FOOSH Injury: Taking Care of Your Upper Extremity Health

During a fall individuals tend to automatically outstretch their hands to help break a fall, which can slam onto the ground causing a falling onto an outstretched hand or FOOSH injury. Should individuals get checked by a healthcare provider if they believe there is no injury?

FOOSH Injuries

Falling down usually results in minor injuries. A FOOSH injury occurs when falling down and trying to break the fall by reaching out with the hand/s. This can result in an upper extremity injury like a sprain or a fracture. But sometimes, falling on one’s hands can lead to serious injuries and/or create future musculoskeletal issues. Individuals who have fallen or suffered a FOOSH injury should consult their healthcare provider and then a physical therapist or chiropractor to safely develop a treatment plan to rehabilitate, strengthen, and expedite recovery.

After The Injury

For individuals who have fallen down and landed on their hand, wrist, or arm, here are a few things to ensure the proper care for the injury, including:

• Follow the R.I.C.E. protocol for acute injuries
• Visit a healthcare provider or local emergency clinic
• Contact a physical therapist

A FOOSH injury could be or become serious, so to avoid letting small issues become big problems, get examined by a musculoskeletal specialist. The healthcare provider will obtain an imaging scan of the injured and surrounding areas. They will perform a physical examination to determine the type of injury, like a sprain or muscle strain. Not getting appropriate medical treatment after a fall can result in chronic pain and loss of function. (J. Chiu, S. N. Robinovitch. 1998)

Common Injuries

A FOOSH injury can injure different areas. These usually involve the wrist and hand, but the elbow or shoulder can also be injured. Common injuries include:

Colles’ fracture

• A wrist fracture where the end of the arm bone is displaced backward.

Smith’s fracture

• A wrist fracture, similar to a Colles’ fracture, is where the end of the arm bone is displaced towards the front of the wrist.

Boxer’s fracture

• A fracture of the small bones in the hand.
• Typically, it occurs after punching something, but it can happen from falling on an outstretched fist.

Elbow dislocation or fracture

• The elbow can pop out of the joint or can break a bone in the elbow.

Collarbone fracture

• The force from falling with the hands and arms outstretched can travel up to the collarbone, causing a fracture.

Proximal humeral fracture

• Falling onto an outstretched hand injury can cause the arm bone to get jammed into the shoulder, causing a proximal humeral fracture.

Shoulder dislocation

• The shoulder can pop out of the joint.
• This can cause a rotator cuff tear or labrum injury.

Regardless of the injury, individuals should visit a healthcare provider to evaluate the damage. If the injury is serious, the practitioner can make an accurate or differential diagnosis and develop a treatment plan. (William R. VanWye et al., 2016)

Physical Therapy

Individuals can benefit from physical therapy to help recover and return to their previous level of function. Physical therapy varies depending on the specific injury, but generally, a physical therapist can help individuals return to function after a fall on an outstretched hand. (William R. VanWye et al., 2016) Common treatments can include:

• Treatments and modalities to decrease pain, inflammation, and swelling.
• Instruction on how to wear an arm sling properly.
• Exercises and stretches to improve the range of motion, strength, and functional mobility.
• Balance exercises.
• Scar tissue management if surgery was necessary.

The therapy team will ensure the proper treatment is utilized to quickly and safely return to normal activities.

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Chiropractic Care For Healing After Trauma

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References

Chiu, J., & Robinovitch, S. N. (1998). Prediction of upper extremity impact forces during falls on the outstretched hand. Journal of biomechanics, 31(12), 1169–1176. doi.org/10.1016/s0021-9290(98)00137-7

VanWye, W. R., Hoover, D. L., & Willgruber, S. (2016). Physical therapist screening and differential diagnosis for traumatic-onset elbow pain: A case report. Physiotherapy theory and practice, 32(7), 556–565. doi.org/10.1080/09593985.2016.1219798