Wrist ganglion cysts, commonly known as hand wrist cysts, are noncancerous growths that form along tendons or joints, usually in the wrist or hand regions. They are composed of a clear or yellowish fluid and are typically painless, though some may cause discomfort or pain. While most ganglion cysts are asymptomatic and resolve on their own, others can become inflamed, tender, and limit joint movement. If left untreated, they can lead to increased size and severe pain. Traditional treatment methods include observation, medication, or surgery, but physical therapy is becoming increasingly popular as a non-surgical option to manage ganglion cysts of the wrist.
Physical therapy can be effective in managing wrist ganglion cysts by incorporating a variety of exercises and techniques that aim to reduce pain, improve mobility, and strengthen the affected area. A physical therapist will assess the size, location, and severity of the cyst and its potential impact on function, as well as the patient's medical history and current symptoms, before developing an individualized treatment plan. This plan may include a combination of the following exercises and techniques:
** Passive Range of Motion Exercises:** These exercises are performed with the affected hand fixed in space by another person. They are designed to improve flexibility and range of motion in the wrist joint. Examples of passive range of motion exercises for wrist ganglion cysts include:
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** Wrist Flexion:** The patient sits with their forearm on a table, and their palm is uppermost. Using the other hand, the examiner lifts the wrist upwards and holds it for 30 seconds.
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** Wrist Extension:** The patient stands with their arm by their side and bends the elbow to 90 degrees. The examiner straightens the fingers and bends the wrist outward, assisting the stretch with their hand pressing through the palm of the patient's hand. The held position is maintained for a moment and then relaxed.
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** Wrist Radial/Ulnar Deviation:** The patient sits upright in a chair with their forearm resting on a table, palm facing down. The examiner slides the hand towards the thumb and then towards the little finger, simulating a side-to-side gesture.
** Isometric exercises:** Isometric exercises involve resistance to joint movement, keeping the bones together and producing pressure without actual movement. These are effective for strengthening muscles surrounding the wrist. An example of an isometric wrist flexion exercise is:
- Situation: The patient sits with their forearm on a table and their palm facing up. The examiner places their hand on the palm of the affected hand and attempts to lift the wrist upwards, holding the position without moving the forearms.
** Resistance Band Exercises:** Resistance bands provide resistance to muscle movement, aiding in strengthening. Wrist extension and flexion exercises can be performed using resistance bands. An example of a wristExtension strengthening exercise is:
- Situation: With the affected hand rested on a table, the examiner holds a resistance band with both hands and pulls the wrist towards the patient's median nerve, causing tension in the palmar fascia and wrist muscles. After a few seconds of resistance, the band is released.
** Strengthening Exercises with Weights:** Exercises that involve weights help to build muscle mass and strength, which is beneficial for wrist ganglion cyst management. An example of a wrist flexion Strengthening exercise is:
- Situation: The patient stands with their arm by their side and holds a light weight or resistance band in their hand. They slowly curl the wrist towards their forearm, then lower it back down. This process is repeated for 10-15 repetitions.
Other exercises that may be included in a physical therapy regimen for ganglion cysts are:
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** Passive ROM exercises:** As mentioned earlier, these are performed with the affected hand fixed in space by another person. They are designed to improve flexibility and range of motion in the wrist joint.
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** Wrist Flexion Strengthening Isometric:** This type of exercise targets the muscles on the underneath of the forearm, helping to reduce tension and improve mobility in the wrist.
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** Wrist Extension Strengthening Isometric:** This type of exercise targets the muscles on the top of the forearm, helping to improve mobility and reduce pain in the wrist.
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Wrist Curl: This exercise targets the muscles in the wrist and forearm, helping to build strength and improve joint stability.
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Forearm Pronation/Supination: This exercise targets the muscles in the forearm, improving mobility and flexibility in the wrist.
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Grip Strengthening Exercises: exercises that focus on grip strength, such as using a ball, can be helpful in managing ganglion cysts.
It is important to note that while physical therapy can be effective in managing wrist ganglion cysts, consulting a healthcare provider, such as a hand therapist or physical therapist, is the best course of action. They will be able to advise on the most appropriate treatment methods for your individual needs based on an accurate diagnosis. Additionally, physical therapy may not be suitable for everyone, and other treatments may be necessary in certain situations. It is also advisable to avoid any exercises that put unnecessary strain on the affected joint, such as heavy lifting or activities that require significant hand strength., physical therapy offers a safe and effective alternative to surgical intervention for managing wrist ganglion cysts. With the right exercises and rehabilitation techniques, patients can reduce pain, improve mobility, and regain control of their daily lives. It is important to consult with a healthcare professional before starting any new exercise regimen, particularly if you have a specific injury or condition.
References:
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Ganglion Cyst. StatPearls. [Online], [Accessed: 2023].
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Ganglion Cyst: Causes, Symptoms, Treatment and Management. Physiopedia. Retrieved from:https://www.physio-pedia.com/Ganglion_Cyst.
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Top 5 Exercises for Ganglion Cyst (wrist). Physio.io. Retrieved from:https://www.physio.io/exercises/wrist-ganglion-cyst/.
