Hand and Wrist Muscles, Nerve Screening and Stability Rehab

More than 30 muscles act on the hand and wrist, including the long finger flexors and extensors, the wrist extensors and flexors that drive the dart throwing motion, the thenar and hypothenar groups, the interossei and the lumbricals. A rock, paper, scissors screen gives a fast check of motor function: a fist for the median nerve, an open hand for the radial nerve, the victory sign for the ulnar nerve and the OK sign for the interosseous nerve. Ian defines stability as bone congruency, ligaments, muscles and an intact neural system working together, so muscle can partly compensate for ligament damage. For scapholunate injuries, extensor carpi radialis longus, abductor pollicis longus and flexor carpi ulnaris close the scapholunate gap, while flexor carpi radialis and extensor carpi ulnaris can open it, so isolated ECU work early on may stress the ligament. Exercises include rocking on a ball along the extension with radial deviation diagonal, reverse curls and slow punches. Ian closes by noting that pain does not map neatly onto anatomy, so functional tests remain important.