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Help Needed: TFCC tear (wrist)--spoiler alert: WHINING

#1
Chronic shoulder complaints for maybe 20 years, sometimes whole arm and hand. It comes of the work I did, which included taking verbatim notes for hours with a pen and paper. I was grateful every day once they allowed us to bring laptops into the jails and lockups so I didn't have to write any more. Pain! and coming home to roost after all those years.

The pain was back this week, really bad in my wrist and pretty bad in my shoulder. I saw the PT today (we were working on my hips!) and she said it's a TFCC tear.
"A TFCC tear is an injury to the triangular fibrocartilage complex found in the wrist. It is caused either by sudden trauma or may develop gradually."
(sportsinjuryclinic.net)

She gave me exercises, said it isn't that serious, and strengthening was in order. Every night, I've been rubbing in CBD cream, wrapping it in an ace bandage (hoping not to bend it a certain way that hurts), and taking some tylenol when it's really bad. I can't take NSAIDS any more. I'm falling apart, actually! She is worried about me skiing because I shouldn't fall! I read up on this a little bit and discover that splinting is a thing for early treatment, and seeing your doctor is recommended. She told me I didn't need to see the doctor (maybe because I already had a diagnosis?). I mentioned thinking of getting some sort of splint for skiing, and she didn't respond. My wrist is craving a splint. I don't want to do strengthening exercises while it hurts this much. <---whining

Okay, done whining. I'll call the doctor. I'll buy a splint. Anybody have any splint recommendations?
 

Iwannaski

Ski Diva Extraordinaire
#2
I don’t have a splint recommendation. When my wrist hurt, I got one at the local pharmacy after talkingto the nice man behind the counter.

Last year, I had a brutal series of muscle and myofascial problems. Pounding 600-800 mg of ibuprofen wasn’t doing anything and I am scared of anything much harder.

I started seeing a REALLY amazing acupuncturist and she’s been nothing short of extraordinary. She was a referral from a friend and of my close group of 6 friends, 4 of us go to her - the other two have a mental block about the needles. She helped DH with his Achilles tear recovery (ortho told him he could do no surgery for #2 so we supplemented with acupuncture!).

My point being, if you know someone who is a really credentialed acupuncture practitioner, it might accelerate your healing and ease your discomfort.
 
#3
Thanks, @Iwannaski - That's a really good point. I have a referral to an excellent acupuncturist about an hour away. I will call the guy! The one nearby charges $250! New York prices.

I had remarkable luck with acupuncture when I was in my 30s and got every cold that came through town, bronchitis, and pneumonia. A year of treatment and never had bronchitis or pneumonia again! And rarely get colds. My old acupuncturist was trained in China and was a teacher here. I've never had one as good since her.
 

WaterGirl

Ski Diva Extraordinaire
#5
@newboots I thought I had a TFCC sprain and I have a very light weight "brace" specifically for TFCC issues which I'm happy to pass on to you if you like. (Wrist Widget). Turns out I have an "inoperable" ganglion cyst. Which now comes and goes. At the time I thought I had torn a tendon, the pain level was pretty high. MRI ruled out any other issues except for the cyst not being readily accesible for removal without potential nerve damage. My (extreemly conservative) wrist surgeon did not want to operate and I used a custom made brace (Exos) at night for about 6 months, and it has now resolved to the point of being able to surf / ski no issues and only a random reminder its there if I over use it. I have used my brace maybe 2 times in the past 5 months. You may want to follow up with DR or imaging to determine what the cause of you pain really is. At the time I thought for sure I tore a tendon.
 
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lisamamot

Ski Diva Extraordinaire
#6
Turns out I have an "inoperable" ganglion cyst.
oooph, I had a ganglion cyst in my wrist, and man I thought I had fractured my wrist...until I bent my wrist and saw a bump pop up! My doc was able to put a needle into it and draw out quite a bit of the fluid - instant relief. The rest of it must have been absorbed over time.

That is awful they couldn't reach yours. Ugh.
 
#7
I don’t have any splint recommendations, but you have my sympathies and I hope you’re able to figure it out. This does seem like a good opportunity to see if acupuncture helps if you can find a skilled one nearby.
 
#8
@WaterGirl - I'm thinking I should see the doctor, if other issues can masquerade as TFCC. The TFCC wasn't self-diagnosed, but there was certainly no imaging. I'm new to this PT, and she seems quite competent, but I was surprised to read that splinting is generally the first treatment, when she was so gung-ho on strengthening exercises.

Signed,
Hurting in NY
 

WaterGirl

Ski Diva Extraordinaire
#10
@newboots are you functional strength wise? There are certain tests that I believe evidence if the TFCC is torn. I could pop up on a surfboard and hold a ski pole, the strength was there, its just certain movements were (extremely) painful. I have a collection of support braces specifically for surfing, riding my bike, and skiing. But I don't really use or need them anymore. I slept with the EXOS brace for over 6 months and that was enough to REST the cyst and let it shrink up a bit so it wasn't always on the nerve. When we sleep we contort our wrists more than we think. Sounds like you have a history of repetitive movement that triggered "something."

@lisamamot yes it would have been nice to aspirate my cyst but its deep and entwined - my dr said if it ever "popped up" to immediately stop by so he could "take care of it." I actually have two, smaller one dorsal and the problematic bigger cyst is palmar (volar) near the TFCC.

FWIW these cysts can also be found in other parts of your body, usually near an injury or repetitive / over use area.
 
#11
It is definitely an overuse problem. But I am also old enough to be vulnerable to a ganglion cyst! However there is no serious lump.

During my career I often took verbatim notes by hand, sometimes for hours at a time, every day. It was relieved eventually by a fatter pen and finally, thank God, by the ability to use a laptop inside jails and lock ups. The damage is long term though, and includes my hand, forearm, elbow, shoulder, and shoulder blade.

I was never able to relax my hand while I wrote, as many physical therapists and massage therapists recommended! I was keeping a mental outline of the questions I needed to ask, writing, thinking of follow-up questions, making notes on behavioral observations, mentally tossing around diagnostic possibilities, and keeping an eye on the clock. There was simply nothing left over to learn how to write differently.
 
#12
Yes! I will!

And @WaterGirl it is quite weak, mostly from the pain, but possibly in general. She only used a "squeeze my hand" test but it startled me, the difference between my hands.

Today I'm getting a massage! I've had good luck in the past with that hand with craniosacral therapy, and I found a massage therapist certified in that with an opening today!
 

Abbi

Angel Diva
#13
Thanks, @Iwannaski - That's a really good point. I have a referral to an excellent acupuncturist about an hour away. I will call the guy! The one nearby charges $250! New York prices.

I had remarkable luck with acupuncture when I was in my 30s and got every cold that came through town, bronchitis, and pneumonia. A year of treatment and never had bronchitis or pneumonia again! And rarely get colds. My old acupuncturist was trained in China and was a teacher here. I've never had one as good since her.
How much difference in cost (approximately)? Because for the person an hour away you are adding time, gas, driving in winter stress etc. etc. The 'cost' adds up fast. AND an alternative is to schedule both but if the more $$ one is available now, take it and get started on healing. Just my unrequested input!! :wink:
 

liquidfeet

Ski Diva Extraordinaire
#14
Wrist guards for inline skating might do the trick. They come in different styles. You'll need to be able to hold a ski pole.
1612994361551.jpg
Dakine makes a version for snowboarding.
 

liquidfeet

Ski Diva Extraordinaire
#16
I found this. It's not a real review, more like a list of things.
https://bestsnowgear.com/best-ski-snowboard-wrist-guards-gloves/
I liked this one the best since it's less than $30 and I think it is worn over one's current gloves/mittens. Whoops, nope, it's made to fit under your gloves/mittens. "Give your wrists the respect they deserve with the stealth protection of the Burton Impact Wrist Guard. The sleek, low-profile design easily fits under snowboard gloves and mitts for top secret security. Soft padding and easily adjustable hook and loop straps keep them comfortably locked around your wrists."
https://www.amazon.com/dp/B00NFS92D0?tag=bestsnowgear-20&linkCode=ogi&th=1&psc=1
 
#17
I have a great wrist splint. It says “Med Spec”on it. It’s soft on the outside. I wore it sleeping for six months and anytime I skied after a wicked wrist/arm break while mtn biking in fall 2019. It also fit nicely under my ski coat and mitts last season. Now I rely on the metal plates they put in that arm hoping it makes me stronger if I fall. I will say that I feel a PTs rather aggressive approach to therapy really saved me. I thought she was crazy when we started and I had zero function in that hand. It was painful but I’m basically 100% when they said I wouldn’t be. I do agree you should see a doc first.
 

Jilly

Moderator
Staff member
#18
I was thinking about the snowboard wrist guard or even an inline skate. But it needs to fit under something. Back when snowboarding was getting started the guard was part of a mitt. I think @WaterGirl has the best suggestion.
 

WaterGirl

Ski Diva Extraordinaire
#19
I have a ton of different braces, but you need to confirm what the issue is and then address what brace will work best. Thinking back my pain level was high enough (like a 9 all the time) for me to seek out a wrist specialist and pay out of pocket for an MRI. I had self diagnosed the TFCC and purchased this specific brace which I am happy to pass on to you @newboots if that is what you have this will help - just pm me. https://www.wristwidget.com

But I think you need to really determine what it is and treat appropriately. You also mention shoulder issues etc, they can all cause pain down the nerve chain. I do agree with Acupuncture for nerve pain, I love my PTs and my Rolfer, but knowing what my issue was helped me resolve it as I knew any pain was not structural, but rather pressure from the cyst.
 
#20
Thanks so much for all the information and concern! I know I can count on the divas to come through.

I decided to simply call my doctor and get an appointment before I make any decisions. My longing for a brace is just the feeling I have every night at bedtime, when it seems like whatever way I move my hand, my wrist hurts.The most painful part is that I had a whole box filled with these kinds of braces and things. But in my valiant efforts to decluttering, I got rid of them! I just want to immobilize it to go to sleep. I think I’ll just get out the ace bandage again tonight.

Thanks again for all the help! I’m sure I’ll get past this and, I hope, ski again this winter!