One of the most common areas people experience chronic pain is in their wrist and fingers. There are many reasons for this ranging from auto-immune inflammatory conditions, to over-use and repetitive activities, to traumatic accidents in sports. Your hands are made up of lots of little bone connections and are particularly vulnerable to pain and swelling when something goes wrong. Also the fact that you need to use your hands to complete many of your daily tasks, greatly diminishes their ability to heal. Therefore, it is critical that you find ways to combat the ongoing stiffness and pain with exercises to restore their mobility and strength to avoid disrupting your entire life. In this article, I will discuss some great exercises you can use to do this and the best part is they are great at preventing problems if you don’t have anything wrong with your hands!

When the joints in the fingers, thumbs, and wrists become stiff and swollen everyday tasks, such as opening car doors and brushing teeth, can become challenging and painful. Hand exercises can help stretch and strengthen muscles and tendons, help relieve symptoms, and improve hand function.

If anyone knows about hand and wrist pain it is me. I have broken my right wrist twice, and broken several of my fingers including my left thumb over the years, my right index finger I have broken 5 times! While all of these injuries healed well and have not caused me any ongoing problems in recent times I experienced a whole new level of pain in my hands.

In 2021 I developed an auto-immune disease called Psoriatic Arthritis that made my finger on my left hand swell up like a balloon and also both of my wrists. As the disease progressed it moved to my knees, my back, and even my shoulders. While I am a lot better than I was in 2022 the ongoing pain and fatigue from this is relentless. More on this later.

While I have experienced several types of hand pain caused by traumatic accidents or disease, there are many people suffering with chronic pain that are not caused from an auto-immune disease or a fracture. The reasons they are dealing with pain are varied and often a combination of factors.

Let’s take a look at some of these different types of pain for the treatments required will be significantly different.

Understanding Arthritis

It is important to understand that arthritis is divided into two primary types:

1. Osteoarthritis which is the most common form of arthritis and associated with wear-and-tear from poor movement.
2. Auto-immune and inflammatory arthritis such as Rheumatoid and psoriatic arthritis, which are auto-immune diseases. 

Synovial fluid is the liquid that fills the empty space within your joints, providing lubrication and support. With auto-immune conditions and inflammatory arthritis the body tends to send excessive amounts of synovial fluid to the joint causing it to swell and become inflamed.

With osteoarthritis it is the exact opposite as there is a decrease in synovial fluid causing the joint to have this feeling of bones rubbing together as seen in the picture below.

Let’s quickly discuss these in more detail for it is important to understand what causes these conditions to find the correct remedy.

Osteoarthritis

Osteoarthritis is a degenerative condition of the joints, which over time become painfully inflamed. If you have joint degeneration without pain, the condition is known as osteoarthrosis. With both conditions there is deterioration of the joint ‘cartilage’ – a smooth substance that covers bone endings, allowing bones to glide over each other with minimal friction. Cartilage also cushions force as it is transmitted through the joints and when you have used it up, there is no way to create more!

Although osteoarthritis occurs in people of all ages, it is most common in people older than 65. Common risk factors include increasing age, previous joint injury, overuse of the joint, weak muscles, and weight gain.

• One in two adults will develop symptoms of knee OA during their lives.
• One in four adults will development symptoms of hip OA by age 85.
• One in 12 people 60 years or older have hand OA.

The questions is how do cartilage cells die and lead to bone on bone arthritis?

The simple answer is that poor movement strategies used over long periods of time lead to destruction of the joint.

The longer answer is that joint instability from ligaments become weak and overstretched forces the body to send fluid into the joint in an attempt to correctly stabilize it from further damage. Once again it is the end result of poor movement strategies and destructive forces creating the instability resulting in extra fluid being pushed through small cracks in the articular cartilage. If the instability is left unchecked it eventually causes the knee cartilage and meniscal cells to drown to death.

Many people believe it is the osteoarthritis causing the pain and inflammation and that this is the end result of getting old. Both of these assumptions are false. Inactivity and poor movement causes the inflammation, not old age. The osteoarthritis is the end result of the pain, not the reason for it.

Synovial macrophages are one of the resident cell types in synovial tissue and while they remain relatively quiet in a healthy joint, they become activated in the inflamed joint and begin to secrete pro-inflammatory cytokines and enzymes involved in driving the inflammatory response and joint destruction.

It is usually at this point that people start using anti-inflammatory medication all the time to relieve themselves of pain and unfortunately this starts the vicious cycle of pain and feedback loop.

I will not go into too much detail about the exercises and methods you can use to combat this as I wrote a detailed article about this late last year which you here – What you should focus on instead of pain relief

Another big factor that is often ignored is inactivity and poor nutrition habits.

When people have pain it is easy to get into a habit of moving less and resting. Rest is important for a bone fracture or traumatic injury to allow the body to heal, however it is destructive when it is due to osteoarthritis. One of the worst things you can do is remain inactive and sit all day. Cartilage thickness is maintained for a long time when we keep moving for it is movement itself that keeps the joints lubricated and prevents synovial fluid loss.

Sitting all day reduces your synovial fluid concentration and if you have long periods of resting the joints they will become stiff and less mobile. This in turn leads to a reduction of hyaluronic acid within the synovial fluid and inhibits the body’s ability to clear inflammatory compounds. Once again an ongoing loop of less movement followed by more stiffness and more pain will continue to worsen.

It is vital you keep moving, however make sure you do not complete movements that aggravate you. Walking is one of the best exercises you can do and it has been well documented how effective this simple movement can be for people with back pain.

Many people would experience a significant reduction in their pain by focusing on improving their nutrition habits and losing some weight.

Experts estimate that for every 1 pound you weigh, your knees feel the force of 3 pounds of pressure when you take a step. When you consider how many steps you take each day this can very quickly add up to a significantly large number. If the average person takes about 5 to 6 thousand steps a day and you multiply this number by 10 pounds of bodyweight you will generate 150 thousand pounds of pressure on the knees per day!

The solution for osteoarthritis is to improve how you move and improve your overall strength to prevent any further destruction of cartilage and bone. This means exercise is essential.

Now that you understand osteoarthritis let’s look at the more complicated inflammatory arthritis conditions.

Inflammatory Arthritis and Auto-immune Disease

When you have an autoimmune disorder, your immune system does not distinguish between healthy tissue and potentially harmful antigens. As a result, the body sets off a reaction that destroys normal tissues.

Unfortunately, the exact cause of autoimmune disorders is unknown. One theory is that some microorganisms (such as bacteria or viruses) or drugs may trigger changes that confuse the immune system. This may happen more often in people who have genes that make them more prone to autoimmune disorders. Gut health is also something discussed as a reason for auto-immune disease as 70% of your immune system is in your gut. However, there is no definitive research confirming that this is always the case.

I can talk about this topic as it affects me personally right now and I can tell you that the constant ongoing pain I experience from Psoriatic Arthritis is relentless and like nothing I have ever felt before.

While the pain from a fracture is excruciating, it tends to go away if you keep the affected limb really still and after a week or two you do not feel much at all. With psoriatic arthritis the pain can be there when you are not even moving at all and it never goes away until you find the right medication. Even then you can still have problems as the side effects of the medications can make you feel terrible.

The pain, swelling, and stiffness of psoriatic arthritis can be misery for the distal joints, the ones closest to fingernails and toenails. The result can be decreased flexibility, strength, and range of motion in the hands and feet.

Though exercises for psoriatic arthritis feet and hands may not seem very appealing when you’re feeling stiff, swollen, and achy, research shows that physical activity can help improve symptoms.

Movement keeps tendons loose and can also lessen pain and inflammation. And when muscles are strong, joints don’t have to work as hard, according to the National Psoriasis Foundation.

Psoriatic arthritis can involve the hands and feet in several ways. In severe cases, fingers and toes may resemble swollen sausages, a condition called dactylitis. Fingernails and toenails may also be affected, becoming pitted or separating from the nail bed. I had all of these problems and still have toenail separated from the nail bed which is very painful.

Another form of psoriatic arthritis inflammation, called enthesitis, can cause tender spots where tendons and ligaments join bones, resulting in pain at the back of the heel, the sole of the foot, around the elbows, or in other areas of the body.

To treat my condition I have to take several medications with the main one being biologics called Humira via fortnightly injections to deactivate the immune system and prevent permanent joint damage.  While this is preventing the immune system from destroying my joints I still need to exercise to restore muscle strength and maintain joint function that I lost when I was in severe pain.

Although osteoarthritis and inflammatory arthritis affect the joints differently, exercise has been shown in both conditions to improve flexibility and range of motion, reduce joint damage, and lessen symptoms of pain.

According to the American Academy of Orthopedic Surgeons, exercise increases blood flow to damaged cartilage, helping it stay healthy and prevent further breakdown; exercise also strengthens muscles around the joints to help take some of the pressure off.

You can read more about arthritis in the various articles I have written about this in the links below

• Understanding arthritis and bone density
• How to prevent osteoporosis and destruction of your joints
• How to use isometric and eccentric exercises to improve joint stability
• Adjusting nutrition requirements as you age

Before we get into the exercises we need to discuss another potential factor for creating problems and that is repetitive movements and inactivity.

Repetitive Movements & Inactivity

Many times someone develops a hand or wrist problem out of nowhere and especially in someone of a younger age, you will find the problem can be traced back to a repetitive movement placing abnormal amount of stress in their hands such as an occupation, hobby, or sport.

There is often a high correlation with elbow/forearm pain and hand pain and it is no surprise to see elbow injuries are attributed to a repetitive movement as well. The same problem the elbow has is often the same problem people have with the wrist. Many of the exercises I use for elbow pain are very similar to those with hand and wrist pain.

Many therapists refer to the forearm as a slave to the shoulder and poor scapula stability is a massive part of the problem. Scapula dysfunction is a massive problem for the elbow for when the scapula does not sit or move as it is designed to, the arm bone has little chance of being in the right position to move. If the arm bone rotates inward the forearm will have problems.

These problems have to do with how well the forearm rotates into a hand-down position known as pronation and the hand-up position known as supination. We use these actions all the time in daily life and most people think that these movements are only performed by the forearm itself. Little do they know, that it is the scapula that is driving these compensatory movements.

If the upper arm bone (humerus) rotates inward then the forearm will also rotate inwards too much. The muscles responsible for this rotation will as a result end up short and tight from never being used, while the muscles responsible for the opposing action will become lengthened and end up in pain from being overused.

Your forearm should rotate 80-90 degrees in both directions (with palm up or palm down). If your elbow is resting on a table your wrist bones should be able to lie flat. When forearm rotation is compromised is when begin to see elbow pain begins.

The muscles that bend and straighten the wrist have their origins at the elbow. When their function is changed in some way you will create the tennis elbow or golfers elbow. The tennis elbow pain refers to the lateral part of the elbow and the golfers elbow refers to the medial part of the elbow.

It must be pointed out that only 5% of people suffering from tennis elbow or golfers elbow relate the injury to tennis or golf! Almost all of the people I have worked with for this injury over the past 16 years have never played either of these sports in their life!

You can read more about elbow pain in this article – Getting rid of elbow and forearm pain is all about scapula stability

The last factor that must be considered is inactivity and a lack of movement which is becoming a much bigger problem in modern society.

Many people try to put up with the pain and avoid activities that hurt their hands which is not a great option for this means many daily life activities will be affected. While the pain may not be to the same extreme as a broken finger or an auto-immune disease it can be just as frustrating and debilitating trying to use your hands with some of the simplest tasks. Instead of trying to put up with the pain and modifying your lifestyle to accommodate your pain it is much better to find ways to combat the problem.

This where the value of using hand exercises to restore mobility and strength comes in.

No Matter How Sore You Are You Must Exercise

Trust me, I know exactly how this feels and it is really hard to get started.

I remember last year and even many times right now when my joints are so stiff and sore and I all I want to do is lie down on the couch and rest. It takes every bit of my energy to force myself to get up and exercise. The thing that helped me when I was at my worst, and also what makes me get out and exercise now, is I know how much better I feel once I start moving.

The hardest part is the first 10-15 minutes, but once the blood starts pumping through my body I begin to improve. The pain is still there the whole time, but I can feel some of my mobility return as the extra warmth in my joints give me some relief.

Multiple studies have demonstrated that exercise reduces fatigue and while it sounds counterintuitive that if you have too much fatigue to exercise, physical activity can help reduce your fatigue it is well worth the effort.

I know I had to modify some of the things I wanted to do for it would hurt too much at the start but as I slowly began to warm up it became a bit better. For example, I used to love doing chin-ups and push-ups when I was feeling great but the pain in my fingers and wrists made this unbearable. Instead of doing nothing I used cable machine exercises that mimic the movements I wanted to but without the discomfort. Once I felt I was warmed up enough I would try to do some push-ups or chin-ups to see if my body could tolerate it. Eventually over time I was able to get back to where I was and do several sets of each exercise relatively pain free.

Many people even believe that exercise worsens rheumatic conditions like psoriatic arthritis and rheumatoid arthritis but this is a myth. If you still don’t believe me then here are a few reviews that confirm this statement.

According to a study published in the journal Clinical Rheumatology people with Psoriatic arthritis who exercise regularly reported less pain and fatigue and a better quality of life. But it was not only less pain and increased energy that changed as there was also a reduction in the amount of disease flare ups.

A systematic review of more than 13 studies published in the journal Clinical Rheumatology found that regular exercise reduced disease activity in patients with psoriatic arthritis.

Although not directly linked to Psoriatic Arthritis, researchers at the University of California San Diego School of Medicine found that one 20-minute session of moderate exercise can stimulate the immune system and produce an anti-inflammatory response.

Another thing that is common to all types of arthritis is poor bone density and weakness within the muscles supporting the bones.

Your bones are in a constant state of renewal — new bone is made and old bone is broken down. When you're young, your body makes new bone faster than it breaks down old bone and your bone mass increases. After the early 20s this process slows, and most people reach their peak bone mass by age 30. As people age, bone mass is lost faster than it's created.

Psoriatic arthritis has been associated with lower bone mineral density, according to a Chinese study of almost 5,000 people with psoriasis and nearly 900 people with Psoriatic arthritis. Strength training, in particular, can help prevent bone loss and may even help build new bone so you’re less likely to experience debilitating fractures. Plus, you’ll get stronger muscles, which protect your joints.

Why Grip Strength Is So Important

A strong grip is critical for many everyday activities such as opening a jar or carrying shopping bags. Pain in the fingers and wrist can have a dramatic effect on your grip causing a lot of problems in daily life. Those who play sports or go to gym will find it almost impossible to participate effectively if they have a loss in grip strength.

I know how much this was a problem to myself with my left hand and I could barely open some packets with snap locks as much as jars with tight lids. Trying to do exercises like deadlifts or any type of pulling exercise in the gym I felt a dramatic loss in strength in the entire body as I could hardly hold the bar or dumbbell.

Your grip can also be an important indicator of your overall health.

A study in the Journal of Strength and Conditioning Research concluded that grip strength is a predictor of muscular endurance and overall strength. Other studies have found that a stronger grip correlates with a lower risk of heart attack and stroke. Researchers say the findings suggest a link between heart health and muscle strength.

Exercising all parts of your hand will also help you avoid creating an imbalance between the muscles that help you open and close your hands. Overworking the muscles used to close your hands, for instance, could lead to tendinitis.

Something I did not know until I experienced problems with my grip is that there are actually three types of grip strength, crush, pinch and support. You need to have adequate strength in each variation if you want to improve the overall sturdiness of your grip.

1. The crush grip is the strength between your fingers and your palm, what helps you shake hands or crumple up a piece of paper.
2. The strength between your fingers and thumb is known as the pinch grip, used to grab a piece of paper, for instance. This particular grip was the one I was struggling with the most.
3. The last grip called the support grip is the ability to hold on to something, such as the handle of a shopping bag or a barbell in the gym during a deadlift.

A recent study of 1,275 men and women found that those with relatively feeble handgrip strength, a reliable marker of overall muscle quality and strength, showed signs of accelerated aging of their DNA. Their genes appeared to be growing old faster than those of people with greater strength.

How can you improve the specific parts of each grip?

Let’s take a look.

Four Exercises To Strengthen Your Fingers, Thumbs and Wrists

While there are many exercises that are extremely useful and help improve joint stability, you must experiment to find what works best for you. Just trying to lift heavy dumbbells and barbells may help with the support grip as explained above, but it may do very little for the pinch grip and the crush grip which is the exact problem I was having. Using exercises to target these grips enabled me to work my back to full strength again.

The best hand exercise program is one that has been customized for a person’s unique anatomy and circumstances. A qualified health care practitioner, such as an occupational therapist or physical therapist who specializes in the hand, can tailor a program to an individual’s needs.

While a personalized hand exercise program is ideal, the 4 hand exercises described below are okay for most people who have problems with the mobility and strength with their fingers.

The goal of these exercises is to:

• Strengthen muscles and tendons in the hand and forearms
• Improving range of motion in the fingers and thumbs
• Improve hand function, including the ability to grip, pinch, and hold objects

Watch the video below to see some of the exercises I used to do this.

Always remember that if hand pain is present, it is a good idea to clear these exercises with a qualified health care practitioner. During each exercise, keep the wrist in a relaxed, neutral (straight) position. Stop any exercise if it triggers sharp or severe pain.

Power Web KEY BENEFITS

In the video above you will see me use an interesting piece of equipment called a power web. I have used this for a long time with people who had severe disability in their hands and fingers and used it myself many years ago after breaking my right index finger.

This is a unique tool in that it allows duplication of virtually all joint actions of the finger and wrist including flexion, extension, opposition, abduction, adduction, pronation, and supination.    The best part about this tool is that the resistance of each web can be modified to meet specific needs by adjusting hand position and/or depth of finger insertion.

Both hands can be exercised at once, or a single finger isolated and exercised. Just like resistance bands that come in different colours and levels of resistance you can also find the one that meets your needs the most.

This really is a handy tool when you have problems with the fingers.

Go to the link below to see more.

https://www.pwrwebintl.com/index.php?m=21

Flex Bar Benefits

The flex bar is another interesting tool I have used a lot in the past especially for people with elbow and forearm pain.

Twist bars are an ideal form of exercise to strengthen and rehabilitate muscles in the hand and wrist. They’re a natural way to improve grip strength, increase flexibility, and improve range of motion, and they’re backed by clinical research. According to a 2009 study published in the Journal of Shoulder and Elbow Surgery, continued use of tennis elbow flex bars can decrease elbow pain by 81 percent and increase strength by 72 percent.

The Twist Bar is ideal for people who have experienced elbow injuries caused by lateral epicondylitis, or “repetitive motions in the arm and elbow,” including elbow tendinitis, carpal tunnel syndrome, or arthritis. Physical therapists and neuromuscular specialists often recommend twist bars as a way to help improve grip strength in athletes or anyone who regularly engages in physical activity involving the arms, such as housework or heavy labor.

Using gentle twisting motions in the wrist and arms, the twist bar helps support rehabilitation in the wrists, forearms, and hands. The ridged design makes gripping easy, and twist bars are small and lightweight enough to be used by people of all ages and ability.

https://www.theraband.com/articles

Integrated Strength Training

It goes without saying but incorporating many of the integrated strength training exercises will also go a long way to improving the strength of the fingers and wrist. I have written about this numerous times in articles about pulling exercises, farmer’s walks, push-ups and chin-ups and the value of these exercises cannot be over-stated.

You will find the exercises shown in the PDF reports below are a great resource for improving the function of the hands and upper body.

You can read more about these in the articles below.

• 7 Best exercises for pulling strength
• How to do deadlifts
• How to do farmers walks
• How to do push-ups
• How to do chin-ups

Summary

There is no doubting that problems at the hand and wrist can have a dramatic effect on everything you do in daily life. Popping anti-inflammatory pills and avoiding using your hands is not going to help, you have to exercise to restore the strength and mobility back to the joints. Sure, it can be very difficult but you have to find a way for if you lose too much strength the stiffness will become chronic and remain forever.

Hopefully, the exercises shown in this article give you some relief and maybe some additional ideas of how you can get your hand strength back.

For more ideas and information on specific topics I may not have covered in detail be sure to check out our INDEX PAGE on the website that has over 300 of our best articles. These are all sorted into categories for quick reference so you can find what you are after more easily. You can also subscribe to our FREE fortnightly newsletter by clicking here.

If you do need specific help with your exercise program please feel free to reach out to me for help and we can set you up with your individualised program.

About The Author

Nick Jack is owner of No Regrets Personal Training and has over 16 years’ experience as a qualified Personal Trainer, Level 2 Rehabilitation trainer, CHEK practitioner, and Level 2 Sports conditioning Coach. Based in Melbourne Australia he specialises in providing solutions to injury and health problems for people of all ages using the latest methods of assessing movement and corrective exercise.

References:

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• Advanced Program Design - By Paul Chek
• Twist Conditioning Sports Strength - By Peter Twist
• Twist Conditioning Sports Movement - By Peter Twist