Wrist Injury Advice

Hi guys, I'm hoping some of you can give me some advice. I apologise in advance, this post is long and rambling but I tried to give as much info as I could...

My husband injured his wrist in February. He was climbing indoors and aggravated his wrist on an undercling when he was working on a bouldering problem. He wore a wrist brace (the kind that just goes over your wrist like the ones weight lifters wear) for a couple of days and it seemed to be healed. Then he went to they gym and did some machine exercises including a bench press (felt a funny sensation), seated row, dips - all machines. Then he tried to use a curl machine but he couldn't do it because it hurt so he stopped. Afterwards his wrist was back to being sore on the ulnar side, mostly hurt when turned his hand palm up from palm down like an opening door action or curling his fist up towards his arm with his palm up. He couldn't fully turn his palm over even through the pain. He's kind of hard headed so he put the wrist brace back on and kept climbing but had a problem with pinches and jug holds.

He took a break here and there and climbed a little less but it wasn't getting any better so he went to the doctor. She had an x-ray done but saw no problems and referred him to an orthopedic specialist. He scheduled an MRI and told my husband not to climb or lift weights until his next appointment (after MRI) which was 2-3 weeks. Nothing showed up on the MRI so orthopedic specialist told him it was probably just a bad sprain and he could start climbing and weight lifting slowly as much as his wrist would tolerate it and to make sure he wore his wrist brace. He said if he still has pain in two months to come back and see him. My husband was still worried so he asked for physical therapy too.

So by now it's been like 2 months since he first injured his wrist. He tried climbing with the brace and he still struggled like he had the whole time and now when he had to pull himself up on a hold on that wrist, he said it felt like his wrist was pulling away from his arm which would instantly take his strength away. He figured out that if he thought about it as he did those types of moves that he was able to somehow put more pressure on his fingers and it wouldn't feel like his wrist was popping out. So climbing wasn't going well and he was getting depressed about his weight lifting because he felt like all the strength he worked so hard to get was slowly fading away.

He did 3 weeks of physical therapy 2x per week. She mostly had him stick his arm in a warm sawdust machine and move it around, then would have him do various movements (unweighted to start and then weighted either by holding a weight or using an exercise band) and then would end the session with ultrasound therapy. Nothing was seeming to change. He stopped trying to go to the gym because he wasn't as strong as he was and he didn't feel like his wrist could do what he wanted. He still tried to climb but not as often and would get frustrated because he couldn't do the grades/moves he was doing.

Then we had car problems and were without a car for almost 3 weeks so he took a break from everything - working out, climbing, physical therapy. He was finally able to turn his hand over all the way though he still had a little pain. We got the car back and scheduled pt again and before his first visit he went climbing indoors. He was so happy and surprised that he was able to climb better than he thought he'd be able to and was basically pain free. All was going well so then he went to the gym. He did most of his normal weight lifting routine but at like 1/2 the normal weight and did pretty ok until he did the curl machine. The day after his wrist was sore once again and he was pretty sure it was because of one of the weight lifting machines either bench press or curl.

He went back to pt, has gone for 3 weeks now. His first visit, the regular tech had someone else sit in (they seemed to know more than her) and they pressed and massaged, and did all kinds of stuff to his wrist on top of the normal sawdust machine and ultrasound. Then she felt his wrist again (checking it for swelling and popping and stuff) and there was this spot kind of in the middle about an inch below his hand where she pushed and as if by magic, he was able to turn his wrist without pain. Of course it came back a couple of minutes later. She said it felt like there was swelling where she pushed in there. She said to completely rest the wrist for two weeks - no climbing, weight lifting, anything. My husband agreed but he wasn't happy about it. After the two weeks, the extra pt tech sat in again and checked his wrist and said she couldn't feel any swelling or anything though she dug her fingers all in his wrist and he was extra sore for days afterwards. (This was last week btw) So they're still doing the sawdust machine, wrist movements (yesterday was weighted again) and the ultrasound. She said he could try climbing and weightlifting again but to try to keep the pain to a 2 or less on a scale of 1 to 10 where 10 is the worst.

Today he went climbing and was seriously upset because he felt like he was weak and could barely pull himself up. He did 2 full routes and was really upset that he couldn't do 2 others though he tried several times. When he was done he said his wrist was sore. By the time we got home 2 or 3 hours later, he says his pain is at a 4 or a 5. He's sick of icing it, I've tried to get him to ice it, heat it, ice it twice a day but the most I ever got him to do it was ice it and heat it one time and others he'd ice it but not willingly. He's sick of his wrist being sore and keeping him from climbing and working out and he's frustrated that he can't do what he was doing at the level he was doing it.

I'm at a loss as to what to do next. It's been two months since his orthopedic specialist saw him last so we'll be scheduling for a recheck next week. In the meantime, does anyone have any ideas as to what could be wrong with his wrist? Any ideas on things to do to rehab an injury like this? Also any tips on getting back into climbing after not really climbing for a period of time?

Hey out there, I busted up my wrist pretty badly and I'm now 10 months out out surgery. It still hurts to sign my name but luckily I can climb more and more with steel plate and screws doing the job. Anyway my surgeon did a fine job piecing radius back together and just figured I'd ask if you were by chance in the Denver area. If you are, It might be worth tracking down my doc that fixed me in Golden, CO. Let me know.
Best,
mike

We're in Central Pennsylvania, my husband is actually from Aurora though. We were planning to drive out there and spend a couple of weeks climbing next month but if his wrist isn't any better we might have to hold out until next year.

Getting a second opinion from another orthopedist might be a good idea.

He should go see a hand certified specialist.These doctors do an extra year in school practicing from the elbow to the hand.
It could be a lot of things.
I have a tear of the TFCC and had surgery on it back in 2012 to clean it up.
It sounds like the same type of symptoms on the same side of the wrist.
He needs to see the right type of doctor not just any ortho.
Good luck!

Yea he was thinking about seeing a hand/wrist specialist though he wasn't sure if he should have his re-check with the ortho he already saw first or just have his dr refer him to a specialist and forget about the regular ortho. What do you guys think?

Forget your regular orthopedist. S/he is wasting your time. Go see a hand and wrist orthopedist just like everyone else has said. You don't need the regular orthopedist's permission. Preferably one who treats athletes. Your husband likely needs an MRA, not an MRI, and it has to be at a facility that provides machines with a very high resolution that is appropriate to create good imaging for structures in the wrist (a good hand doc will know what I am talking about and they should know a facility to go to).

Hey! I've been having wrist pain pretty similar to what you described for almost two years now. Turning door knobs, picking up pots/pans, grabbing pinches or slopers, and sidepulls and underclings feel horrible. I felt like I had pretty much all the symptoms of a TFCC tear. I went to my GP and he recommended an MRI. The first ortho I went to said he didn't see anything, gave me a cortizone shot and said if that doesn't help come back. The cortisone helped for maybe a month, then the pain came back even worse. Went to a second ortho, he said the MRI I had done was the wrong kind, it was not powerful enough to see anything, so he recommended a second MRI. The MRI tech told me the first one I had was a 1.5 magnetic strength (or however you measure MRI strengths) and the one I was getting now was a 3.0. Yay, paying for two MRIs! Went back today for my follow up and he said my ulna is longer than in should be, and its rubbing on my wrist bones, and has frayed part of my cartilage. So, getting 3.5mm of my ulna shaved down this Friday! He said probably 6months of no climbing, then I should make a full recovery.

So possible your husband maybe got the wrong MRI, which is a bummer that doctors even let that happen. Just thought I'd share what I've experienced since it's been super frustrating and sounds a bit similar! Best of luck to him

Aerili wrote:Forget your regular orthopedist. S/he is wasting your time. Go see a hand and wrist orthopedist just like everyone else has said. You don't need the regular orthopedist's permission. Preferably one who treats athletes. Your husband likely needs an MRA, not an MRI, and it has to be at a facility that provides machines with a very high resolution that is appropriate to create good imaging for structures in the wrist (a good hand doc will know what I am talking about and they should know a facility to go to).

+1 on a Hand specialist.

Aerlii, do you mean an MR arthrogram? I've always thought an MRA was an MR angiogram, which may not be the best study.
Supposedly MR arthrography is the best way to see the scapholunate ligament, but that may not matter depending on the physical exam.
The strength of the magneet in MRIs is described in teslas, I think 3.0 is the highest at present.

The Hand specialist's office should be able to tell the OP exactly what he needs as far as minimum teslas and whether he needs an arthrogram.

It is definitely worth calling around and asking about MRI prices unless you have really good insurance. It often varies a lot.

Sounds like similar symptoms to my TFCC tear, though I was pretty debilitated for a while--couldn't type or anything because I couldn't turn my palm down. My occupational therapist made me a removable cast that went all the way up through the elbow, which prevented me from being able to turn my hand over. It seemed to be the only thing that worked (but neither my ortho hand specialist nor my first occupational therapist had made one for me!) I guess normal hand movements just kept the injury chronically inflamed, so until it was immobilized it wouldn't heal. Anyway it took a while, but it finally got better--after maybe 6 months or so.

My hand specialist told me that some people have TFCC tears and don't feel them; others are debilitated like I was. Though the tears do, apparently, show up on MRIs, as that was how mine was definitively diagnosed.

I hope he finds answers and gets better soon!

"He wore a wrist brace for a couple of days and it seemed to be healed."

"He's kind of hard headed so he put the wrist brace back on and kept climbing"

"did some machine exercises including a bench press (felt a funny sensation), seated row, dips"

"He took a break here and there and climbed a little less"

"He still tried to climb"

"We got the car back and .... he went climbing indoors."

"He did most of his normal weight lifting routine"

"Today he went climbing and was seriously upset"

"does anyone have any ideas?"

Umm.... He injured himself. All he had to do is chill out, stop climbing and lifting, and let the fu*ing wrist heal. Clearly he exacerbated the original issue, and now the recovery is going to be even longer and more complex. Your narrative contains all the clues as to what the issue was. Just some basic tendonitis type stuff, probably something common and simple, but his stubborness to leave it alone for a while has been detrimental. The truth is staring you in the face with your very own words.

Mark E Dixon wrote: Aerlii, do you mean an MR arthrogram? I've always thought an MRA was an MR angiogram, which may not be the best study. Supposedly MR arthrography is the best way to see the scapholunate ligament, but that may not matter depending on the physical exam. The strength of the magneet in MRIs is described in teslas, I think 3.0 is the highest at present. The Hand specialist's office should be able to tell the OP exactly what he needs as far as minimum teslas and whether he needs an arthrogram. It is definitely worth calling around and asking about MRI prices unless you have really good insurance. It often varies a lot.

Yes, I meant MR arthrogram, I believe when I had mine done it was called MRA. But that was a number of years ago and maybe I forgot. Why does angiogram get all the preference when it comes to acronyms?!

Russ Keane wrote: All he had to do is chill out, stop climbing and lifting, and let the fu*ing wrist heal. . . . Your narrative contains all the clues as to what the issue was. Just some basic tendonitis type stuff, probably something common and simple

Spoken like someone who never had a wrist injury. Yeah, they're all simple and straightforward tendonitis. Ridiculous hand/wrist fellowships after all that med school....

Sorry to hear about your injury. This sounds somewhat similar to a wrist injury I got last year.

As I understand it, the first step with climbing wrist injuries is to rule out a TFCC injury. I had two doctors and various physical therapists confirm that my injury was not a TFCC injury.

All the medical professionals I saw confirmed that I had injured my FCU tendon near the wrist. The pain was on the ulnar side and was most pronounced if I tried to undercling.

The FCU tendon is the same tendon people injure when they get golfer's elbow, and the protocol that finally seemed to work for me was a variation of the treatments used for golfer's eblow.

What worked for me

• Strength training: wrist curls, reverse wrist curls, and a "wrist flick" exercise where I hold one end of an unevenly loaded dumbbell and contract the ulnar side of my wrist.
• "Reverse tyler twist" eccentric exercises with a therabar.

I do those three times a week (twice a week after climbing plus one extra day).

I had the injury for about a year and tried a bunch of different treatments. Here are a few treatments that did not work for me

• Rest: At various points I took several weeks to a month off climb. This did not help my condition. At least in my experience, I have had to actively rehab soft issue injuries for them to get better. The trick has been finding the rehab protocol that works.
• Other eccentrics: at various points I tried eccentric wrist curls with 20-25 lbs every day, five days a week, or three days a week.
• Just strength training: My wrist did not start to get better until I introduced the therabar eccentric exercise. The strength training exercises alone did not seem to be enough, even if I emphasized the eccentric (lowering) portion of those exercises).
• Armaid massager: hard to say if this helped or didn't, but I used it for a year and didn't get better. When I switched to the rehab protocol that finally worked, I was not using the armaid.

Good luck!

Well, almost all sound medical advice, is to stop the offending movements/actions when you suffer an injury.

If you sprain your ankle running or playing basketball, you are sidelined. You need to stop getting after your sport for a while. How will your body heal?

Never mind whatever the injury is/was, the narrative contains like 15 references to the fact that the guy refused to stop climbing. Laying low is the one thing he never tried. It's not that complicated.

Henry AB wrote:Sorry to hear about your injury. This sounds somewhat similar to a wrist injury I got last year. As I understand it, the first step with climbing wrist injuries is to rule out a TFCC injury. I had two doctors and various physical therapists confirm that my injury was not a TFCC injury. All the medical professionals I saw confirmed that I had injured my FCU tendon near the wrist. The pain was on the ulnar side and was most pronounced if I tried to undercling. The FCU tendon is the same tendon people injure when they get golfer's elbow, and the protocol that finally seemed to work for me was a variation of the treatments used for golfer's eblow. What worked for me * Strength training: wrist curls, reverse wrist curls, and a "wrist flick" exercise where I hold one end of an unevenly loaded dumbbell and contract the ulnar side of my wrist. * "Reverse tyler twist" eccentric exercises with a therabar. I do those three times a week (twice a week after climbing plus one extra day). I had the injury for about a year and tried a bunch of different treatments. Here are a few treatments that did not work for me * Rest: At various points I took several weeks to a month off climb. This did not help my condition. At least in my experience, I have had to actively rehab soft issue injuries for them to get better. The trick has been finding the rehab protocol that works. * Other eccentrics: at various points I tried eccentric wrist curls with 20-25 lbs every day, five days a week, or three days a week. * Just strength training: My wrist did not start to get better until I introduced the therabar eccentric exercise. The strength training exercises alone did not seem to be enough, even if I emphasized the eccentric (lowering) portion of those exercises). * Armaid massager: hard to say if this helped or didn't, but I used it for a year and didn't get better. When I switched to the rehab protocol that finally worked, I was not using the armaid. Good luck!

I will give him your advice because this sounds kind of like what he's going through. Rest doesn't really seem to be cutting it because he says it seems to feel more sore when he's not using it. When he does strengthening exercises it seems to help so we were thinking something to strengthen it would help.

Annie Leavitt wrote:Hey! I've been having wrist pain pretty similar to what you described for almost two years now. Turning door knobs, picking up pots/pans, grabbing pinches or slopers, and sidepulls and underclings feel horrible. I felt like I had pretty much all the symptoms of a TFCC tear. I went to my GP and he recommended an MRI. The first ortho I went to said he didn't see anything, gave me a cortizone shot and said if that doesn't help come back. The cortisone helped for maybe a month, then the pain came back even worse. Went to a second ortho, he said the MRI I had done was the wrong kind, it was not powerful enough to see anything, so he recommended a second MRI. The MRI tech told me the first one I had was a 1.5 magnetic strength (or however you measure MRI strengths) and the one I was getting now was a 3.0. Yay, paying for two MRIs! Went back today for my follow up and he said my ulna is longer than in should be, and its rubbing on my wrist bones, and has frayed part of my cartilage. So, getting 3.5mm of my ulna shaved down this Friday! He said probably 6months of no climbing, then I should make a full recovery. So possible your husband maybe got the wrong MRI, which is a bummer that doctors even let that happen. Just thought I'd share what I've experienced since it's been super frustrating and sounds a bit similar! Best of luck to him

Wow, glad they finally figured out what was wrong with your wrist. 6 months out of climbing is a bummer but if that's what it takes to be pain free so be it. Good luck with your surgery!

Aerili wrote:Forget your regular orthopedist. S/he is wasting your time. Go see a hand and wrist orthopedist just like everyone else has said. You don't need the regular orthopedist's permission. Preferably one who treats athletes. Your husband likely needs an MRA, not an MRI, and it has to be at a facility that provides machines with a very high resolution that is appropriate to create good imaging for structures in the wrist (a good hand doc will know what I am talking about and they should know a facility to go to).

We're waiting on a referral for a specialist now from his family doc. Apparently there's a group of them with offices around our area so we'll see...

Russ Keane wrote:Well, almost all sound medical advice, is to stop the offending movements/actions when you suffer an injury. If you sprain your ankle running or playing basketball, you are sidelined. You need to stop getting after your sport for a while. How will your body heal? Never mind whatever the injury is/was, the narrative contains like 15 references to the fact that the guy refused to stop climbing. Laying low is the one thing he never tried. It's not that complicated.

Thanks for your advice, actually he did stop everything a few times and the last time when he stopped doing anything it actually got worse. So yea, that by itself isn't the answer.