By Alan Williams, PT, OTR/L, ATC, CSCS

The orders are piling up. You’ve promised a sweater to the neighbor, your best friend wants a blanket for her daughter’s new baby, and the grandkids have each requested a hat in their favorite color. Normally you’d love the challenge of so much knitting to be done – if only your wrists didn’t hurt so much…

“Knitter’s wrist” (the affectionate term for the painful, stiff, weak, swollen wrists often suffered by serious, seasoned knitters) can be experienced by anyone who engages in prolonged or strenuous twisting, pulling, pinching, and gripping activities. Cooks, musicians, painters, writers, and others may also experience this condition. Actually, it’s not so much a condition itself, but more the end result of two possible common afflictions.

The first is Carpal Tunnel Syndrome (CTS). The carpal tunnel is a narrow ridge in the base of your hand that houses the median nerve as it stretches from your forearm into your hand. CTS occurs when the carpal tunnel becomes compressed, causing irritation and impaired function in the median nerve. The result is numbness and weakness of the hands in mild cases; untreated, this may progress into general immobility, muscle atrophy, and even nerve death in the most severe of cases.

The other possible culprit is tendonitis, which is inflammation of the tendon. Most often caused by overuse of the tendon, tendonitis is characterized by swelling, stiffness, aching, and pain that increases with activity. When tendonitis is left untreated (or when the afflicted area is not given enough time to heal properly), it often progresses into tendonosis – a chronic condition in which the tendon has sustained damage at the cellular level – and recovery is much more difficult.

While tendonitis and tendonosis can manifest in nearly any area of the body, knitters have their own special brand of tendonitis; known as tenosynovitis, or more specifically de Quervain’s tenosynovitis, this injury is characterized by inflammation of the tendons on the thumb side of the wrist. In de Quervain’s, any movement that requires grasping, making a fist, or twisting of the wrist will result in pain. These symptoms are also often accompanied by a “freezing” or “sticking” of the thumb, in which it becomes stiff and regaining mobility requires effort.

It’s important to determine whether your symptoms are originating from CTS or tendonitis so that a proper course of action can be taken. While both conditions will benefit from rest, ice and/or heat, and breaks during activity, there is a major fundamental difference between their treatments. Is your primary complaint weakness and numbness or pain and stiffness? Are your symptoms triggered by the position of your wrists or by the activity itself? If you answered “yes” to the former, you may have CTS. If you answered “yes” to the latter, you most likely have tendonitis.

Because CTS hinges on compression of the carpal tunnel, activity modification must be made to keep the wrist from being in extreme positions. Braces can help hold the wrist straight, and learning different knitting techniques and styles can also be beneficial as it allows for more types of positioning in your wrists and hands.

Since tendonitis is essentially an injury, this condition requires rest as a component for a full recovery. Rest does not mean complete inactivity, however, as tendons that aren’t allowed to move will become stiff, causing new problems. Gentle stretching and strengthening exercises will relax and rehabilitate the tendons and help prevent re-injury. Braces and wraps can also be used to support weakened tendons during daily activities.

While minor symptoms can usually be managed at home, symptoms that persist or worsen should be seen by a physical therapist or doctor. They will assist you in achieving a diagnosis and making a plan for recovery. But you don’t have to wait for the problem to get worse before being seen by a professional – early intervention always lessens recovery time. That’s good news because those sweaters won’t knit themselves.

Don’t let wrist pain hold you back. Call 463-0022 today for your FREE Wrist Pain Assessment!