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ozren


Feb 9, 2011, 12:40 PM
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aerili


Feb 10, 2011, 9:30 PM
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Re: [ozren] TFCC long standing injury - please help [In reply to]
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Hi ozren,

I had a TFCC injury that was basically completely debilitating for me for 10+ months and had symptoms identical to yours. My first surgical opinion was also identical to yours, although he had me try PT (it didn't help; it made it worse). I got a second opinion: it was contradictory to the first. I didn't know who to believe, so I finally got a third opinion (all this, over a period of many months) and he agreed with #2. By this point, I was READY to have surgery.

My answers to your questions:

1) If your perforation is anywhere except the peripheral TFCC, resting for long periods will not heal it. It has no blood supply.

2) Taking glucosamine will be a waste of your money. It will not heal anything.

3) I don't think icing helps. The TFCC is too deep.

4) Stretching in flexion will not heal anything.

5) PT might be effective for you, but my gut feeling is that I doubt it after all this time....and because your symptoms are so similar to mine.

Here's what I would do: GET A NEW SURGEON. Find one who treats athletes. TFCC surgery CAN and DOES work. It got me back to a normal functioning wrist and climbing harder than ever. I wish I hadn't waited sooo effing long. STOP WASTING TIME. NOTHING IS CHANGING FOR YOU. If all you require is a debridement, I don't see why this procedure, under the expertise of a good surgeon, WON'T help you. But find out-- by getting another opinion from the best hand doc you can find. Go. Now!


ozren


Feb 11, 2011, 9:15 AM
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Re: [aerili] TFCC long standing injury - please help [In reply to]
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Hey Aerili,

Thanks a bunch for the quick response.

You cannot imagine the relief your post has given me! I feel like I am in some 10 month long alternate reality and I keep thinking 'what if' I had not injured it, where would I be now in terms of climbing and also in terms of my whole damn life... this injury has ruined many plans..

I realize now it is next to impossible to improve it. However, my other question is how difficult is it to MAKE IT WORSE?

In the past several months I have occasionally done a number of stupid moves and things that stressed my wrist unnecessarily and sometimes extremely...

At other times I have been hyper sensitive not to put any pressure on it what so ever... thus canceling plans to go bike touring...

Is this caution worth it? Will biking or certain types of stress really make it worse and how? The problem is the pain does not really prevent me from doing a lot of these things, including some moderate climbing... I read some posts from people that seem to just live with minor pain in their wrist from TFCC problems...

Everything physical activity I do that requires use of my hands always makes me wonder weather I am just messing it up more...

Finally, regarding pt, does the pt essentially amount to aggressive massaging of the area? Is it something I can do at home?

Sorry for all the questions but it has BEEN SO LONG since I have had any answers at all...

Thank you again!


aerili


Feb 12, 2011, 11:15 AM
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Re: [ozren] TFCC long standing injury - please help [In reply to]
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ozren wrote:
I realize now it is next to impossible to improve it. However, my other question is how difficult is it to MAKE IT WORSE?
I don't know. This may be dependent on the individual and their pain tolerances and the nature of the tear?

The radiologist who did my dye injection told me to wait while the films developed and he would go over them with me and my boyfriend personally (the bf was a doc). While reading them for us in his office, he told me that it is so weird to him that some people have giant tears and virtually no pain at all, whereas other people have tiny little tears and are in extreme pain. So, pain doesn't correlate with severity, apparently.

The other information I have is that my second surgical opinion said that since MY tear was in the avascular portion, waiting for surgery would not change anything about the outcome--i.e. it would not make it worse because no healing was occurring anyway. So...depending on WHERE your tear is, doing "more" might not change anything except your pain symptoms, but this might not indicate you have damaged it more.

In my case, the pain was severe enough I was not capable of climbing, riding a bike, putting weight on my palm, picking up a plate of food, wringing out a washcloth, etc.

As for living with "minor" TFCC pain, I guess this is a subjective call for the individual. There's no hard and fast rule. If the pain becomes great enough to really impede your quality of life, then I would say surgery might be a possible solution.



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Finally, regarding pt, does the pt essentially amount to aggressive massaging of the area? Is it something I can do at home?
Massaging won't do shit for the TFCC. You can't even palpate it anyway. You would need to do strengthening in all four directions. Stretching in flexion and extension (the most effective stretching in flexion for me was making a fist and then pulling it toward my forearm while keeping the elbow straight).

Getting some hand putty is useful too. My hand therapist (post-op) gave me some: pink and green. I had to work up to the green.

Keep in mind that this rehab was only beneficial for me AFTER I had surgery, not before.

I am still of the opinion you really SHOULD get a second opinion now.


ozren


Feb 14, 2011, 9:16 AM
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Re: [aerili] TFCC long standing injury - please help [In reply to]
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Thanks again Aerili

Did your pt come after your surgery or can it be tried before?
I am wondering because the surest way for me to provoke pain in my wrist is precisely by making a fist and flexing it towards my forearm...
Should I try and do this exercise in order to provoke healing? If so, for how many reps and how long?
Sorry about the silly questions but I having trouble distinguishing between pain that might be caused by scar tissue, the actual TFCC perforation and weakness of the wrist...

In any case, I will definitely take your advice and get a second opinion...

Thanks again for all your help.


aerili


Feb 17, 2011, 11:08 PM
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Re: [ozren] TFCC long standing injury - please help [In reply to]
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ozren, if you read my posts carefully, I mentioned more than once about "when" I tried PT. Sorry, but I'm super busy and don't have time to be repeating answers.

I don't think stretching your wrist in flexion will provoke healing in the TFCC; stretching my forearm was just part of my particular rehab (prescribed by a hand therapist) AFTER surgery. They did not have me try this BEFORE surgery.

"Pain from scar tissue"--if your perforation is in the avascular portion of your TFCC, there won't be scar tissue. That part doesn't heal. (Maybe you need to do more research on what goes on with a TFCC injury? Sometimes I feel like I am repeating myself.) But you've also never said WHERE your tear is precisely. Do you know?

Weak wrist muscles can definitely contribute to your continued cycle of pain (certainly it doesn't help). But your pain primarily might be caused for the same reason I think mine was: the perforation caused jagged edges of tissue to be flapping around and which hurts when you move your joint. In my case, the surgeon excised (cut out) this crap and debrided the edges of the hole down to a stable rim. He also did a synovectomy (the far more painful of the two procedures). The synovium was inflamed and goopy from having a malfunctioning wrist for so long. End result for me: pain gone. This is similar to what they do when they scope knees.


ozren


Feb 18, 2011, 7:09 AM
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Re: [aerili] TFCC long standing injury - please help [In reply to]
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I hope you didn't re-tear your tfcc replying to my repetitive questions haha...

Anyway, you have been a great help, thanks a lot for everything!

If anyone else has some experience with this injury, please post away, every bit helps..


Forums : Climbing Information : Injury Treatment and Prevention

 


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