How do I recovery after wrist injury?
Hello everyone, I was a massage therapist up until two years ago and I enjoyed it, but I sustained a sports injury to my right wrist that ended my career. It caused severe tendonitis. However, I would like to return to massage, but only doing a minimal amount in order not to injure myself again. Do you think this is feasible? I had physio on it and two steroid injections into the wrist, but two is my limit. They worked, but I don’t want steroids in my body again. Do you have any advice for me please? Kind regards to all, Jane.
I think this post is from a long time ago and so you probably have sorted this by now. Its a little difficult to give a comprehensive answer as you did not mention where in your wrist the pain is. I will assume it is at the base of the thumb on the side of the wrist as this is the most common place. You need to look at why the overuse occurred. When it comes to tendons a typical reason is a sudden increase in workload and stress on the area. When this happens the tendon has not trained up to have the 'capacity' for such work and gets overworked and inflamed. If it then does not have sufficient time to recovery properly before being stressed again then it will go into the next massage session weaker and more easily aggravated than before and instead of progressively getting stronger and more tolerant over time the opposite happens and you end up in a cycle of inflammation, incomplete repair and further injury. To get past an injury like this you have to gently increase its tolerance by starting with isometric exercises, progression to concentric and then eccentric exercises for the local area. Once you are pain free when not massaging then you can gradually re-introduce massage but with steady increases and a day off between massage sessions to allow adequate recovery so that the tendon progressively gets stressed enough to stimulate it to get stronger but not so much/ so frequently that it gets overloaded to the point of injury. In this way eventually you can get back to 6-7 hours of massage in a day, but it does take time. Plan for this 6-7 per day goal to take at least a year.
Aside from the local area of pain, you need to look at what else is impacting and stressing that area. Commonly working ergonomics are not good, the wrist/ thumb falling into compressive positions onto the affected tendon. If you are not using your body weight to apply the pressure and instead are relying on pushing with your arms this will also overstrain all of your hands. If you are not hydrating well or eating enough when you work then you will lack energy and circulation which will negatively impact any injured area. If your shoulder and scapula muscles lack strength and stability you will end up using and compressing your wrist in a way that causes or aggravates a wrist injury, and likewise, if your thoracic spine is stiff or your breathing mechanics are sub-optimal then it will impact on the way you move.
A really valuable thing to do is video yourself massaging and then do an honest evaluation of what might be in need of correction. If you are unsure then show it to a trusted colleague who can give feedback.
Get a full assessment by a physio, functional movement specialist, osteopath to figure out which areas of the body are not doing their job properly so that you can address these and hence get the 'overwork' off your wrist when you are doing massage.
In recovery you must also ensure you are eating lots of protein, you need this to help rebuild the collagen, you need hydration for oxygenating the injured tissue, you need omega 3s to take care of the inflammation. Sleep is super important as is resting the area after any periods of stress, and this includes things like a tablet and smartphone use.