allow it to slowly fall back down. Keep your forearm on the table throughout the movement.
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| Wrist Extension using a Hand Weight |
If using resistance band then wrap the band around the middle of a broom handle or rolling pin. Use a similar position to the dumb-bell exercise but grasp the handle with both hands this time. Now stand on the other end of the band with your foot and wind the broom handle until a suitable amount of resistance is felt. Keep it gentle at first.
The exercise involves slowly raising the handle up towards the ceiling while keeping your forearms supported on the table. Hold for second before allowing your wrists to slowly drop back down to the starting position.
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| Wrist Extension using Resistance Band |
Week 1 : Do the exercise 10 times, twice daily
Week 2 : Do 2 sets of 10-15 repetitions, twice daily.
Week 3 and beyond : Do 3 sets of 10-15 repetitions, twice daily
After week 3, slowly increase the dumb-bell weight (or put more water in the bottle) or increase the amount of resistance felt through the band (or change to thicker band eg. red colour)
3) Strengthening Exercise - Pole Winding
Tie a length of resistance band to the centre of a broom handle or pole. In standing or sitting, grasp the pole with both hands and stand on the other end of the band with your foot. Grasping the pole, reach out in front of you and start winding the band around the pole with both hands. You should wind the pole backwards, in the same direction as if winding a motorbike throttle. Keep winding slowly as the resistance band steadily tightens to a point where it starts becoming mildly painful (green or yellow level). Then slowly unwind the pole back down again.
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| The Pole Winding Exercise |
Repeat the exercise until you've been doing it for about 2 minutes and then slowly increase this to about 5 minutes as the weeks progress. The exercise can be repeated twice daily.
4) Strengthening Exercise - Forearm Pronation / Supination
Sitting down, rest your painful arm on a small table allowing your wrist to drape over the edge. Grasp a small hand weight or a rolling pin. Slowly rotate your forearm from the palm down position to the palm up position. Slowly build up to 3 sets of 10-15 repetitions over the coming weeks. Repeat twice daily.
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| Palm Up Mid Position Palm Down |
You can increase the resistance by holding the hand weight or rolling pin at one end, or by holding something which is heavy at one end, like a hammer.
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| Palm Up Mid Position Palm Down |
5) Strengthening Exercise - Towel Twist
This is a functional exercise which mimics the action of wringing out a wet towel. In standing, grasp a towel with both hands. Reach out in front of you with elbows straight. Then twist the towel by turning your wrists in opposite directions. Hold for 5 seconds and repeat 5 times. Then twist the towel in the other direction and again hold for 5 seconds and repeat 5 times. Over the coming weeks, slowly increase the length of time you hold the twist for, aiming for 10-15 seconds.
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| The Towel Twist Exercise |
The next 5 exercises are general whole arm exercises aimed at improving the strength of the main supporting muscles around the elbow and shoulder. These should also be done as part of a comprehensive strengthening programme which increases the likelihood of the problem getting better, and not recurring again in the future.
These following exercises should be done once daily for 3-4 days of the week. Build up slowly, aiming towards 3 sets of 8-12 repetitions. Use a weight that you can manage without causing pain, but which still feels like an effort for your muscles.
A hand weight, dumb-bell or resistance band can work well, or a water bottle (1 litre = 1kg) or a standard bag of sugar (1kg).
1) Biceps Curl
2) Forward Lean Rowing
3) Triceps Curl
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| 4) Single Arm Bench Press / Shoulder Press |
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| Single Arm Bench Press |
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| Single Arm Shoulder Press |
5) Wrist Ulnar and Radial Deviation
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| Wrist Ulnar Deviation |
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| Wrist Radial Deviation |
The exercise above can be done by holding a hand weight in the middle or at one end (as pictured) depending on how much resistance you need. A rolling pin, a hammer or even a golf club could also be used.
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