Diagnosis Explanation:

A TFCC injury is a tear or damage to the triangular fibrocartilage complex (TFCC), a cartilage structure in the wrist that stabilizes the ulna (forearm bone) and supports wrist motion. It is commonly caused by falls onto an outstretched hand (FOOSH), repetitive wrist twisting (sports, manual labor), or degenerative wear.

Types of TFCC Injuries:

• Traumatic (Type 1) – Caused by sudden impact, such as a fall or twisting motion.
• Degenerative (Type 2) – Develops over time due to cartilage wear (common in arthritis).

Symptoms:

• Pain on the ulnar side (pinky side) of the wrist, especially with twisting motions.
• Clicking, popping, or grinding sensation in the wrist.
• Weak grip strength and difficulty lifting objects.
• Swelling and tenderness on the outer wrist.

Specific Work Modifications:

• If your job involves typing or writing: Use an ergonomic keyboard and wrist rest, and take frequent breaks.
• If your job requires manual labor: Avoid gripping, lifting, or repetitive wrist twisting. Use wrist braces if needed.
• If your job is desk-based: Keep the wrist in a neutral position, adjust desk height, and avoid resting directly on the injured wrist.
• Avoid: Forceful wrist movements, repetitive rotation, and prolonged wrist flexion/extension.

Specific Activity Modifications:

• If you play sports: Avoid racket sports, weightlifting, and activities requiring wrist rotation (golf, baseball, tennis, gymnastics).
• If you do yoga or Pilates: Modify wrist-bearing poses (e.g., plank, downward dog) to reduce joint stress.
• If you play an instrument, knit, or garden: Use larger-handled tools and modify grip positions.
• Avoid: High-impact activities, repetitive wrist twisting, and excessive weight-bearing on the wrist.

Recommended Supplements:

• Collagen Peptides – 10g daily for cartilage and ligament support.
• Vitamin C – 500mg daily to promote collagen synthesis.
• Glucosamine & Chondroitin – 1500mg/1200mg daily for joint lubrication and cartilage health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support tissue healing.
• Eat Anti-Inflammatory Foods (berries, leafy greens, turmeric, nuts) to reduce swelling.
• Consume Hydrating Foods (cucumber, watermelon, citrus) to maintain joint lubrication.
• Limit Processed Foods & Sugars to prevent inflammation.
• Hydration: Drink 8-10 cups of water daily to support joint and cartilage function.

Home Exercise Prescription (Rehabilitation for TFCC Injury)

Early Phase (0-4 Weeks, Protecting the Wrist & Reducing Pain):

• Wrist Bracing – Wear a wrist brace or splint for 4-6 weeks as needed to stabilize the joint.
• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression, Elevation.
• Gentle Wrist Stretching – Extend arm, pull wrist back gently, hold 20 seconds, 3x/day.

Strengthening Phase (4-8 Weeks, Restoring Mobility & Function):

• Wrist Ulnar Deviation (Light Resistance) – Move wrist side to side with a light weight, 10 reps, 2x/day.
• Wrist Flexion & Extension (Light Resistance) – Hold a small weight, curl wrist up and down, 10 reps, 2x/day.
• Grip Strengthening (Soft Ball Squeeze) – Squeeze a soft ball 5 seconds, repeat 10 reps, 2x/day.

Advanced Phase (8+ Weeks, Preventing Recurrence & Maintaining Function):

• Forearm Pronation/Supination (Light Resistance Band) – Rotate forearm palm-up and palm-down, 10 reps, 2x/day.
• Wrist Circles – Slowly rotate wrists in both directions, 10 reps, 2x/day.
• Thumb Opposition Drill – Touch thumb to each fingertip, 10 reps, 2x/day.

Helpful Books:

1. The Healthy Wrist Handbook: Exercises & Treatments for Wrist Pain & Injury – Dr. Ross Clifford.
2. Overcoming Wrist & Hand Pain: A Self-Help Guide – Susan J. Barnhart, PT.

Contact the Key West orthopedic clinic or reach out to Dr. Jason Pirozzolo.