What are the recommended work restrictions for an individual with a wrist injury?

Work Restrictions for Wrist Injury

Individuals with wrist injuries should avoid repetitive wrist extension, forceful gripping, weight-bearing on the wrist, and high-impact activities until cleared by their treating physician, with specific restrictions tailored to the injury type and healing stage.

Immediate Restrictions (Acute Phase)

Activities to Completely Avoid

• No weight-bearing activities on the affected wrist including push-ups, planks, or leaning on the wrist 1, 2
• Avoid repetitive wrist extension activities such as typing without wrist support, using hand tools, or activities requiring sustained dorsiflexion 2, 3
• No forceful gripping or rotational movements including using wrenches, opening jars, or activities requiring torque 2, 4
• Eliminate high-impact activities such as contact sports, gymnastics, or activities involving potential falls 1, 5

Modified Duty Recommendations

• Limit lifting to 5 pounds or less with the affected hand during the initial healing phase 6
• Avoid sustained wrist flexion which can exacerbate carpal tunnel compression; use wrist splints during work if compression symptoms are present 1
• Restrict repetitive hand motions including assembly line work, prolonged computer use without ergonomic modifications, or repetitive tool use 6
• No overhead work or reaching that requires wrist stabilization 2

Progressive Return to Work Protocol

Week 1-3 (Immobilization Phase)

• Begin active finger motion exercises immediately to prevent stiffness, which is a critical and disabling complication 1, 7
• Maintain strict wrist immobilization with splinting as prescribed 1
• Work restrictions: sedentary duties only with no use of the affected hand for any work tasks 7

Week 3-6 (Early Mobilization Phase)

• Initiate gentle wrist range of motion after stable fixation, typically around 3 weeks post-injury 1, 7
• Light duty work permitted with lifting restrictions of 5-10 pounds maximum 6
• Avoid high job physical strain activities which are associated with increased wrist pain prevalence 6
• Continue to avoid forceful gripping, twisting, or impact activities 2, 4

Week 6+ (Strengthening Phase)

• Gradually increase weight-bearing activities as tolerated and cleared by physician 7
• Progressive return to manual labor with continued avoidance of high-impact or repetitive strain activities until full healing is confirmed 6
• Monitor for signs of re-injury including increased pain, swelling, or decreased range of motion 3

Occupation-Specific Restrictions

Manual Laborers and High Physical Demand Jobs

• Extended work restrictions are necessary as wrist pain prevalence is significantly higher (24% medium-term) in physically demanding occupations compared to non-manual workers (4.2%) 6
• Avoid high-frequency impact tool use which is a documented risk factor for wrist pain 6
• Consider temporary reassignment to non-manual duties during healing 6

Office Workers and Low Physical Demand Jobs

• Implement ergonomic modifications immediately including wrist rests, adjustable keyboard height, and frequent breaks 3
• Limit continuous typing to 20-30 minute intervals with rest breaks 6
• Use voice-to-text software to minimize keyboard use during acute phase 3

Critical Pitfalls to Avoid

• Do not allow premature return to weight-bearing activities as this can lead to chronic instability or re-injury 2, 5
• Avoid over-immobilization of uninvolved fingers which leads to unnecessary stiffness; maintain active motion of all unaffected digits 1, 8
• Do not ignore signs of nerve compression including numbness in the 4th and 5th digits (ulnar neuropathy) or median nerve symptoms; these require immediate splinting modifications 1, 3
• Prevent finger stiffness through early active motion as this complication is extremely difficult to treat after it develops and may require surgical intervention 1

Special Considerations

• For suspected carpal tunnel involvement, use wrist splints during sleep to avoid excessive wrist flexion and exacerbation of compression 1
• High job psychological strain is associated with increased wrist pain and should be addressed through workplace accommodations 6
• Female workers and older individuals have higher risk for wrist pain and may require more conservative restrictions 6
• Athletes and sports participants show higher prevalence (10% short-term) and require sport-specific clearance before return to play 6