How to Perform a TFCC Evaluation:Real patient, real injury!
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- เผยแพร่เมื่อ 10 ก.ย. 2024
- Here I demonstrate a brief TFCC (Triangulo-fibro cartilage complex) evaluation on a patient who had a fall and injured his wrist. I show you the most common special tests for a TFCC tear and show the location. We did confirm the diagnosis with MRI results after our initial evaluation. Here are a few videos of the individual special tests we used:
TFCC Press Test: • How to Perform the Pre...
Supination Test: • How to Perform the Sup...
Piano Key Test: • How to perform the Pia...
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Thanks for the video, I just got my MRI results back and the main issue being TFC, I cannot push off the chair at all, and 50% hand rotation. Have an appointment to see hand surgeon but I am always very curious and like doing my own homework and your video was spot on. BTW I have lifted weights for 35+ years and it was heavy dumbbell press that began making my wrists sore, before it tore, so for anyone working out do not ignore the wrist pain, rest it and protect it.
I too have had problems with my wrist from lifting weights. With is more of a nagging feeling than painful. What have you done? should i taking rest for 4/6 week?
It's crazy. I don't have any pain when I do the chair test... but typing on the keyboard does hurt a bit
Thank you Paul! These videos are very helpful during my DPT studies!
You are welcome Edward! Glad you are enjoying the content. You should check out our new website: orthoevalpal.com
Oh wow, I have the exact same tear from falling back and breaking the wrist , 4 months ago. I feel like I’ll never get to do some yoga and push ups again!
Hi Cathy,
These can take a long time to get better( over a year) but often times they need to be fixed surgically if you have tried all conservative measures. Best of luck! Paul
Has it healed now?
@@ssiddique59
Yes, I have strength back, but, I still have limited pronation when my elbow is pulled back like in a typing position. I don’t think it’s from this ligament, I think I had other tears. 14 months since my fall, but still have soreness. Overall not bad.
I have the same thing and it's been 6 months without any progress, Has your tear healed now?
@@cathytussing4718how is it now 3 years later?
I've been dealing with this for 2 years. Felt completely hopeless since every doctor couldn't figure out what was causing it. Is surgery the only long term fix?
unfortunately, yes. pretty expensive too. my doctor recommended me some meds and braced my wrist for 6 weeks and still no progress or whatsover.
@@kyoon-chan2512 Ligaments and tendons do not heal well at all. Our bodies haven’t evolved to produce new collagen or to improve blood flow to these hard to reach areas. Conservative care options are mostly a scam and placebo.
My doctor has suggested PRP (platelets rich plasma) of my own blood injected on the injury, is it effective?
I'm pretty sure I tore my TFCC by just playing guitar. I've made the same motion thousands of times but a few weeks ago I got a pain on the lateral side of my wrist. It hasn't healed and has only became worse.
Hello doctor, You said this patient had ulnar variance? Can you tell me if it's positive or negative ulnar variance please? I have pain in the same area and I have been struggling with it for 6 months and I can't work anymore. Some doctors said I had negative ulnar variance which caused the problem but negative ulnar variance should cause in the radius part of the wrist, right? the last doctor I've seen said it's not ulnar variance and you can't diagnose ulnar variance from an MR. He said it's something with the tfcc. I used to sculpt and paint everyday which is why I had pain in my wrist, I am 24 years old and I just wonder if I will ever get my hand back to normal?
Hey doc, i have all the tests done, and all hurt exept for the pushing out off the chair test, is that possible??
what's the difference between TFCC and tendonitis?
Tfcc is the actual structure. While tendonitis is a potential problem or symptom in a particular tendon
My ulna bone clicks on supination and i have ulnar wrist pain. I’m currently resting my wrist and using a wrist widget. Does it sound like a tfcc injury? I am an avid gym goer and the pain mostly flares up when I grip something
Sounds like TFCC but can't be 100% sure without a full evaluation.
Hey mate we’re on the same boat. I just came back from an ulnar styloid fracture 10 weeks ago and my ulnar side or pinky side of my wrist hurts whenever I do bicep curls. How’s the pain in your wrist doing?
Diether Figuerres I got an x ray and it came back normal. I’m due for an mri in the coming week so I don’t have an answer yet.
Renjiii how did it go? Seems like we’re all on the same boat
Updates on your injury recovery?
How long does take to repair tfcc by self
What is the course of action for this injury?
hello first sorry for my English I can't speak well . please help me this pain made me depressed. I'm 17 and a boxer.5 months ago after punching a bag my TFCC was damaged. Early on, I couldn't lift a heavy think like a laptop, and the part you showed in the movie hurt.But now about 80 or 85 percent of my TFCC is fine and I can lift objects like a laptop Or a heavy object.But I still don't feel like I'm completely well. I did ten sessions of physiotherapy, but it didn't go well.I still have problems with some movements, such as push-ups, and they get less pain (the pain is very litte now but at the first 3 months it was a lot). ulnar bone protrusion at the wrist (the protrusion before TFCC tendons start) become a litte bigger .
what i have to do for What do I need to do to be completely well? Do corticosteroids injections help?
The injections can help some with the pain. These take a LONG time to get better if you don't have surgery. If it continues to bother you, you should see an orthopedic specialist who specializes in hands and wrists. Best of luck!
dang same bro lol it’s been 6 months
Hi i have the same problem, it was also from kickboxing and i get everyday better so can u tell me how is going with u and im not good at english ether
@@ibrahimalyaqoob4939 i still get pain here and there, not sure whether i should go with surgery or not
@@marianomorin8814 same man its over 8 months now idk what to do
the diagonosed me with a torn tfcc but im not sure they got the diagnoses like in the pinky muscle and one side of the writst from keyboard games and controller games the part in the wrist hasent gone away in months but doesnt really react to much except pushing down with thumb over and over or typing too long othewise it just kinda aches on the right side of the wrist all the time
mine is at the joint where the my thumb meets my wrist, I feel pain when moving or stretching my thumb and there are a lot of clicking sounds
Hi doctor. Greetings. I am experiencing the exact kind of wrist pain since my dog pulled me of when leashed. It's been two months. I have constantly rolling wrist using crepe and splint during night sleep. I feel bit of pain when i perform these exercises. Do u suggest me to continue with exercises or not. And any other type u got for my case? Thanks
What kind of treatment for this I have this issue partial tear of ligament what should do
Hello, Sir. My right hand has just been injured for a week. Is it necessary for conservative treatment for a month? Is it necessary to start rehabilitation after conservative treatment?
I have the same issues when I overwork the area..it gets painful for a few days and makes it hard to do anything...but if I stop using it for a day or so it all goes away. A few days ago those tests would be painful, but today the tests you just did didn't bother me. The pain all comes from that Ulnar area.
EDIT: Actually 5 minutes after doing those tests I just had some pain come back in my left hand. Have had issues with both hands.
Did you find the issue?
I have a slight tfcc tear. I don’t feel much pain until I add a lot of stress on my pinky side. I bodybuild. Should I keep working out with a wrapped brace, like is it possible to heal even with me lifting or should I take the time off
You really need to let these heal up some. Avoid wrist twisting exercises or weight bearing through the wrist like push ups. Consider the wrist widget. Link in the notes. Made a huge difference for me when I had this.
@@OrthoEvalPal thanks
Did the pain end up going away or did you get surgery? I’m dealing with the exact same thing from curling too heavy weights at the gym.
Maybe you can answer.
I have a pain on the lateral side of my right hand that feels mostly in that area in my wrist and travels up the pinky side of my hand and into my pinky.
Turning my wrist/hand on the side (you did a 'tfcc load test - I grimaced) gives me a slight pain (annoying but doesn't exactly stop me, for instance, if I am typing and need to turn my hand/wrist).
Stiff when turning my hand up. (Not really painful but now it's almost a burning(?) feeling around my wrist like someone gave me -lack of a much better term- an 'Indian burn' in that area).
No pain with pressure put on the area(s).
I have no idea where it came from. I was fine and woke up after falling asleep with a sore wrist/hand. My other hand is starting to have what I would call 'annoyances' near/at the same area but nowhere as much.
Any thoughts would be appreciated. I bought and am currently using a hand suppression glove that seems to help a little bit.
Thank you for the video.
It could be TFCC or could be a branch of the ulnar nerve
@@OrthoEvalPal thank you for answering. I appreciate it.
Hi, Thank you for your video!
It's very helpful for me to test myself. I get injured my wrist six month ago, and even now, I can feel pain when I do piano test and can't pass chair press test. I think my wrist getting better a little bit over times.
However, it's 6 month while I stop all exercise and rest my wrist, But I did not feel wrist completely fine. Do I have to do get surgery? or it can be healed without surgery by doing physical therapy like stretching? Please help me
Thank you in advance
I want to know the same
Is your tfcc treatment?
I sustained TFCC from work related repetitive motion and the doctor I went to prescribed anti-inflammatory /musclr relaxant medication, analgesic gel, multivitamins, and wrist brace/support strap and they definitely helped a lot. He also recommended to opt for physical therapy that's gonna take 3-6 sessions. I'm still in the process of healing, so I can't say if mine is gonna heal in time, but I suggest you go book an appointment for thorough consultation and evaluation.
I need this fixed not surgically my wrist hurts so bad when I try to lift up my son 😢 and it got worst yesterday trying to fix the stroller now I can’t pick him up at all I feel horrible. This sounds like exactly what I’ve been going through, I just want to be able to pick up my son 😭
Try a wrist widget. You can get it on Amazon.
And then when i rotate it it has clicking sounds and its painful
Pain is medial aspect not in lateral sir
believe I have a TFCC. It hurts right under the pinkie like the TFCC do. It only hurts when I fully extend/stretch it vertically and horizontally. Do u think that means it's a self-fix or should I see a doctor. It have been hurting the same for 3 weeks now. I tiny but improvement I would say.
How's it doing right now? And i wanna know about that bcuz i'm also having wrist pain on the pinky finger side of my right hand (probably tfcc tear or ulnar nerve entrapment) and it's been about a month since it's started. I feel my wrist pain getting better each day but when i stretch my wrist at certain positions and try to lift some heavy stuff, what comes around is a tingling and needle like burning sensation around that tfcc area.Anyway i hope your wrist really goes back to normal.
@@zarvinneonlin1280 My pain is now gone. It took 3 months ish
@@andreaswahlgren4327 what are you doing to fix ur tfcc bro?
@@rafirizhasyakhari2694 did nothing. Some dumbell exercises. That is it
1:24 was the first test a combined MMT or elbow/wrist flexion?
i fell on the ulnar side of my right wrist from skating and now i cant pronate my hand entirely without my shoulder and bicep getting involved and doing the motion. Is this a case of tfcc?
So hard to tell without seeing you. Take a look at all of my wrist playlist videos. I have several with TFCC tests. You should start with an X-ray. That is a common way to fracture the wrist.
I have tfc proplem and i train crossfit should i keep working out with wristband
Yes. I would. You need to keep the wrist stable. Don't push too hard or it will not heal.
I am a boxer I have tfcc injury doctor say after surgery you don't play boxing please tell I play or not
I just can’t move my hand to a push-up position or do a proper bench press, (basically a 90° angle both forward and backward) there’s only pain when I try to move it into that position but I can perform daily tasks perfectly fine. When can I expect to get a full heal? It’s been about 6 months since the injury and I stopped using a brace after about a month
Hard to tell without a full evaluation
How is your injury now? Really curious...
How are you with it now?
Are you really asking a doctor to give you free medical advice based on a few sentences?
How do i treat TFCC? Please help! Thank you.
I have tfcc injury from one year nd i didn't get better so cast is better or brace is better??? Does cast will repair my hand completely or its trail nd error method???
Hey doc. Im had wrist pain in left arm. Is tfcc also had symtoms like mild swelling in the area.
You could. Yes
Does TFCC require surgery?
Thanks for a very good video.
I have the pain in the same hand positions/movements (outer position when rotating my hand and when I lean on/press with the hand). The pain is not unbearable.
For example, I have no (or only very light) pain when I use a hand gripper in a neutral hand position. Will this exercise help the healing process? (Maybe because of more blood flow.)
Or can you recommend other exercises that help the healing process?
Hi Tommy, if you can grip with a neutral position without pain then you are safe to do it. Avoid push ups or activities that ulnar deviate or push the pinky toward your forearm.
@@OrthoEvalPal Thank you very much 🙂
Hai sir. I am also facing same issue last two months onwards. Now what to do to relieve pain .
Hi Narasimha, This is what I love to use with my TFCC tear. amzn.to/2D8lGHs Small, lightweight and really relieves the pain when I do a lot of lifting.
Hey doc I appreciate the video I’ve had this same mysterious wrist pain for about 2 months now and after resting it feels the same if not worse. I play hockey and can’t shoot or handle any resistance on it. I was told it was a possible TFCC tear. There has never been swelling associated with the injury which is why I didn’t think it was a big deal at first but I can barley use it in normal daily routine things at this point. What course of action am I looking at? Will surgery fix the problem and how long is the recovery? Thanks for your time!
Has it healed yet? I hurt mine 3 months ago boxing. Pain has went down a bit but not 100%
@@jakesnake6842 hii bro i also got hurt by boxing since 1 year..my wrist is still in pain plz help me 😭😭😭
Yo I got the same thing from playing hockey
same i cant twist my right hand to the right cant extend my thumb much or else i start to feel something pop. not much pain no swelling just discomfott
A doctor is not going to give you a diagnosis and free medical advice on the internet based on a few sentences
I have injured my wrist during aikido training. Something popped . I did that tests not once no twice. I did MRI can it showed that I might have it but it’s not sure . Doctor said that I shoul to Arturo MRI but I didn’t actually. I had brace for 3 months and it didn’t help at all. I have some rehabilitation and exercises but it made it worse. It’s been 15 months since that but it still hurt a lot. Nothing works so I think sooner or further I will have to do arthroMRI and arthroscopy to fix it.
Yes I agree!
Sir i hurt my wrist by boxing in last 1 year before..my mri Report are normal but it is still in pain😭😭😭 help
I hurt my wrist in boxing a month ago and the dr said my X-rays are fine. Do you still have the pain or did it go away?
I have the pains but I also have a hard lump that feel like stone in my wrist
I would recommend you see your medical provider
Look up "kinesiology taping for carpal tunnel" because it's similar to what you'd do for Guyon's Canal Syndrome (look at wrist anatomy). And please make sure to get a good tape like KT Original, a friend to put the tape on you, and watch John Gibbons (osteopath) taping a wrist. What the taping does is provide some space to ease the pain. It will also, if applied correctly, remind you NOT to do certain motions. Look up occupational therapy for Guyon's Canal Syndrome, Carpal Tunnel Syndrome, and TFCC of the wrist "after" I hope, you see a hand specialist and get an MRI done to rule out serious tears, hairline or larger fractures, and so forth.
I tape my wrist, the right one (I have tape on now) for nerve pain on the lateral side, because of a flare-up from nerve damage that accompanied a fractured pinky back in 2003 or so. The doctor (my PCP at the time) didn't even tell me it was broken, didn't mention the nerve damage, even though the pinky was bent and moved away from the ring finger, plus it hurt like hell (burning sensation).
You'll need someone calm and caring to tape your wrist and take off the tape appropriately as it's a two-person job to do it right: Prep by cleaning it, using 92% or higher isopropyl alcohol to after cleaning it to make sure it's completely dry before applying the tape.
Because you've never had tape there, you don't want to leave it on for more than 24-hours, have your partner in this put olive or some kind of similar oil to saturate the tape, letting it sit for at least five minutes, the s-l-o-w-l-y have the person peel the tape back "on to itself" as though laying down the tape that is being pulled up on top of what is still adhered, this will reduce the painful sensation of pulling up tape, although if you only leave it on the first time for 24-hours, it shouldn't hurt as much as it would (or will) if you leave it on for 3-5 days, and that's because the tape will have adhered REALLY well to your skin, and dried out (OUCH).
After pulling some of the tape up, use PLAIN nail polish remover to the area to get up tape residue, using either cotton balls, or my preference--even though I don't wear makeup, which is the cotton rounds you'll find around the pharmacy area (ask someone about cotton makeup remover pads that are round, someone should know how to direct you to them).
Once your partner has got the tape up using the olive oil and plain nail polish remover, have him or her hold your wrist and gently wash it with a mild soap, then apply some plain white vinegar (it's an anti-bacterial agent, cheap compared to what is sold as an anti-bacterial lotion or whatever), use the alcohol again to dry your wrist, pat it dry, and let air and gentle movement improve you circulation.
BAD NEWS: This is not a "healing" method, but a "stabilizing" and "pain relief" method.
If it works for you, and you already got an all-clear from your doctor, you can repeat this as long as necessary. For my wrist, and some other areas (knees, for instance) it'll be a lifelong method of stabilization and pain relief.
Hope I've given you, or anyone who might wander in here, some information that might help you.
Please help! I have a question about tfcc.
I injured my wrist over a year ago and left it untreated because I didn't think much of it more than just a sprain. But I went to the doctor a month ago and was told it was a tfcc injury. The doctor says the surgery is up to me but my problem is that my wrist only has a persistent clicking and popping but no pain or anything that interferes with my daily activities. A surgery I think is a bit overkill considering it is just the popping that is bothering me. But it has been over a year and the clicking doesn't seem to get any better. What is your advice on this? Thank you so much. Much love!
Hello brother if you find any natural treatment then please inform me too .
@@shaurya4984 I’m trying to do more research on recovery without surgery, how has your injury been? I’m about 3 months in but only been out of the gym for a month now (I kept playing around)
@@stjepanjakic5726 I do workout with the help of wrist widget otherwise I can't even do bicep curls with more than 5 kg weight . As I live in undevelope place hand surgeon is not available here .I am trying to deep massage and phonopherosis on that area
@@shaurya4984 how long have you been injured for and how heavy are you going? Plus what exercises? Bench? I could care less if I can’t bicep curl anymore but as long as I can get the compounds in pain free and continue the gains I’ll be happy
@@stjepanjakic5726 I'm injured for almost 6 months . Yes I can bench heavily but you need to strengthen your wrist muscles before doing any kind of heavy lifting and keep it slow or you might reinjure yourelf . The only advice I will give is to train your wrist muscles as strong as you can train . Many times you can't recover full strength on your wrist after surgery . So consistent physio is the way .
My wrist is paining a lot when I am doing supination. I have TFCC injury since past 8 weeks. I'm using Splint Band from past 2 weeks. Can you please tell what to do now
I’m pretty sure I have the same thing. Just got an mri today. I’ll tell you what my doctor says for recovery. Hate to see injuries.
@@Sophia-ht2dd yes Please tell what your doctor says. I will follow the same
@@Spartan31 ok. I’ll know Tuesday. How did you injure it?
@@Sophia-ht2dd I don't remember exactly
.might be injured when I lifted 20lts water can in a wrong position or in gym I did forearms exercise with weights. Might be in gym I may did in wrong position. Eventually the pain occured after few months
@@Sophia-ht2dd I cannot twist my hand now. It's really painful when I do supination.😭
No surgery?
Piano key doesnt hurt and the second test doesnt hurt, only the suprenation test hirt
Might just be a mild sprain.
Along medial not lateral
I have this however i have swelling too.. i must have torn in :(
That is possible. I would see a hand specialist. Important to get a good diagnosis early.
@@OrthoEvalPal having an ultra sound in January , im a scaffolder/rigger so i use my wrists every day with my spanner
Doc, what is ulnar variance?
Hi Monique, it's when the ulnar is longer then it should be on the outside of the wrist. Good question
@@OrthoEvalPal thank you, i have had a pain in hand and suddenly one unlna styloid process seems swollen because it is now more prominent than the other. I have pain at times in the wrist especially if i wring things. What could cause this?
Medial wrist. Not lateral.
Hey Paul, I've had a tfcc injury for 6 months. I was a weightlifter which is what caused my injury. It has gotten alot better, I can do everyday things, however it still hurts to lift heavy objects. What is there that I can do for treatment? Do I need to consider surgery? Please let me know boss, thank you so much and keep up the great videos!
i think i got mine from weightlifting, but it only hurts when i twist it and it’s a really sharp pain any advice on how u recovered?
@@cj-rc2wh brother it's been 7 months and I still havnt recovered, but, it's almost gone. Just rest it, but also if you can every once in a while, lift some really light weights (5lbs or under). Otherwise, let time do it's course.
@@prabhrajrakhra7446 damn yeah it’s been about a month or so and i haven’t lifted. only thing i can do is squats but we’ll see. appreciate it
@@prabhrajrakhra7446 How's it doing right now? And i wanna know about that bcuz i'm also having wrist pain on the pinky finger side of my right hand (probably tfcc tear or ulnar nerve entrapment) and it's been about a month since it's started. I feel my wrist pain getting better each day but when i stretch my wrist at certain positions and try to life some heavy stuff, what comes around is a tingling and needle like burning sensation around that tfcc area.Anyway i hope your wrist really goes back to normal.
@@zarvinneonlin1280 So after about 6ish months it was near perfectly healed and I was able to start lifting heavy objects and doing strenuous activity again, sometimes it would come back a little bit but it wasn't so painful and more of a dull feeling. Fastforward to now about 1.5 years later it's 100% fixed, zero pain, can do things like pushups and stuff, just crackles and pops periodically
Would’ve been great to know the treatment plan not just how to diagnose. that being said I still love the video. Keep up the great work
I think he said he is not a hand specialist and the patient should see a hand specialist 🤦🏿♂️
i'm so fucked just because of this injury 4 months now i can't work can't provide i'm literally fucked and seeing all this comments gives me no hopes anymore, can somebody do a video on what to avoid doing ? like typing in your pc.. or if allowed to type after a while in what position, what hand should be positioned like .. generally about hand positioning , do massage in spots avoid hot tubs or use this gel before sleep etc..
Look up "kinesiology taping for carpal tunnel" because it's similar to what you'd do for Guyon's Canal Syndrome (look at wrist anatomy). And please make sure to get a good tape like KT Original, a friend to put the tape on you, and watch John Gibbons (osteopath) taping a wrist. What the taping does is provide some space to ease the pain. It will also, if applied correctly, remind you NOT to do certain motions. Look up occupational therapy for Guyon's Canal Syndrome, Carpal Tunnel Syndrome, and TFCC of the wrist "after" I hope, you see a hand specialist and get an MRI done to rule out serious tears, hairline or larger fractures, and so forth.
I tape my wrist, the right one (I have tape on now) for nerve pain on the lateral side, because of a flare-up from nerve damage that accompanied a fractured pinky back in 2003 or so. The doctor (my PCP at the time) didn't even tell me it was broken, didn't mention the nerve damage, even though the pinky was bent and moved away from the ring finger, plus it hurt like hell (burning sensation).
You'll need someone calm and caring to tape your wrist and take off the tape appropriately as it's a two-person job to do it right: Prep by cleaning it, using 92% or higher isopropyl alcohol to after cleaning it to make sure it's completely dry before applying the tape.
Because you've never had tape there, you don't want to leave it on for more than 24-hours, have your partner in this put olive or some kind of similar oil to saturate the tape, letting it sit for at least five minutes, the s-l-o-w-l-y have the person peel the tape back "on to itself" as though laying down the tape that is being pulled up on top of what is still adhered, this will reduce the painful sensation of pulling up tape, although if you only leave it on the first time for 24-hours, it shouldn't hurt as much as it would (or will) if you leave it on for 3-5 days, and that's because the tape will have adhered REALLY well to your skin, and dried out (OUCH).
After pulling some of the tape up, use PLAIN nail polish remover to the area to get up tape residue, using either cotton balls, or my preference--even though I don't wear makeup, which is the cotton rounds you'll find around the pharmacy area (ask someone about cotton makeup remover pads that are round, someone should know how to direct you to them).
Once your partner has got the tape up using the olive oil and plain nail polish remover, have him or her hold your wrist and gently wash it with a mild soap, then apply some plain white vinegar (it's an anti-bacterial agent, cheap compared to what is sold as an anti-bacterial lotion or whatever), use the alcohol again to dry your wrist, pat it dry, and let air and gentle movement improve you circulation.
BAD NEWS: This is not a "healing" method, but a "stabilizing" and "pain relief" method.
If it works for you, and you already got an all-clear from your doctor, you can repeat this as long as necessary. For my wrist, and some other areas (knees, for instance) it'll be a lifelong method of stabilization and pain relief.
Hope I've given you, or anyone who might wander in here, some information that might help you.