A common complaint during Pilates classes is pain in the wrists when in a four point kneeling position to do exercises such as the cat stretch, superman and the plank.
Although they are great exercises to build functional strength and stability, these positions all require loading through the wrists.
The wrist is quite a complex joint and to support your weight there needs to be full extension in the wrist and some rotation through the forearm.
Full wrist extension is not a functional position, so we do not spend much time in this position during our normal daily activities. This means that the forearm muscles can get tight reducing the range of movement in the wrist. It also means we tend to be weaker in these unaccustomed positions. The combination of weakness and lack of flexibility has an impact on the loading through the joint and can cause pain.
To help reduce wrist pain in these positions we need to:
Think about posture. Good shoulder posture will allow you to stabilise and weight bear through the shoulder. Taking more of the load through the larger shoulder joint will offload the wrist. Elbows should be pointing back and not turning out to the side. Hands should be under shoulders with the thumbs under the arm pits. Hands should be flat, lifting or curling the fingers will but more weight on the heel of the hand increasing the pressure in the wrist.
Turn on your core muscles. ‘Sagging down’ or lifting the hips too high stops you using your core muscles effectively so you put more weight on your hands, straining the wrist. Focus on maintaining the neutral position by activating your core muscles.
Regular stretching of the forearm muscles will help reduce muscular tightness.
If these adjustments do not help with your wrist pain, you may have an underlying condition such as an acute muscle or ligament strain, carpal tunnel or a chronic condition such as arthritis. Physiotherapists are trained to treat wrist pain so book an appointment today for an assessment of your wrist.
For more information or advice on Pilates, one on one individualised Pilates sessions can be booked with any of our Physiotherapists in addition to the group classes.
~ Felicity Salenius, Physiotherapist