Today we gonna take a deep dive into the wrist injury I see the most in my clinic - the TFCC injury. It is crucial to have a good understanding of this injury for climbers, as it can lead to chronic pain and limited mobility. Keeping you grounded for quite som time.
I'll explore the world of TFCC injuries and how they relate to wrist pain in climbing. Walk you through the symptoms, causes, and treatments for this condition, and provide tips on how to prevent it from affecting your climbing.
By the end of this article, you'll have a better understanding of what TFCC injuries are and what you can do to keep your wrists healthy and keep climbing.
Understanding TFCC Injuries in Climbing
Climbing can be a strenuous sport and often comes with its share of physical injuries, with wrist pain being a common one. Wrist pain in climbers may be caused by a TFCC injury, which refers to an injury of the Triangular Fibrocartilage Complex (TFCC) - an intersection of discs, ligaments and cartilage structures located on the little finger side of the wrist joint.
When climbing, our wrist joint serves as the central pivot point, generating significant twisting and pulling forces as we shift our body position relative to the handhold - whether it be a jug or a crimp grip. The stronger your stabilizing muscles are, the better can you withstand the pulling and twisting forces created from your moving body.
Therefore, it goes without saying that exercises for the wrist are important in the prevention of TFCC injuries.
Common Symptoms of a TFCC Injury
In climbing, the twisting and pulling motion of the wrist can put significant stress on the ligaments, the disc and the cartilage which are all a part of the TFCC.
To be more specific. Anatomically the TFCC includes the triangular fibrocartilage disc, extensor carpi ulnaris tendon subsheath, ulnotriquetral and ulnolunate ligaments, dorsal and volar distal radioulnar ligaments, meniscal homolog, and the ulnocarpal collateral ligament.
The symptoms of a TFCC injury can range from mild discomfort to severe pain and limited mobility. Pain is in most cases felt on the lateral side of the wrist and are worsened with activities like gripping or twisting.
Usually all the following are present, even if swelling in mild cases are not visible.
Pain
Swelling of the outer side of the wrist
Pain with twisting motions of the wrist
Pain during gripping
Decreased grip strength
In cases where pain has been present for a longer period, decreased range of motion and/or stiffness can be present.
Bad news for climbers! But fear not... You can take steps to prevent TFCC injuries by using proper technique, include wrist exercises as a part of your training regime and of course by warming up before climbing.
Being aware of the symptoms and incorporating small changes to your routine can help protect your wrists and keep you on the wall for years to come.
Diagnosis of a TFCC Injury
TFCC (Triangular Fibrocartilage Complex) injuries are common among climbers and can cause severe wrist pain. It's crucial to understand the diagnosis to treat it correctly.
Diagnosing a TFCC injury can be a challenge, but a specilized physiotherapist can help diagnose a TFCC injury and will, if needed, refere you to a doctor for further examinations like x-ray, diagnostic ultrasound or MRI to establish the severity of the injury and rule out bone fractures or other wrist injuries.
If by then the diagnosis remains unclear, the doctor may refere to an arthroscopic procedure to observe the wrist's internal structures. This will allow them to identify any damage to the TFCC.
Once diagnosed, it's essential to protect the wrist from further injury and begin your work with a seasoned physiotherapist.
You should be aware of the signs and symptoms of TFCC injuries and seek prompt medical attention without delay if you experience any of the symptoms.
Treatment Options for TFCC Injuries and Wrist Pain
As described common symptoms of a TFCC injury include pain, swelling, and stiffness. Treatment options for TFCC injuries include immobilization, physiotherapy, and in more severe cases nonsteroidal anti-inflammatory drugs (NSAIDs).
If nonsurgical treatments are unsuccessful, surgical options may be necessary, including TFCC repair or reconstruction.
The rehabilitation strategy for TFCC injuries in climbers include proper technique, specific mobilization and strengthening exercises, gradually increasing the intensity and frequency of training, taking rest days, and using protective equipment like the wrist widget.
Prevention Techniques for TFCC Injuries
Preventing TFCC injuries is always preferable to treating them. The best way to avoid a TFCC injury is to strengthen the muscles in the wrist and forearm by doing specific exercises, while ensuring good technique in climbing.
This can be done for example by using a flexbar, working with putty or a grip strengthener and doing variations of forearm exercises like wrist curls, wrist extensions, supination and pronation and ulnar and radial deviations.
Another method I recommend to a lot of the climbers I see in my clinic is the use of a bucket filled with rice to build strength and endurance. You simply submerge your hands under rice, make a fist and do variations of repetitive movements in all directions and gripping and extension movements of the fingers.
I find the "rice bucket-method" extremely effective, in combination with the use of a pinch-blog, density hangs or pull-up variations when guided by a physiotherapist. All in all, I find that this strategy is the most underrated method for building strong and durable wrists for climbers.
Additionally, to strengthening exercises, it is important to adopt good technique when climbing. This means keeping the wrists in a neutral position and avoiding over-crimping or over-gripping holds. Maintaining proper posture (strong core) and using the legs more effectively will also help to reduce stress on the wrists.
Wearing a 'wrist widget' or taping the wrists can provide added support and stability, and is an important part of your strategy to overcome a TFCC injury. This is also useful if you have experienced previous TFCC injuries or if you are climbing on particularly difficult routes.
By incorporating these techniques into your climbing and your training and taking a proactive approach to protecting your wrists, you can reduce your risk of TFCC injuries and enjoy a safer and more enjoyable climbing experience.
Conclusion
TFCC injuries can significantly affect climbers, causing wrist pain and limiting their ability to climb. It's important to seek medical attention if you are experiencing persistent wrist pain or discomfort while climbing, as early diagnosis and treatment can prevent the injury from becoming worse.
A specially trained physiotherapist can help you with your rehabilitation and the activity modification needed to manage TFCC injuries and help you return to climbing.
As with any physical activity, prevention is key, so proper warm-up exercises, adequate rest, and using proper climbing techniques can all help reduce the risk of developing TFCC injuries and other wrist problems.
By taking proactive measures and being aware of the risks, you can continue to enjoy sending while minimizing your risk of injury.