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Hand, Wrist and Elbow

The office environment is not necessarily classified as hazardous, however the behaviours and postures adopted throughout a normal day could still be a detriment to health and well-being. The affect of the lockdown has encouraged more individuals to work remotely, be that from home or the office, where in some cases more time has been spent at a desk keeping respective industries live. The impact of this rise has augmented the prevalent risk for hand, wrist, and elbow injuries.



These injuries can range from muscle, tendon, and nerve disorders, which are linked to a variety of factors including normative behaviours, genetics, general well-being, and other health conditions that may be experienced.


Although resultant symptoms from such disorders may be caused or triggered by ergonomic factors in the workplace, they can be sourced o exacerbated through other means, including hobbies, recreational activities, driving and sleep positions.


Some causes for hand, wrist and elbow injuries at work have been identified through:


Repetitive motions

Doing the same motion over and over with few relief breaks can inflame or restrict an area from carrying out a task.


Remaining in one position

Sitting still in one position for long periods of time can cause your muscles and tendons to fatigue, thus losing their ability to support your posture.


Cold temperatures

The cold may impact your ability to move and function effectively rendering muscle and tendon to become more injury prone.


Pressure on nerves or tendons

Constant pressure on certain parts of the body, i.e. your wrist on your desk while you’re typing, can cause compression and inflammation over the nerves and tendons, which may lead to pain and immobility.


Joints in non-neutral positions

Sitting or standing awkwardly at a desk for long periods of time or ultimately maintaining a joint beyond their mid-range of motion over time can cause a depreciation of load tolerance at the hand, wrist, and elbow (and others that may be affected) and cause injury.

Although not an exhaustive list of influencing factors when it comes to desk relatable injuries, the reality is our behavioural “misuse” is more of a cause. Poor posture can affect the position and function of your vital organs, particularly those in the abdominal region. So sit up straight and promote your best health, using the core and back muscles.


Injuries of the hand, wrist, and elbow are generally highly preventable. If the potential ergonomic causes that may be contributing to a disorder are identified, you can likely make small cost-effective adjustments to promote comfort.



Sitting at your desk

  • Sit upright with your head and torso aligned vertically, your weight evenly dispersed in the chair and buttocks at the back of the seat.

  • Position the screen at least 20 inches in front of you, with the screen at eye level.

  • Adjust chair height or keyboard level so that your hands are slightly below your elbows. With your shoulders relaxed, start with your hands folded comfortably in your lap with your elbows flopped loosely at your side.


Using your keyboard

  • Raise your hands up, but keep them below the level of your elbows.

  • The back of the wrists should be flat or only slightly bent back.

  • Don’t rest your arms on chair arm rests while keyboarding; adjust or remove them if necessary.

  • Do not use wrist or palm rests. You should be positioned in a way that’s similar to playing piano… floating above the keyboard. No gel pads for the mouse either.

  • The keyboard position should be adjusted to allow for the elbow and wrist positioning described above.

Using your mouse


  • The mouse should be just to the side of the keyboard so that the elbow does not have to leave your sides nor out of reach.

  • The hand should remain below the elbow, and no pressure should be placed on the wrist.

  • There should be only light pressure between the mid-palm of the hand and the mouse, avoiding that on the wrist.

Keep moving

  • Take frequent micro-breaks from typing 5 seconds every 30 minutes to stretch overhead and improve posture.

  • Perform other tasks to break up long periods of typing.

  • Change position from time to time; adjust yourself in your seat, rotate your arms, stand up, twist your body, walk about.

  • Don’t pound the keys or put a stranglehold on the mouse.

  • Develop a smooth typing motion without flourishes and jerking movements.

A common injury experienced in a desk-based environment is Carpal Tunnel Syndrome. This disorder affects the hand and the wrist, causing pain due to chronic compression of the median nerve at the wrist, which runs from the forearm into the palm of the hand.

The carpal tunnel is a narrow, rigid passageway of ligament and bones at the base of the hand which does not accommodate well to the inflammation of the soft tissue that pass through. Often, it’s a combination of risk factors that causes the condition and resultant pain.

The symptoms of carpal tunnel syndrome include:

  • an ache or pain in your fingers, hand or arm

  • numb hands

  • tingling or pins and needles

  • a weak thumb or difficulty gripping


Similarly, its worth considering the chronic impact of poor posture may result in an aggravation of the tendons at the elbow, which may lead to Lateral Epicondylitis (Tennis Elbow) or Medial Epicondylitis (Golfer’s Elbow).

Lateral epicondylitis, commonly known as tennis elbow, is swelling of the tendons that bend your wrist backward away from your palm.


Tennis elbow can be caused by trauma to the elbow or more often by repeated stress on the elbow tendons such as from sports or use of certain tools. Symptoms of tennis elbow can include pain or weakness when grasping and aches or pain in the elbow area.


Medial epicondylitis - commonly known as golfer's elbow is a type of tendinitis, inflammation or irritation of a tendon. Overuse of the muscles or injury causes small tears in the tendon that connects the elbow to the wrist. These tears cause swelling of the tendon and pain.

A person with medial epicondylitis typically experiences pain when they bend the wrist toward the forearm.

The symptoms of Golfer's elbow include:

  • Pain and tenderness - can be felt on the inside of your elbow and may radiate down to inner side of your forearm.

  • Stiffness - making a fist may hurt.

  • Weakness - in your hands and wrists.

  • Numbness or tingling - may radiate into one or more fingers — usually the ring and little fingers.


Keeping your body moving and supple is the best way to lower the prevalent risk of injury. Having identified some of the ways in which to provide a more comfortable working space there are also actions we can use to physically condition and relieve the elbows, wrists, and hands from overuse pathologies.


To start you off, here are some movements to support healthy hands, wrists, and elbows:

Try these exercises twice a day and you will be conditioning yourself against injury risk!


1. Wrist extensor stretch

  • Straighten your arm fully.

  • Relax your wrist so that you leave your hand hanging.

  • With your other hand, gently push against the

  • back of your hand so it bends towards you.

  • Feel a stretch along the top of your arm.

  • Relax.






2. Wrist flexor stretch

  • Straighten your arm fully.

  • Relax your wrist.

  • Use your other hand to gently pull your fingers towards you.

  • Feel a stretch in your wrist muscles.





3. Extensor strengthening

  • Rest your forearm on a table.

  • Hang your wrist and hand off the edge.

  • Hold a light hand weight or a can of beans.

  • Moving only your wrist, raise the weight. Hold

  • for 10 seconds then slowly lower it.

  • Repeat this x10.




4. Wrist Curls

  • Hold a light hand weight or can of beans.

  • Rest your forearm on a table, palm facing up.

  • Hang your wrist and hand off the edge.

  • Moving only your wrist, gently raise the weight.

  • Hold here for 5 seconds.

  • Gently lower the weight.

  • Repeat x10.



5. Handshake Stretch

  • Holding the weight or can with your thumb pointing up. (Imagine you are going to shake hands with someone)

  • Move the can or weight up and down slowly.

  • Keep your arm still by resting it on the table and only move your wrist .






6. Wrist Rotations

  • Hold the weight or can in your hand with your thumb pointing up.

  • Turn the wrist inward as far as possible.

  • Hold for 2 seconds.

  • Then turn the wrist outward as far as possible.

  • Hold for 2 seconds.

  • Repeat as many times as you can.




7. Sock squeeze

  • Hold a rolled-up sock / tennis ball.

  • Make a fist around it and squeeze.

  • Hold the squeeze for 5 seconds.

  • Relax. Repeat x10.










8. Bicep Curls

  • Hold a light weight or can of beans.

  • Secure your injured elbow with your other hand or by sitting in a chair and resting it on your thigh.

  • Slowly curl the weight up towards your chest and down again.

  • Repeat this x10.






We hope by trying one or more of these tips you may enjoy a healthier and more productive day. For further support specific to you please contact us: trapezius.physio@gmail.com or simply call on: 01908 973090 to connect with one of our specialists.

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