This article summarises the potential types of injury that can occur at the wrist and basic symptoms and treatment ideas. The wrist is a complex joint, so it is advisable to seek medical advice through your GP, casualty department or a chartered physiotherapist.

Wrist injuries in walkers tend to be caused by direct trauma: for example, falling and landing on an outstretched hand. In this case they may either fracture the wrist or sprain the ligaments in the area. Overuse injuries can also happen, where pain might develop over time, perhaps due to improper use of walking poles.

Fractures

Symptoms - Typically a walker will injure their wrist by falling on an outstretched arm. The fracture will be in the region of the small wrist bones or at the distal part of the ulna and/or radius. In either instance the person will feel extreme pain at the area and be very hesitant to move the hand at the wrist and fingers. Swelling and possibly deformity will be present. Strength will be severely reduced. The person will have a tendency to 'splint' the hand or arm in an elevated position to their chest.

Treatment - Basic First Aid sense is good treatment in this case. Support of the lower arm is vital and a triangular bandage to sling the arm will most probably be the most comfortable position for the walker. It is always a good idea to carry a triangular bandage in your medical kit. Get to A & E for a medical opinion as soon as you can. Small fractures in the carpal bones of the wrist can be hard to see. Early diagnosis is important. If fractured the wrist will probably be re-set and splinted in a cast. After the cast is removed physiotherapy can speed recovery, as the limb will need to be strengthened.

Sprains

Symptoms - Wrist sprains are not very common for walkers, but they can happen. A bad fall on a wrist that has not resulted in a fracture might have resulted in a sprain. The wrist will swell slightly, and be possible but painful to move. There will be some loss of strength. Most people will be hesitant to use it at first but will persevere. Immediately after injury the wrist will be more comfortable in a sling with support, but a tubigrip support will be sufficient to help it after a few days. Gentle range of motion exercises will help too. If the symptoms persist it is worth seeking medical advice, as there may be a small fracture in the wrist that gone unnoticed.

Treatment - Walkers can get thumb and finger sprains. Finger sprains feel like 'staved' fingers, but they recover well. Supporting them to the adjacent finger with some tape will make use of your fingers more comfortable. Make sure you tape above and below the offending joint and do not pull the tape too tight. Moving the fingers is good.

Thumb sprains happen when someone gets their thumb caught in something - often on the handle of their pole if they fall over. The web space gets over-stretched and the joint at the thumb knuckle gets injured. Gentle range of motion exercises will help recovery. It's worth supporting or taping the thumb and to make it more comfortable.

In most cases, the finger and thumb sprains will heal naturally over 2-6 weeks. If you feel that they are not getting better then seek medical advice in case something more serious has happened. If ever there is deformity or lack of major function then seek medical advice as quickly as possible.

Tendonitis

Symptoms - Overuse injuries to the wrist are not common but unusual repetitive actions can irritate tendon, perhaps where someone who has never used a walking pole, goes out for several days and uses poles the whole time. Here, the poles are not a piece of equipment that their wrist is used to, so using them can put unusual stresses on the wrist tendons. Continued usage can irritate and inflame the tendon.

Treatment - Initially, rest the area, seek advice on anti-inflammatory treatments from a pharmacist or doctor and stretch the tendons gently but regularly. If the pain does not diminish seek medical advice. In some cases a steroid injection might be appropriate. You can help to preventing tendonitis by keeping your forearm tendons stretched out, introduce new equipment gradually and learn to recognise early symptoms. Respond by reducing activity quickly and seek advice as necessary.