Question #3: How do you I modify for clients with weak wrists?

In this week’s Ask Holly we have a question from our student Ashley about options for sore wrists. This is a doozy with lots to discuss, but here are some basic thoughts from Holly Wallis.

If someone finds weight-bearing on their wrists painful it may be due to arthritis or loss of bone density in that area. Some options often used include putting the clients on their fists or on their forearms for 4-point/quadruped exercises.

Placing the client on their fists as an alternative puts significant load on more vulnerable areas of the hand, like the very small bones and joints of the fingers that are not intended to bear our body weight. This in turn transfers more demand onto the bones and joints of the wrist which may already be compromised.

Wrist pain in 4-point weight-bearing (quadruped) may also be an indication of weak shoulders. Resting the client’s forearms on a sitting box transfers the load directly into the shoulder complex to build more strength around these larger joints with bigger muscles for support. Once the shoulders are strong enough for adequate weight-bearing, supporting on the wrists should be more comfortable if strength is the issue.

The wrists need to be completely aligned to have enough structural integrity to safely bear a client’s body weight. When choosing appropriate options for your client, consider the load demand on this small body part that is not conditioned to carry our weight, as well as asking them whether they have other conditions (arthritis, osteopenia, osteoporosis, carpal tunnel syndrome) that may make supporting on the wrists or hands contraindicated.

Thanks for your question Ashley!

Please share your thoughts and ideas on this question, and also email your questions to to be discussed in a future Ask Holly.

Written by
Holly Wallis, Certified Movement & Rehabilitation Specialist, PMA®-CPT
Director of US Operations, Body Harmonics Pilates & Movement Institute
Studio Director, ReActive Movement, 6200 LaSalle Ave, Oakland, CA 94611

© Movement Monthly 2018. All rights reserved.

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