How To Protect Loose Wrists In Ehlers-Danlos Syndrome

Wrist pain with Ehlers-Danlos syndrome can feel unfair: you’re trying to stay strong, but the joint keeps acting “loose” and unpredictable. We walk through what’s actually happening when ligaments are too flexible, why that creates wrist instability, and how certain training habits quietly make it worse. If you’ve ever wondered why a heavy bag, knuckle push-ups, or even pushing up from a chair can light up your wrist, this conversation connects the dots in plain language.

Carl gets specific about mechanics and movement choices. We talk about when open-hand weight bearing may be slightly better, how to “dose” push-ups so you are not hammering the joint with nonstop reps, and why extreme wrist ranges are a bad trade for hypermobility. You’ll also hear practical cues for pressing in the gym, including keeping a neutral wrist and pushing through the heel of the palm to reduce hyperextension and help prevent impaction issues often called gymnast wrist.

Strength work is still on the table, but the target is muscle control and stability, not end-range stretch. Carl also share a simple athletic tape or kinesiology tape wrap that can add stability and confidence during workouts, plus a warm-up “don’t” that surprises a lot of people: skipping wrist rolling circles.

If this helps you train with less pain and more control, subscribe, share it with a friend managing hypermobility, and leave a quick review so more people can find these wrist stability strategies.

Transcript

Welcome And EDS Basics

SPEAKER_00 0:02

Welcome back to the hand to shoulder solution where pain meets its match. I'm your host, Carl Petito. Let's talk about Ayler's Danlos syndrome. What is it? In short, it's really loose ligaments. Ligaments connect bone to bone. So the ligaments are too flexible, they allow too much movement. What does that mean? That means that joints aren't as stable as they should be because it's the ligaments that keep things quite stable underneath the tendons, which connect muscle to bone. So the ligaments connect bone to bone.

Why Wrist Instability Hurts

SPEAKER_00 0:38

Today let's talk about the wrist. I've been having more patients come in with Ahlers-Danlos syndrome. They're having laxity or looseness of the ligaments and they're having wrist pain primarily due to instability.

Avoid Fist Weight Bearing

SPEAKER_00 0:51

I would like to mention a couple of things that we should avoid when the ligaments are lax or too loose. And one of them is leaning on a fist or punching a target. If you like to work on a heavy bag or you like to do push-ups on your fist, or just leaning to push yourself up out of a chair, that weight bearing through the wrist causes decapitate bone right here, which is one of the carpal bones, to push between this peanut-shaped bone on the thumb side of your hand and the lunate, which is a little offset toward the pinky, toward the base of the middle finger. Now, when that pushes through there with an axial load or a or a weight-bearing force through the fist, that causes this ligament that connects the scaphoid bone to the lunar bone to loosen even more, and it starts to cause further instability of the wrist. Weight bearing on an outstretched hand is a little bit better because there is the transverse carpal ligament that forms the roof of the carpal tunnel that helps stabilize things. That can become a little bit too loose, but I would try to avoid any prolonged weight bearing. If you want to get down and do some push-ups on an outstretched hand, you know, do some, take a break, or spread it out over uh a week or two uh time period so that you don't have the continuous stress over and over again.

Safer Push-Ups And Grip Work

SPEAKER_00 2:31

Now, in addition to that, let's talk about hand grip strengthening. So if I'm working on my grip and I'm squeezing a hand grip strengthener, that also is creating an axial load, causing that capitate bone to push between those two bones in the um right next to the end of your forearm, the scaphoid and the illuminate that we're just mentioned. An excellent exercise to do is an isometric exercise where you're just holding something, you're holding something steady, like a hammer, where you're working your grip, not terribly hard, but you are holding it enough to hold that hammer, and the hammer is creating a force to turn it palm up. So you're you're working the muscles that work your grip, you're working the muscles that turn your hand palm down, and you're working the muscles that bend your wrist up toward your palm. The opposite direction, and both of these making sure that you're not resting on the ligaments, but you're holding it at a steady position, you're working your grip, the muscles that turn it palm up, which the primary mover for that is the biceps, and the muscles that bend your wrist up toward the back of your hand. So that's an excellent exercise. And why do we want to do some exercises for strengthening? Because if we strengthen the muscles that are attached to the bones with the tendons crossing the wrist, that gives it some more muscle control, it gives it more muscle stability. Another good thing to do is to use a dumbbell to hold a weight that's a bumper for you to hold it steady and work those muscles that bend it up toward your palm, and then you can flip it over and work those muscles that bend it up toward the back of your wrist. Doing those motions and most other exercises that you would do in weightlifting in the gym will strengthen the muscles and give more stability to the joints.

Train With A Neutral Wrist

SPEAKER_00 4:31

What you absolutely must avoid is going to extreme motion. And here's an example. And I see a lot of patients, uh, and one of my first questions is when you go to the gym, what's your wrist position like? So pretend you're seated in the chair and you're doing a press. Put your wrist on there. And a lot of people will put their hand on there like this, and they're they're pushing on this part of the hand, and they're in a in a hyperextended position. What's better is to push on the heel of the palm just beyond the carpal tunnel. The copper carpal tunnel is the heel of the palm. So just beyond that, now you can have a straighter wrist and push through that. You're not going to have terrible pushing of that tiny bone through that spot that we just mentioned, but you will have better control. And what that avoids is hyperextending or causing more stress on the ligaments of the wrist when you're coming back here. Now, because the ligaments are a little bit too loose, it allows the wrist to come back further into extension. And this bony ridge on the front right here starts to jam into the carpal bones. And that's there's a name for that. It's called gymnast wrist. So, gymnasts, when they're flipping and and tumbling and they're landing on an outstretched hand, that causes a lot of impaction. So that impaction syndrome can really be prevented by pushing and pulling with a with a straighter wrist, primarily pushing.

Skip Wrist Rolling Warm-Ups

SPEAKER_00 6:11

Now, as a warm up, a couple of other don'ts. Do not roll your wrist. That's not good for anyone, especially someone with laxity. Doing this as a warm-up, that's not good. I've met several gymnasts who that's what they do in class before their practice or before their matches. They'll roll their wrists. And I advise folks to not do that because that causes a lot of irritation, aggravation, increases inflammation, and especially someone with Erlers Danlow syndrome, that will cause undue stresses to the connective tissue, in this case, the ligaments.

Taping For Extra Wrist Stability

SPEAKER_00 6:51

Now, when going to the gym and doing other exercises, it's excellent to use athletic tape. In this case, I have some kinesio tape, athletic tape. And if you find your wrist where there's that bony knob right there, that's the end of your ulna, that's the ulnar head on the pinky side. So if you look at the pinky side in the back of your wrist, just go a little bit beyond that knob and you find the most narrow part of your wrist, and that's where you can center the tape. So you take your tape and center the tape right over the most narrow part of your wrist, and I would pull it about 50% of its elasticity. So if that's 100% of the elasticity, I'd pull it 50 to 60%, and then go right around the wrist, circumferential, and that's going to give it some stability. Because with the Airless Downlow syndrome, you don't have stability. So doing this at the gym, along with keeping a more neutral wrist, not hyperextended, you're going to really preserve the health of your joints, and you will avoid pain. Thank you very much for watching the hand to shoulder solution. For pain meets its match.