Hey, everybody! Welcome to Episode 8 of the Upright Health podcast. This is Matt Hsu. And today, we are going to be talking about a problem that Liam from Ireland has with his wrist. So Liam wrote me a message on YouTube about the problem that he’s been having with a clicky wrist. He’s had it for years. It does get worse when he does bench press or press ups. He’s looked up online anything that he could do to help it. It doesn’t get inflamed. It doesn’t get swollen, but it just feels like he need to rotate it and click it sometimes. It does get a little bit sore.
He’s found a lot of trigger points in his forearm muscles. And when he works those trigger points, he does get some relief but that relief only lasts a last few minutes. He’s done dry needling up and down his forearm and shoulder and nothing helped. He also feels like there’s no stretch in the world that helps as the joints seems so far removed from muscles involved. So he was asking me for some ideas and he said anything, basically any ideas, he’d love them. In Ireland, it’s like going back in time when it comes to this kind of stuff. That’s his quote, not mine.
Well, Liam, I think in Ireland, in the United States, in many parts the world, when you’re dealing with musculoskeletal stuff, it is like we’re going back in time. And trying to get straightforward advice about what you can do about muscles seems extraordinarily difficult — well, to get good advice is extraordinarily, extraordinarily difficult. It’s very easy to get bad advice like cutting things, stapling things down and shaving down bones — very easy to get that advice.
Anyway, Liam, his question is about his clicky wrist. So what we hear in his message is that he has already done stretching. He’s already done massaging. So what that tells you is that the problem is very unlikely to be a problem that comes from having over tightened muscles, and over active, overly strong musculature of his forearm. If the problem were really just because the muscles in the forearm and tendons were all over tightened and unhappy, then stretching and massaging should have made some sort of difference for him. But they have not.
So we can, right off the bat, rule out the problem being a result of his forearms being overly tight. And it certainly doesn’t sound like he has any kind of like nervy issue. It that doesn’t sound like he’s compressing things which would make his hand go numb like in Carpal Tunnel Syndrome or anything like that, which is a total other topic. But it does sound like he’s got an issue that can be addressed with an approach other than the one he’s thinking.
So what approach can Liam take? We’ve already stretched. We’ve already massaged. The only other choice you have when trying to troubleshoot something like this is to strengthen. Actually, let me back that up. You have two choices: your other choice is to start looking at other parts of the body that may be influencing the movement — patterns that would affect the part that currently hurts. Liam could also look at shoulder positioning to see if his… he’s mentioning he’s doing bench press and press seems to bother him.
He could also be looking at whether his triceps are actually doing something at the elbow, if they are overly tight, if his triceps are doing something to the elbow that’s then affecting the way the muscles of the forearm work. He could also check to see if the pectoral muscles are getting overly tight and dragging his shoulders forward, in such a way as to cause moderate impingement up under the clavicle, if that is throwing off the way the biceps muscles are helping keep the arm in place or whether deltoids are now going a little bit funky. You can definitely be looking at other parts of the body to help re-position, to make sure that those things are not throwing off the mechanics around the area that is currently symptomatic.
Now then the other option, let’s assume that that’s already taken care of, although for most people, it’s not. I would definitely be looking there first. But assuming that that’s taken care of, we also want to think about, “Well, if this is a local problem with the problem really stemming from for something from the elbow down, then what can we do?” If we already rule out stretching and massage, then the only thing that’s left is to try to build some strength.
Now, with bench press and with pressing, the way you hold the bar definitely does put a bit of a stability challenge to your wrist joint. Your hand is bent back a little bit. You’re going into wrist extension. And so in doing so, you actually can get a little bit of wiggle. You can probably feel this yourself. You get a little bit of wiggle in your wrist. And if you got a big, heavyweight coming down on your hands, that could definitely cause some stress and be a bit of a challenge to the wrist joint stability.
Now, how you can actually make the bench press… I assume he’s talking about overhead press, harder on yourself is to hold the bar wrong. And that is possibly something Liam is doing. So Liam, I would definitely suggest you make sure you have the bar in the heel of the hand, and not in the middle the hand at the base of fingers, and then bending the wrist back. That’s going to destabilize your wrist and cause you some of those problems. You wanna double check to make sure you’re holding the bars correctly when you’re pressing them, either over chest or over your head. And make sure that your wrist in this is in as neutral a position as possible while you’re exercising.
If even that doesn’t seem to help, then you may have some pretty good weakness in your wrists. So what you’re going to wanna do is do some boring exercises to try to get your wrist’ stability higher. That can be as simple as doing barbell curls or dumbbell curls. You could be doing wrist curls. Even overhead pressing with dumbbells. If you have a kettlebells, you could do bottoms up kettlebell presses. Things like that, that actually force the wrist to stabilize in a neutral position probably would be very, very helpful.
Clicking is usually a sign that something is not stabilized in the way that it should. So, forcing your muscles to actually stabilize it would do you a whole world of good. I should add that clicking is not always coming out of a joint though. A lot of people tend to thinking that clicking and popping only comes out of joints. Well, the story goes that the popping in joints is from oxygen escaping the joint. In my experience, that may be possibly true for some popping that’s coming out of joints. I’ve also had scene popping happened in areas where there are no actual joints for that to happen. So I’m pretty convinced that you also can have clicking and popping actually from within muscle tissue. I don’t know where that comes from, but I’ve definitely heard it, felt it and experienced it. And that is also something that people can get around other joints.
Around the wrist, I don’t think you see it so much. And in fact I think around the wrist, you probably only get the clicking at the wrist. Especially around the hips and near the knees, you can definitely get some other types of clicks and pops that are not coming directly out of the joint. And those are a topic for another day, but definitely something to pay attention to because those usually tell you something about the weakness of the actual muscles that are popping.
So, Liam, to recap, a couple ideas are to double check your form. Make sure you’re actually doing the thing correctly – doing your bench press correctly, doing your overhead press correctly. And then also to deal with the lack of strength in the forearms, rather than focusing on trying to massage and stress things out. The basic protocol that I always take when I’m helping somebody train to get better and stronger, more mobile, is to test my idea, test their idea, figure out if it is actually the right way to do things. If after about two weeks we’re not getting any results in any positive direction, then we need to switch it up and try something else.
So it sounds like you’ve done the massage and stretching. If that’s not working, then you need to flip things around and start looking at other pieces of the puzzle, and see if you can make some progress that way. So to everybody else, all of you who are not Liam, I hope listening in on this little podcast has been helpful for you today, and helps you troubleshoot some of your own issues. This is Matt Hsu, reminding you that, “Pain sucks. Life shouldn’t.”