1.Wrist construction:
Wrist (carpus)  - constructed of 8 bones of different shapes, aligned in two fitted rows.
The closer row contains (from thumb to pinky finger):
scaphoid bone
lunate bone
triquetral bone
pisiform bone
The further row (from thumb to pinky finger):
trapezium bone
trapezoid bone
capital bone
hamate bone

The wrist bones have each a couple joint surfaces, which are joined with the neighboring bones in both the closer and the further row. The two conjoined wrist rows form an arch with its concave side facing towards the palm surface, and its convex side towards the back of the hand. The palm (concave) side of the wrist has two bone protuberances called:

-eminantia carpi radialis (Radius)
-eminentia carpi ulnaris (Ulna)


Both protuberances are connected by the flexor retinaculum, closing the space between them and forming the so-called wrist canal.

1.Connections within the wrist:

The wrist is so flexible due to joint connections with many neighboring bone structures. Those joints are:
-radial-wrist joint
-midcarpal joint
-inter-carpal joints
-wrist-mid hand joints

Wrist-radial joint:
The joint pan is formed by the wrist surface of the radial bone and the articular disc (to be discussed further on in the article). The joint head is formed by the bones of the I wrist row, excluding the pisiform bone. The first wrist row connects with the radial bone, and then to the elbow bone by the means of the triangular gristle (multi-storied joint section, subject to repeated injuries). This is a double-axis joint, subject to bending and unbending, as well as adduction and abduction. Following ligaments are present in this joint:

- radial wrist ligament
- elbow wrist ligament
Present on both side parts of the wrist, impede adduction and abduction of the hand.
-radial-wrist palm ligament
-lateral lumbocostal wrist ligament
-elbow-wrist-palm ligament
Inhibit back of hand bending movement – arm straightening

- dorsal radiocarpal ligament
- ligamentum arcuatum carpi dorsale
Inhibit arm bending motions.

Midcarpal joint:
Otherwise known as further joint. Forms the first and the second wrist bone row, while the joint fissure is shaped like a horizontal letter “S”. Bending and straightening movement take place here.

Intercarpal joints:
Located between neighboring first – and second-row wrist bones. Bones are connected with joint capsules and ligaments. The ligaments are short and flat (because of their location). Movement in those joints is very limited.

Carpometacarpal joints:
The combination of II row wrist bones with the closest ends of intermetacarpal bones forms the carpometacarpal joints. They have very little mobility, with the exception of thumb joint.

1. Kontuzyjność w obrębie nadgarstka:
Z uwagi na zawartość bardzo wielu części ruchomych w obrębie nadgarstka oraz na dość sporą mobilność jest to struktura anatomiczna, w obrębie której dochodzi do dość licznych i trudno gojących się kontuzji.

1.Injury within the wrist:
Due to the presence of many mobile parts within the wrist it is an anatomical structure prone to many types of complicated and hard to heal iniuries.

Articulate disc problems:
A gristle structure appearing as an “insert” and forming, among others, the radiocarpal joint pane. It is triangular in shape and located on the elbow side of the joint, between the radial bone and a piece of elbow bone, and the I wrist row. It functions as a buffer in this part of the joint, mainly in relation to the adduction movements of the wrist (bending and adduction movements appear much more often during day than straightening and abduction). Serving as a buffer, it divides the joint into 2 layers, which serves as a filling for a “blank” that would appear otherwise. The more complicated structures and the more mobility within them, the bigger the risk of a pathology is – this universal rules applies here perfectly.

As mentioned before, the articulate disc serves as a buffer mainly to the adduction movements of the wrist, especially when combined with extreme bending. This is the most common position for a contestant when he gains an upper hand during a fight. After the opponent’s elbow is “opened” the wrist is then bent inwards and slightly adducted in the last phase of the movement. In that moment the high tension of the joint capsule and the tension within the wrist canal lead to high compression of the disc. Of course, injury is not instantaneous, but seeing as this movement is repeated many times, inflammation of the joint is unavoidable, and pain will follow. At first the pain is slight, aggravating only when performing maximum range movements (light severe stage). When not treated properly, it then evolves into the prolonged form of injury, which is much harder to cure. There is also a second form of forced movement that can lead to damage within this delicate structure. Straightening and abduction – appears in the losing stage of a fight, when a contestant’s wrist is unnaturally abducted and, trying to put up an opposition, is then adducted suddenly. That causes strain in the layered joint and the jamming of the articulate disc between the pisiformal or triquetral bone of the I wrist row, and the radial bone surface. The effects are similar  - inflammation during repetitive movement. As we can see, two extreme positions of the wrist can have a similar effect.
The pain that follows is often accompanied by a feeling of blockage in this part of the joint, and in later stages – swelling. It’s hard to diagnose at first, so it’s often necessary to use USG tests. The treatment involves taking a hiatus from training and competing, applying RICE cold temperature treatments and slowly following with warm temperatures and applying lasers. As a core method of treatment, manual mobilization techniques of joint slides should be used, with traction after the severe stage is cured. Proper physical treatment combined with delicate mobility should quicken recuperation. Avoid all training during treatment, as it can only lead to aggravating the severe stage even more. In extreme cases, injections with infiltration of the painful area can be applied.

Straining / tearing of ligaments:
One of the most common forms of injury within the wrist. These are osteogenetic structures with inhibitive functions within the joints. They are very elastic because of their collagen components. Tearing / straining comes from unnatural range of movement. In armwrestling the collateral ligament is mostly endangered, leading to instability in the sideways movements of the wrist (adduction / abduction). The problem targets the:

-collateral carpo-radial ligamenr
-collateral carpo-ulnal ligament

Although strains within those ligaments heal fast, tears require professional physio-therapeutical intervention. It is interesting, that after the severe stage is over (best treated with ice and immobilization); the best results come from light movements towards adduction, adding lateral massage (also successful in muscle therapy). Ligaments “like” to move, they heal much faster then. It is important to start this at the right stage of therapy, applied too soon it may cause the inflammatory state to hold much longer. Any tears shown by USG need to be immobilized for a period of time dependent on the size of the injury. It is sometimes necessary to quit training and rein in your ambitions for a while in order to avoid prolonged periods of pain.


Going back to particular ligaments, strains can also happen in other structures of the wrist. The two ligaments mentioned at the beginning are the statistically most common ones. Relatively common are also the abduction inhibitive structures. They can suffer injury in a situation when a contestant loses position, adducting his wrist to the maximum. Strains can happen then in:


•    Radiocarpal palm ligament
•    Arc-carpal palm ligament
•    Ulnocarpal ligament

The first one of those deserves special attention, as it has a few strings going from the processus styloideus to the particular bones of the I wrist row (scaphoidal, lunal, triquetral). With maximum ranges of movements one of the strings can strain, causing pains. The ulnocarpal ligament is often connected to this. It has an identical function, but it begins on the other side on the palm side of the elbow bone and ends at the fourth bone of the first wrist row – the pisciformal bone. The head of this bone is easily found by touch on the outside of the palm – it is the first protuberance by the pinky finger, near the wrist. If you experience pain in this area, there is a large possibility of  a strain.

Other wrist injuries:
Wrist tightness syndrome has a pathological basis, the components of which are:
-overload
-pressure
-increased pressure within the wrist
-prolonged pathological positioning

Also the joint capsule connected to surrounding ligaments can be subject to strain. Therapy is very similar to that of ligaments. That leaves us with blood vessels – arteries and veins. If we don’t suffer from wrist tightness, circulation should suffer no disturbance from armwrestling.
In this work we have listed the most common problems, that can happen to anyone; the wrist is a basic body part that often determines success. Injury is a part of any sport, we just need to approach them appropriately. I wish you all success without the mental strains of injury.

mgr Tomasz Kopeć.
BODYPAK.EU – Xtreme Body Trainers