Wrist pain – I'm Handling It

Swimming is a great, low-impact form of exercise that gives a full-body workout. I knew that if I could stabilise my wrist enough, swimming would help me to build up strength in my arm that is still weakened after a fracture and nerve damage from a road accident. I tried several ways to stabilise the wrist, and found some great solutions.

Disclaimer: This blog post is based on my experiences. I am not a medical professional so always check with your doctor before trying new things that could aggravate your medical condition.

Support Tape (Lightweight Support)

Physio tape/ kinesiology tape/ sports tape is adhesive and slightly stretchy. It can be applied in different ways to best support muscles or joints during exercise. A waterproof tape should last for at least one swim session. Because this tape is designed to provide support without restricting movement, it’s on the lightweight side. Personally, several layers of tape wrapped around my wrist and crossing my palm were not enough to prevent my wrist subluxing when swimming.

If you have sensitive skin, tape might not be suitable for you.

Box of Rock Tape kinesiology tape. Photo of a woman on the box with tape applied to her upper arm and upper leg — Kinesiology tape

Neoprene Splint (Medium-High Support)

Neoprene splints are a comfortable support that can easily be removed and reused. Neoprene is slightly buoyant in water, and heavier when saturated when lifted out of water. For this reason, wearing a splint on just one wrist gives a slightly lopsided feel, especially when swimming frontcrawl, butterfly or backstroke. It feels less odd in breaststroke and is otherwise quite easy to adjust to.

Neoprene wrist splint secured across the back of the hand and wrist by velcro straps — Side view of neoprene wrist splint

Using a neoprene splint with a metal insert will restrict wrist movement the most, giving the most support. A metal insert will lock the wrist so that the back of the hand is slightly drawn backwards towards the wrist. Although possible to swim in this position, if you don’t require so much support, using a wrist wrap or splint without a metal insert will allow the wrist to move into a more streamlined swimming position. Click here for my reviews of different types of wrist splints. You could also combine a splint with support tape underneath.

Chlorine will damage the elasticity of the neoprene splint over time so it is important to rinse well after every use.

Forearm Fulcrums and Bolster Paddles (High Support)

Forearm fulcrums and bolster paddles are swimming aids designed to lock the hand and wrist in the optimum position for swimming (early vertical forearm position, or EVF). As well as supporting your wrist, they will improve your technique! All main strokes (breaststroke, frontcrawl/freestyle, backstroke, and butterfly) are possible using these swim aids. Because they alter your swimming style, it is recommended to try them out over short distances at first.

I use the FINIS Forearm Fulcrums which pass over the back of the forearm, under the wrist, and across the back of the hand in a figure 8 loop to lock the wrist in position. Rubber at the inside of the wrist and back of hand and arm prevents the Forearm Fulcrum from slipping. Because there is no fabric involved, they are very easy to care for. They come in two sizes: Junior for teens and petite adults, and Senior. I tried both sizes and although both worked for me, the Junior size was a better fit and didn’t require so much tension to hold the fulcrum in place when swimming.

I have palmar mid-carpal wrist instability and can happily swim using these without any subluxations or dislocations as my wrist is unable to move up or down when they are in place. I also have a partially-trapped median nerve, and preventing my hand from moving also helps to reduce nerve irritation and pain. The FINIS forearm fulcrums enabled me from not being able to use my right arm at all, to swimming 500m using both arms the first time I used them.

The FINIS Bolster Paddles are designed with the same goal of stabilising the wrist in the EVF position with a solid hand paddle to increase water resistance. The plastic paddle is secured around the forearm with two velcro straps, and the fingers are held in place by a rubber strap. I haven’t had the chance to try them yet so please leave a comment if you have/haven’t found them useful.

My recommendations for wrist supports to prevent subluxation and clenching at night.

I have a pain response where I tightly clench my fist and arm in my sleep. This causes my wrist to sublux (joint pops partially out) and stretches and irritates my median nerve, which was damaged in an accident. Both of these things cause more pain and perpetuate the cycle so a year ago my doctor recommended wearing a wrist splint at night to prevent these things from happening.

Recently I had to replace my splint and was a bit bewildered by all the different options, so I have tested and reviewed six supports below. All the splints cover the palm and include a metal bar up the inside of the wrist and bent into the palm. It’s more comfortable than it sounds and the bar helps to stop the fist from folding in towards the arm. When putting a splint on I clench my fist and arm muscles with my arm straight so that I won’t make the splint too tight or restrictive.

In an ideal world, consult with your doctor for the best advice. I appreciate we don’t all have the access we need at the moment and sometimes a quick fix or stopgap is helpful. For the same reason, although I try to avoid it, these are all links to Amazon. They have a huge range of wrist supports, and a decent return and refund system.

My original splint (Praxis)

My doctor gave me this splint when I first said I was having problems clenching my fist overnight. The strap around the wrist and arm is fully adjustable as it can attach to anywhere on the neoprene and provides enough support to stop my wrist from subluxing. It’s easy to line up and put on one-handed because of the way the big strap wraps around. The neoprene gives some additional warmth which I find nice except for on very hot nights. This splint comes quite high up over the palm of the hand so the design and the metal bar inside really stop the wrist from being able to flex.

I love this splint and find that it works really well and is very comfortable. The only downside is that attaching the Velcro to the neoprene causes it to fuzz and become less sticky over time. I think the lifespan of this splint if you wear it every night is probably around six months before the Velcro stops working. You can sew Velcro on top of the neoprene to increase the lifespan which I did but after about 12 months it’s really frayed and stretched beyond repair.

Splint #2 (Praxis, £5.99)

I bought this splint as a replacement for my worn out one. It’s the same brand, but a slightly altered design. They’ve changed the type of velcro on the wrist wrapping part, maybe to try to avoid the neoprene fuzzing. I’m not sure if it’s an improvement as I found this made it less sticky at the edges.

It’s one size fits all; I have small hands and wrists and find it comfortable and supportive enough. It restricts wrist movement curling the hand towards the wrist best, but doesn’t totally restrict wrist movement side to side.

Splint #3 (Actesso, £9.85)

I was looking for something that would be more breathable and cooler to wear in the summer. The design of this splint is quite a common one with panels of stretchy, breathable fabric at the sides. It’s quite difficult to put this splint on because has multiple straps and it’s tricky to hold the splint closed and line them all up. I chose this splint specifically because it looked the most breathable, but unfortunately because it has both elastic and thin parts, it doesn’t prevent my wrist from bending very much.

Splint #4 (BodyTec, £6.49)

This splint has a similar design to the one above but is made of neoprene. Again, from the side view it can be seen that the fabric of the splint doesn’t actually overlap itself. This does cut down on bulkiness but if you’re looking for a sturdy wrist support, it might be too stretchy. It was still possible for me to flex my hand inwards and sublux my wrist so I found this splint too flimsy and didn’t brace my hand well enough.

Splint #5 (Zofore, £13.97 but currently unavailable*)

If splints are like a prison for your wrist, this splint is Alcatraz. It’s very well made and sturdy, and the design ensures that skin doesn’t get trapped in the join. The straps are not stretchy and the middle strap wraps all the way around the arm and back on itself, making this splint the most supportive that I tried. It’s possible to tighten the straps so that you have no flexion in the wrist at all. I ordered the smallest size but the top strap is still a little long, so has to be positioned at an angle. Overall the fit is fine for my wrist and arm though. It is made of breathable fabric but now it’s cooler I haven’t noticed whether it’s effective.

The ‘strengths’ (literally) of the splint are also its weaknesses. Three straps are quite difficult to coordinate with one hand, especially the long middle one which sticks to everything when I’m trying to put it on. The first few times it was difficult to find the correct fit and not over tighten it, which led to me cutting off my circulation in my sleep, because it’s not so stretchy.

* Correct October 29th 2020

Wrist support (Dr Arthritis, £12.95)

Not a splint, but I sometimes use this wrap-around neoprene wrist support during the day. Although not as supportive, I find it useful if my wrist is feeling very weak and I have to do something where I need wrist flexibility like yoga or moving heavy things around. The neoprene strap that wraps all round the wrist gives the extra support I need to stop my wrist subluxing. Again because it’s neoprene it showing signs of wear, but I’ll probably replace it with the same kind because it is very comfortable.

I can’t speak for how well these splints will help for other wrist conditions like arthritis or carpal tunnel syndrome- you may find that you don’t need as much support or restriction of movement, or prefer to wear something less bulky. Several of the product pages state that they are used by the NHS although I’m not sure how you’d check that.

For preventing wrist clunching and subluxation at night, my top recommendation would be the Praxis splint, as I find it the easiest to put on and the most comfortable. Its only downsides are that it wears out relatively quickly (this may have been improved by the new design) and it can be hot to wear. The black Zofore splint was the sturdiest splint that I tried and was very supportive. I did find it difficult to get the fit right and coordinate the straps at first but have got the hang of it after a couple of weeks. I’d recommend putting a new splint on an hour or so before going to bed to get the fit right and avoid overtightening.

Tips for choosing a wrist splint:

Fewer straps will make it easier to put on
A strap that wraps all the way around the wrist will give better support
Stretchy and breathable materials might not provide enough support
Neoprene is a comfortable and warm material, maybe too warm
Doctors may advise against wearing splints in the day to avoid deconditioning muscle. Always speak to a doctor for the best advice

Tag: Wrist pain

How to Stabilise The Wrist When Swimming