Strengthen the wrist to prevent a fracture

If you have osteopenia (lower than normal bone density), you are at risk of developing osteoporosis. Osteopenia is early warning to take action to avoid wrist, spine, and hip fractures that can occur with osteoporosis. Specific exercises focusing on prevention will strengthen the bones and reduce the risk of a break.

What is your risk of wrist fracture with osteoporosis?

Fifteen per cent of all osteoporosis fractures occur at the wrist, compared to 40% in the spine and 25% in the hip.
While being the least common fracture site overall, a wrist fracture is the most common fracture before age 75.
Often the result of an outstretched hand to break a fall, a wrist fracture is a red flag for osteoporosis at any age.

Consequences of a wrist fracture

A wrist fracture is the least invasive type of break, compared to life-altering hip fractures and posture bending vertebral fractures. (Please note that not all bone density tests measure the wrist site, focusing instead on the hip and the spine).

However, in one study this “least invasive” fracture was linked to a downward spiral leading to increased frailty. Patients with osteopenia and a healed wrist fracture scored significantly lower on quadriceps strength, balance, physical ability, and quality of life compared to their age-matched peers.

Treatment for a wrist fracture

Simple cases require a cast
More complex cases require surgery and a cast for 6-8 weeks
Rehabilitative exercises for hand, wrist, forearm, elbow, and shoulder

Preventive wrist strengthening exercises:

Alignment mindfulness
Weight bearing for the arm and shoulder
Site-specific weight training

1. Alignment mindfulness

When working with external resistance like free weights or stretch bands, align your hand with your forearm so that your wrist is straight. Also pay attention to the position of your wrists when performing day-to-day activities like housework, computer work, and gardening to avoid putting repetitive force on a bent wrist.

2. Weight bearing exercises for the arms and shoulders

Pushup from the knees
Opposite arm & leg lift
Straight arm plank

When your arms support your body weight, as in the following exercises, your wrists will experience some strain and pressure. While this can be helpful for strengthening the bones, use caution if you have conditions like arthritis or carpal tunnel that could be exacerbated by the strain. In those cases, follow the guidelines for those conditions.

Pushup from the knees
All forms of pushups are weight-bearing through the arms and shoulders. If you are just beginning to work on strengthening your wrists, start with wall pushups, which put the least strain on the wrists, then progress to diagonal pushups before attempting floor variations.

If you have issues with your wrists, stick with doing pushups against the wall.
Kneel on the floor with your wrists directly under your shoulder, 3-4 inches wider than shoulder width apart.
Drop your hips and shift your weight forward onto your arms so that there is no direct pressure on your kneecaps.
Draw your abdominals in to keep your spine straight from shoulders to hips to knees.
Anchor your shoulder blades by drawing them down and together.
Inhale, as you bend your elbows out to the side, lowering your chest toward the floor.
Exhale as you straighten your arms and push up to the starting position.
Build up to 15-20 reps.

Pushup from the knees: Osteopenia wrist - Video 1

Pushups are weight-bearing through the arms and wrists, while building strength in your chest and shoulders.

Opposite arm & leg lift
Kneel on the floor with your wrists directly under your shoulders and your knees under your hips.
Look down to keep your head and neck aligned with your spine.
Contract your abdominals, and lift one leg behind you to hip height.
When you have your balance, reach the opposite arm forward at shoulder height.
Hold for a second, then slowly lower both your arm and leg to the start position.
Switch sides and repeat for 5-10 reps, alternating sides.

Opposite arm & leg lift: Osteopenia wrist - Video 2

Kneeling opposite arm & leg lift is weight-bearing through the arms and wrists, while strengthening the spine and challenging your core stability and balance.

Straight arm plank
Perform the plank with your arms extended for upper body conditioning.
On your hands and knees, position your wrists directly under your shoulders, step back one leg at a time until you are supported on your hands and toes.
Draw your abdominals tight to maintain one straight line from head to heels.
Build up to holding for 30- 60 seconds.
Straight arm plank: Osteopenia wrist - Graphic 3

The straight arm plank conditions the upper body, including arms and wrists. The forearm plank, performed with arms bent at the elbows, emphasizes the core.

3. Site-specific strength training

Strengthening your hands and wrists makes it easier to perform daily activities with ease, whether they include computer work, housework, or simple tasks such as being a le to open a jar or lift a full tea kettle. Should you happen to stumble. you’ll be able to break a fall with less risk of fracturing your wrist.

Wrist curl
Make sure that your working arm is supported on a firm surface, like your other arm on top of a cushion (as pictured) or table top or arm of a chair.
Begin with a light weight, even a soup can from the kitchen, and perform 10 reps of each exercise for both hands.
As you get stronger, build up to 3-5# weight and do 10-15 reps of each variation.

Site-specific strength training: Osteopenia wrist Graphic 4

From Strength Training Exercises for Women by Joan Pagano, DK Publishing 2014.

See related articles with videos: Exercises for Osteopenia of the Hip and Exercises for Osteopenia of the Spine

Disclaimer: The information presented in this article should not be construed as medical advice. It is not intended to replace consultation with your physician or healthcare provider.

Wrist Strengthening Exercises for Osteopenia