Kienbock disease is a progressive condition that occurs when the blood supply to the lunate bone, one of the 8 main bones in the wrist, is disrupted.
This loss of blood supply can happen for various reasons; the most common is trauma to the wrist experienced from falling onto an outstretched arm and hand. Other instances where blood supply to the wrist can be disrupted include varying lengths of the forearm bones, an irregularly shaped lunate bone, repetitive wrist stress, or certain medical conditions such as gout, lupus, or sickle cell.
All of which can lead to Kienbock’s wrist.
This post discusses the exercises and physical therapy treatments required to help patients regain full strength and wrist mobility, as well as the benefits of hand therapy in promoting long-term hand health.
Kienbock’s wrist
- Symptoms of Kienbock disease can include:
- Pain in the wrist, hand, fingers, and forearm.
- Swelling around the wrist area, moving into the hand.
- The area is sore to the touch, tender.
- Limited motion, with a need to keep the wrist as still as possible due to increased pain with movement.
- Weak grip strength, which continues to decrease as the disease goes untreated.
Kienbock’s disease therapy
A big part of recovery after surgery to correct Kienbock disease is the set exercises and physical therapy we, as hand and wrist specialists, use to help patients maintain flexibility and strength. These start with gentle motion techniques and progress to strengthening exercises as mobility and muscle strength increase.
Kienbock treatment can also include heat and cold therapies to reduce pain and swelling, as well as techniques such as soft tissue massages and joint mobilisations, such as splints and casts, to reduce pain, swelling, and prevent movement to allow bones and tissue to heal appropriately.
Some of the main Kienbock stretching exercises include:
Wrist flexion – a technique that involves bending the wrist down while bringing the palm towards the forearm. This is often repeated several times, with each instance becoming easier as the wrist heals.
Extension exercises – similar to wrist flexion, this technique involves bending the wrist backward while bringing the palm toward the forearm.
Wrist supination and pronation – this exercise involves extending the arm out in front with the palm facing down. You will then be asked to slowly rotate the wrist, turning the palm upwards, holding this position for a set time, before releasing and returning to the original position.
Wrist radial and ulnar deviation – with the arm extended out in front and the palm facing down, bend the wrist toward the thumb side of the hand (radial deviation), slowly moving the hand toward the outside of the forearm. This exercise will be repeated several times as appropriate. For ulnar deviation, in the same position, move the wrist towards the little finger side, moving the hand towards the inside of your forearm.
Specific strengthening exercises can range from:
Wrist curls – once the specialist is happy with your progress, you will move to wrist curls using a weight, continuously curling and flexing the wrist to build strength and muscle function.
Finger curling and extension – all movement of the hand is connected to the wrist, so it’s important to keep all parts of the hand working, including the fingers.
Grip strengthening: Here, stress balls are typically used to improve flexibility and regain strength.
Wrist rotations – small circular movements with the wrist can help to build and strengthen muscles, as well as help increase the range of motion.
Note: Ergonomic assessments should be carried out to ensure long-term wrist health and to put in place proper, corrective measures that allow patients to continue with everyday activities.
These assessments should be carried out both when the patient is at home or at work, and when taking part in physical activity, where the healing of the wrist could be compromised.
Why is physical therapy for Kienbock important?
It’s important to get the right treatment in good time to have the best chance of regaining full wrist function.
With tailored treatment plans and exercises designed around the stage of your condition and your response to treatment, physical therapy can reduce pain and help you get back to daily activities and activities you enjoy in no time.
Designed to strengthen the wrist, improve range of motion, reduce pain, and prevent further damage, exercises for Kienbock disease aim to strengthen the muscles surrounding the wrist joint, stabilise the wrist and provide ongoing joint support.
Therapy Kienbock
The right exercises, along with encouraging patients to participate in physical therapy, will provide the best chance of a full recovery.
Kienbock disease is a progressive condition and will only worsen if left untreated.
At Ladan Hajipour, we specialise in a range of hand and wrist conditions, providing all our patients with high-quality treatments that help put them on the right path to recovery.
For specialist treatment you can trust, speak with one of our hand and wrist specialists today.
Call 0808 101 0337
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