TFCC, To surgery or not to surgery....

You might look into prolotherapy.  I had some minor tears and overuse issues in my shoulders about 15 years ago and after prolo I was back to full speed.  Insurance doesn't cover but it's a very reasonable cost.  After about 15 years, it's bothering me again.  Started treatments this week.  As far as prolo goes; the worst that can happen is nothing.  The best is what I got: a fifteen year extension to my climbing.  Climbed pretty hard afterwards; age being the primary obstacle.

Update: I'm just over a month out (12/17/19) from TFCC debridement and "mini" repair:

Background: I tore my TFCC in July 2019 in a bicycle accident. My insurance pushed back on getting an MRI (I am a clinician) so I was left with a very painful and confusing condition for quite a few months. I switched health insurance in November, which allowed me to get the MRI-- of course, it showed a full central tear. I was told I needed surgery, most likely a full repair, but possibly just a debridement-- I wouldn't know til I came out of surgery. I was also told to prepare for the worst, as the full repair requires a biceps-length cast for 6 weeks-- no bending of the albow or supinating of the arm allowed.

When I came out of surgery, I was told by the surgeon that my situation was unique; despite the full TFCC tear, he had found that my joint was very stable (I'm guessing this is because of the musculature and connective tissue strength I've gained climbing). As such, the surgeon debrided the area, threw two sutures into the TFCC, closed me up, and put me in 1. a short arm splint for two weeks, 2. a short arm cast for another two weeks, and now, a short-arm custom brace, to be worn full time except showering and doing OT. I was told by the hand therapist not to lift more than a pound for another 4 weeks, which is not realistic for me as I live alone, but I've been doing my best. Nevertheless, my wrist seems to be doing fine. It is still stiff/painful with ulnar/radial deviation and forearm supination (which was true before surgery as well), but as I continue my exercises it's getting gradually better. I was told this is normal for a few months post-op, and that only time will tell if the surgery was successful.

In any case, my wrist is definitely better than it was. Even if the repair didn't work, the debridement calmed the inflammation. The last six weeks have been a pain in the ass (wearing a bag over my arm while I shower, not being able to clean my house, and just generally looking like a dork), but the reduction in pain is worth it. I am going to be very slow about returning to activities, as I have read about a number of people (mainly climbers) who go hard too soon and re-tear their TFCCs.

Living with a torn TFCC for almost six months before I got the surgery sucked and I would have loved to get it done sooner if it weren't for my insurance. I basically had to baby it and try to stay away from anything I enjoy doing. I couldn't even ride a bike without pain. I would recommend the surgery to anyone whose pain is ongoing. My understanding is that if you only need a debridement, your down time is much shorter, like 2-4 weeks. I can't speak to the full-arm cast, but I am sure it would be even more annoying. Still better than having a chronic injury, though.

Hi Meghan, I am in my thirties and had a TFCC debridement + repair done few weeks ago, my arm has changed to a sugar tong splint now for another few weeks. May I know how was your recovery during the process? Will the fibrocartilage regenerate after debridement? I am worried the disk will wear out in the near future with sports as the fibrocartilage is thinner after debridement? Thank you

Hi Megham, How is your post surgery wrist doing? Hope everything is going well.
I had a tfcc tear in my right wrist around Dec 2018 while serving tennis ball and for next 3 months there was hardly any pain but the pain can be felt later and had to meet my fysio who quickly refer to me surgeon. The surgeon in 2 mins said it's a TFCC complete tear because my wrist was unstable. Pronation and supination was painful. Therefore I went through a surgery on 2nd July 2019. After one month permanent cast till biceps and later split, I was having shooting for few motions, but later I was realising it's getting better. Though pronation and supinations causes lots of pain but with regular exercises it was getting better and better. After 3 months i started with light badminton but i was getting some pain because of weak tendons on the ulnar side coming from elbow to pinky finger. After couple of months rest, it was better. Now I can dumbbell upto 5kg and pronation and supination are almost 180degree. I have still some pain and tiredness after using my wrist. Because it's a right hand wrist, so using lots of mouse and keyboard makes it painfull by end of the day. Someday i have good days and some days are really bad but i feel the wrist is getting better and stronger. After 10months post surgery I started with light tennis for 45mins and it went okay. The week after i played tennis for 1:15hrs and i can feel the pain. Possibly my scars are getting stretched. So i have to take 2 weeks off from tennis again and it's feeling much better. Usually with too much deviation of wrist on ulnar side still causes pain. I have to check with my fysio about it. But I am happy that I went through the surgery and my wrist is lot better than before surgery.

Jack Sparrow wrote: Hey Alyssa if you haven't tried the wrist widget while climbing, i highly recommend it for tfcc related injuries. My tfcc injury was chronic overuse, i took two months off then found the wrist widget, after wearing the wrist widget for a few weeks i started climbing with it and have been relatively wrist pain free for the past year. I always were the brace while climbing and will also wear it when ever my wrist is cracking a lot. Check it out if you haven't already and good luck. Also they are expensive but totally worth it.

Jack,

Do you continue to wear the Widget...or did your wrist eventually improve to not need it?

I don't wear it anymore but it was a long time till I took it off. My injury was from overuse and not traumatic so I think that played a role. However funny enough I just started trying a route with a ton of tweaky underclings and it was flaring up my wrists so I busted out the wrist widgets and still worked like a charm. Good luck