Wrist and Hand Soft Tissue Injury (PIFU)

Patient Experience

  • Reference Number: HEY-1340/2022
  • Departments: Physiotherapy, Plastic Surgery
  • Last Updated: 30 November 2022


This leaflet has been produced to give you general information. Most of your questions should be answered by this leaflet. It is not intended to replace the discussion between you and the healthcare team, but may act as a starting point for discussion. If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team.

What is a soft tissue injury?

The term soft tissue refers to muscles, ligaments and tendons that surround and support our joints. Injuries to the soft tissues can occur due to a fall, overuse, over stretching or direct impact and means there has been no injury to the bone.

Following a soft tissue injury you are likely to experience swelling, pain, bruising and tenderness and this can result in stiffness and loss of function. Soft tissue injuries can often feel worse in the first few days but it is important to move your wrist, hand and fingers immediately after the injury.

How should it be treated?

The most important initial treatment is aimed at controlling pain and swelling.

  • Complete rest is not advisable but it is important to not over load or strain the injured area in the early stages of healing.
  • Ice will help reduce pain and swelling. This can be ice cubes, crushed or frozen peas. It is important never to apply directly to the skin as this may cause ‘burning’. Wrap the ice in a damp towel and apply for a maximum of 10-15 minutes.
    • Only use on areas that have normal skin sensation i.e. where you can feel hot and cold.
    • Do not apply over an open wound
    • Do not apply to an area of poor circulation, check your skin every 5 minutes and stop using if the area becomes white, blue or blotchy, excessively painful, numb or tingly.
  • Simple pain relief can be bought over the counter and can help manage your pain, especially if taken regularly. If you have allergies or conditions which prevent the use of pain relieving or anti-inflammatory medication, please seek advice from your doctor or a pharmacist.
  • If you have swelling in your wrist or hand, elevate your hand so that it is level or higher than your shoulder. The exercises below will also help to reduce the swelling especially if done in an elevated position.


Complete rest is not advisable. It is important that you try to use your hand normally for light activities such as washing, dressing and eating, and then gradually build back up to your normal levels of function. It is normal to feel mild discomfort at first, but this should gradually settle once the hand and wrist become stronger. If the discomfort continues after the exercises try reducing the number of exercises and build up again slowly.

The following exercises should each be repeated 10 times and completed every 2-3 hours. Support your elbow on the table with your wrist straight.

Recovery and when to initiate PIFU?

If you follow this basic advice your injury should take around 6 weeks to heal. However, everyone recovers from injuries at different rates and it is dependent on the severity of the injury and the presence of any other medical problems. It is possible that you may be back to normal in 2 weeks however it is also possible you may suffer symptoms for up to 3 months.

If your job involves regular activities using your wrist and hand you should practice similar tasks so that you build your strength and function gradually.

If you participate in an active hobby then it is advised that you do not return to this until you have full strength, full range of movement and can use your hand normally without experiencing pain or swelling.

If you play a sport involving the wrist and hand, practice the sports specific activities/movement and build these gradually before returning to full training sessions and competition.

Please initiate a Patient Initiated Follow UP (PIFU) appointment if:

  • You are struggling to fully straighten any of your fingers or thumb at 2 weeks following your injury or you feel it is getting worse
  • You are struggling to make a full fist or reach the base of your little finger with your thumb tip at 3 weeks following your injury
  • You feel your movement or function is worsening
  • Your pain or swelling worsens

Details of how to book a PIFU appointment can be found in the PIFU leaflet which you will have received alongside this leaflet. If we do not hear from you within 3 months we will assume that you no longer require any further intervention and will be discharged from the PIFU pathway. If you have further problems with your wrist or hand after this date please contact your GP practice.

Should you require further advice on the issues contained in this leaflet or wish to initiate a PIFU appointment, please do not hesitate to contact the Physiotherapy Department on telephone: 01482 674880

This leaflet was produced by the Physiotherapy Department, Hull University Teaching Hospitals NHS Trust and will be reviewed in July 2025

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

We collect and use your information to provide you with care and treatment. As part of your care, information about you will be shared between members of a healthcare team, some of whom you may not meet. Your information may also be used to help train staff, to check the quality of our care, to manage and plan the health service, and to help with research. Wherever possible we use anonymous data.

We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

Under the General Data Protection Regulation and the Data Protection Act 2018 we are responsible for maintaining the confidentiality of any information we hold about you. For further information visit the following page: Confidential Information about You.

If you or your carer needs information about your health and wellbeing and about your care and treatment in a different format, such as large print, braille or audio, due to disability, impairment or sensory loss, please advise a member of staff and this can be arranged.

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