Diagnosis Explanation:

Intersection syndrome is a type of wrist tendonitis caused by inflammation where the tendons of the first and second dorsal compartments of the forearm cross. It is common in individuals who perform repetitive wrist extension, gripping, or twisting motions (e.g., rowing, weightlifting, manual labor).

Symptoms:

• Pain and swelling on the back of the forearm, about 2-3 inches above the wrist.
• Crepitus (grinding or squeaking sensation) when moving the wrist.
• Tenderness and redness in the affected area.
• Pain with wrist extension or gripping activities.

Specific Work Modifications:

• If your job involves typing or writing: Use an ergonomic keyboard, wrist support, and take frequent breaks.
• If your job requires manual labor: Avoid excessive wrist bending, repetitive gripping, and forceful pulling.
• If your job is desk-based: Keep the wrist in a neutral position, adjust desk height, and avoid resting the wrist on hard surfaces.
• Avoid: Repetitive wrist movements, forceful gripping, and prolonged wrist extension.

Specific Activity Modifications:

• If you play sports: Avoid rowing, weightlifting, racket sports, and activities requiring repetitive wrist extension (tennis, baseball, golf).
• If you do yoga or Pilates: Modify wrist-bearing poses (e.g., plank, downward dog) to reduce strain.
• If you play an instrument, knit, or garden: Use larger-handled tools and modify grip positions.
• Avoid: Excessive wrist extension, prolonged gripping, and forceful twisting movements.

Recommended Supplements:

• Collagen Peptides – 10g daily for tendon repair.
• Vitamin B6 – 50-100mg daily to support tendon and nerve health.
• Omega-3 Fatty Acids – 1000mg daily to reduce inflammation.
• Turmeric (Curcumin) – 500-1000mg daily for pain relief.
• Magnesium – 300-400mg daily to support muscle relaxation and tendon function.

Recommended Nutrition and Hydration:

• Increase Lean Protein (chicken, fish, tofu, eggs) to support tendon 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 tendon recovery.

Home Exercise Prescription (Rehabilitation for Intersection Syndrome)

Early Phase (0-2 Weeks, Reducing Pain & Preventing Further Irritation):

• RICE Protocol – Rest, Ice (15-20 min, 3x/day), Compression, Elevation.
• Wrist Splinting (if needed) – Wear a wrist brace to reduce repetitive motion.
• Gentle Wrist Stretching – Extend arm, pull wrist back gently, hold 20 seconds, 3x/day.

Strengthening Phase (2-6 Weeks, Restoring Mobility & Function):

• Wrist Flexion & Extension (Light Resistance Band) – 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.
• Forearm Pronation/Supination (Light Resistance Band) – Rotate forearm palm-up and palm-down, 10 reps, 2x/day.

Advanced Phase (6+ Weeks, Preventing Recurrence & Strengthening the Wrist):

• Wrist Ulnar Deviation (Light Resistance Band) – Move wrist side to side against resistance, 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.