I HAVE WRIST PAIN AS A GAMER - DO I NEED A BRACE?

Introduction

Wrist pain is frustrating, but even more frustrating is not being able to do the things that you enjoy or misinformation around this. Like most people, if you develop pain then we may ignore it or if it stays around long enough we might do a Google search or see a doctor about how to fix the pain. Oftentimes Google or the doctor only recommends bracing and patients leave feeling good because they have a solution to reduce the pain, however THIS IS A TRAP.

 

 

This article is intended to help our community understand what role the brace has in managing wrist pain but also to realize that this thought process will often only provide temporary relief to your pain.

 

BRACING: MANAGING WRIST PAIN IS NOT ABOUT PREVENTING MOVEMENT

It is very important to know and understand that through immobilization alone will not lead to fixing wrist pain. Oftentimes when we have wrist pain it is most commonly a result of repetitive strain.

 

This means the cause of the pain is usually tendon or muscle related (more often tendon). So why is managing wrist pain NOT about preventing movement? There can be quite a long discussion here but with any injury it is important that we manage load on our tissues. What we mean by this is we have to manage how much stress is placed on the tendon or muscle that is injured – balancing continued movement to promote proper healing and EXCESSIVE movement which may irritate tissues further. We prioritize continued movement to increase our ability to handle stress and prevent excessive movement to damage our tissues further while bracing helps with preventing excessive movement. 

 

Bracing is helpful in moderation as this allows us to avoid unnecessary overuse or pain throughout the day while then taking the brace off to complete necessary and personalized exercises. Think of it like this, if you go without a brace then the muscles/tendons do 100% of the required work that they’re being asked upon. If I wear a brace all day then the muscles/tendons do 0% of the work. Best practice is to help reduce the overall load by a small percentile. Oftentimes this alone can be achieved at night while sleeping, but for more acute or fared up pain then a splint for part of the day to again reduce one’s load may be helpful. A general rule of thumb is “Wear the splint as much as you NEED, but as MINIMAL as possible”. 

 

Again, this tends to be a balancing act as bracing provides a false sense of security as it may be comfortable and offer protection, but this can be where people get in trouble. Some will then become reliant on wearing it more than they planned and now we’re in a situation where the muscles/tendons have deconditioned and are more susceptible to injury once you do come out of the splint. This is the trap that some fall into!

In sports this is commonly known as load management which many fans disagree with but it is coming from a good place by the training staff and physiotherapists. Load management in athletes involves strategically balancing training, competition, and rest to optimize performance and minimize injury risk by monitoring both external and internal loads. Again, these principles still apply to us gamers. We must eliminate and control variables which can be done by bracing outside of gaming with activities that cause pain while simultaneously focusing on specific exercises to work the muscles/tendons that are injured and we’re trying to heal.

USING A BRACE FOR GAMING PAIN: IT’S ABOUT LIMITING EXTRA STRESS

 

So a wrist brace is a great option to limit extra stress on the tendon when you ARE NOT gaming – especially with daily movements which may also irritate your tendon. When we are managing wrist pain – essentially rehabilitating tendons at our wrists it is important we allow our tendons to continue MOVING to help restore function and reduce pain. We have to do it with SPECIFIC exercises/movement. However there are situations in which we want to LIMIT movement through the brace to prevent extra stress on the tendon. 

 

So let’s talk about when we can use the brace with any gaming pains. I’m going to go over several situations for you guys so you are able to make the best decision for yourselves. Before I discuss each of these stages it is important to first consider playing below or up to our “endurance limit.” To keep it simple: our tissues can only handle so much strain as-is, and even less when our tissues are injured. This strain limit is reflected by the amount of time we play before our wrist/hand/forearm begins to hurt. As a first line of defense, consider playing only to this limit before you consider adding in performing our exercises or utilizing a brace as described in this article. Again: I want to emphasize that movement is more important than immobilization through a brace, both before and during injury. (For the “before” phase, we have an injury prevention routine for those who are interested below.)

Let’s have a look at the most appropriate situations to use a brace.

 

 

Early Stages (First 3-5 days)

One appropriate time to use a brace is during the initial stages of the injury when you start to feel pain. Your tissues are more sensitive in this stage because of the inflammatory processes and that means you aren’t able to handle much stress. In this situation, we want to keep the brace on as much as possible because we want to LIMIT EXTRA STRESS. 

 

1. At all times when you are not gaming – Day to day activities like cooking, lifting, grabbing, carrying etc. can place extra stress on the tendon. 
2. Sleeping – When we are sleeping we have the potential to place our hands in awkward positions which may irritate the tendon further
3. During gaming if you can manage it (understanding that it can affect performance) – This is especially for more sensitive cases and if it is severe enough that you are unable to play, you may get more benefit from taking a day off while focusing on recovery. After the 3-5 days put it on only after you play your games (situations 1 & 2). During this time you would ideally be gradually increasing your tissues tolerance to stress through exercise.

 

Flare-up

Another situation is after you have been dealing with it for awhile and you flare the pain up by playing too much. This is often because we feel better through exercise and good early management. With a reduction of pain we are quick to jump back to the habits which caused the strain in the first place – usually playing too much without managing our wrist health well. We ignore our “endurance limit” causing our tissues to again become strained and making the painful area more sensitive, this is known as the Boom-bust Cycle and is something that we want to avoid as it can prolong an injury.

 

In this situation we keep a brace on primarily when you are not gaming, but again focus on your exercises and don’t become overzealous in a return. Instead listen to your body and gradually increase activity to allow your body to adjust.

 

Why Do I Need Exercises If I Already Use My Hand

A common question patients ask is “Why Do I Need Exercises If I Already Use My Hand” and there is a simple answer. Exercises eliminate or control unwanted variables, that’s it. 

 

If I am a librarian and have to put books away I have little control over how many books I put away (reps), the height of where I put them (movement pattern/form), or the weight of the book. Sure my leg might be bothering me, but if I’m at work and I have to get up and down from my chair 100s of times over the course of the day I have little control over this. Technically I did my squats so why would I ever go to the gym now to squat? 

 

This is the thought process that many have. I’m already lifting plenty, shouldn’t it be better? Well this is where the problem is. You lack the control of your reps, weight, form that structured exercises allow for and this is really where we’re saying it may be a time to wear a brace as it eliminates these variables that we don’t have control over. Once the work is over then you can take the splint off and complete your exercises with your set reps, sets, and weight to allow for better form and focused efforts on working specific muscles. 

 

Pain and Exercises

As discussed, exercises are crucial in recovery especially when bracing is involved. If we’re bracing often then we also have to get out of the brace 3-4x/day to complete exercises. These exercises may not be aggressive exercises we are used to seeing in the gym, but may mean just moving the injured area without any load whatsoever. Over time as pain subsides then strengthening exercises will become more important. For a full guide take a look at our Youtube Page or consider checking out our Troubleshooter program here that creates a specialized plan to your pain location.

 

Pain Scale

Bracing is something that we want to wean away from over time and through the weaning process this may mean keeping the exercises at the same volume of reps, sets, and load as you begin to do more throughout the day with the injured arm.

 

It is important for us to understand how to perform our exercises, especially if we have pain. The rule of thumb is to perform the exercise right before the point of pain. So that means if I am asking you to perform a biceps curl. If it hurts halfway through the range, then curl it to the point right before it hurts. Mild Discomfort is okay, as long as the pain is not sharp.

0-5 = Discomfort range (Acceptable range for exercises)

5-10 = Pain (Not something encouraged to exercise too)

HOW TO USE A BRACE FOR WRIST PAIN

Different braces are designed for different injuries; some come as one-size-fits-all and others require you to measure yourself first. There are a variety of different braces available with varying degrees of restriction, compression, and mobility limitation. There are specific brace recommendations to address specific injuries and so it is important to know which brace is helpful for what injury. 

 

Upon wearing a brace for the first time it should very quickly provide some relief though uncomfortable and annoying to get used to at first. Generally a brace should fit snug, but comfortable as that is what is truly needed for it to be effective at its job of immobilization. A brace should not cause pain nor leave any strong indentations or marks on one’s arm/wrist. is pain.

Correct Splint for Specific Injuries

Condition	Splint Name	Why
DeQuervians Tenosynovitis	Forearm based thumb spica, wrist splint with thumb included, DeQuervians Tenosynovitis splint	Tendons irritated with this condition cross the wrist and lead to the thumb (abductor pollicis longus and extensor pollicis brevis). This means that both the wrist and thumb require immobilization to effectively treat.
Tennis Elbow (Lateral Epicondylosis)	Wrist Brace without thumb included OR counterforces strap, tennis elbow strap	Tendons irritated with this condition start at the elbow and cross the wrist therefore a wrist splint can add support to the irritated wrist extensor muscles. OR A counter-force strap works by redistributing stress away from the injured tendon however due to the nature of this brace it can result in compression of the radial nerve which is why this can only be worn in segments (2 hours at a time) and never at night while sleeping for risk of resulting in radial nerve palsy.	AND/OR
Carpal Tunnel Syndrome	Wrist Brace without thumb included, Carpal Tunnel brace, Volar wrist splint without thumb	The median nerve can be provoked through excessive bending of the wrist (flexion/extension) where the splint holds the wrist in a neutral position. *Recommended primarily at night while sleeping, but may be helpful for some during the day as well.
Cubital Tunnel	Cubital Tunnel Brace, Night splint for elbow	The ulnar nerve can be provoked through excessive bending of the elbow (flexion) where the splint prevents the elbow from becoming excessively bent. *Recommended only at night while sleeping

 

Conclusion

Braces can be helpful for some, however it is not the fix that gamers should only use. It is crucial to understand this article fully as bracing can result in further deconditioning under the guise of trying to fix pain. Motion and exercises remain extremely important throughout the process even when pain is present there needs to be a time outside of the splint even at the very least moving the injured area gently. Understand load management, when/how to brace, exercises to complete, gradual progression, and the difference between good/bad pain.

 

Lastly, our recommendations are to brace whenever you are not gaming during the first three-five days of a flare-up. After the first 3-5 days, you brace after your gaming session for about 1 week. After that you can wear the brace as needed when you are not gaming (given you are working on your endurance this whole time). Remember the phrase “Wear the splint as much as you NEED, but as MINIMAL as possible,” because we do not want to get stuck in a situation of becoming reliant on this brace to feel confident.

References

Gabbett T. Load Management: What It Is and What It Is Not! Sports Health. 2023 Jul-Aug;15(4):478. doi: 10.1177/19417381231179946. Epub 2023 Jun 1. PMID: 37260145; PMCID: PMC10293561.