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FattyFat
Level 0
Join date: Apr 2008
Location:
Posts: 1352
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ajj6603 wrote:
Lol finding another dr might be tough when the guy who wrote the book of hand surgery and invented my procedure was the one who did the surgery.
Don't find another doctor, then and just have your surgeon re-evaluate your wrist.
ajj6603 wrote:
I think I painted a picture of a useless hand to you.
Nah. You're just kinda blotting out all sensible options available to you.
ajj6603 wrote:
I can still play a mean game of racquette ball and lift a decent amount of weight in certain lifts...I can do assisted dips, tricep pull downs...etc..stuff I know isnt possible with a truely instable hand.
All of which is pretty awesome. Considering I still have a TFCC and could get in trouble with triceps pulldowns pre-prolotherapy.
ajj6603 wrote:
Id lift .. get real sore and scared and take time off...then came to the conclusion that resting wasnt gonna do shit...
I'm glad you brought that part up.
Rehab and easing back into your training should be a continuous process. What you've described doesn't sound like it.
ajj6603 wrote:
Again I came in all bone to that surgery and used my hand very differntly...i think the whole arm needs to be re-trained.
Of course. As I've already written: your biomechanics have changed.
ajj6603 wrote:
I do have some laxity on the ulnar side...but it is slight...
Lol. See?
I don't know what you mean by this slight laxity.
Can you pinpoint the ligament(s) responsible for this laxity?
ajj6603 wrote:
I just cant figure out how to stentghen that area... Im doing the wrist curls ou have recommended and I already see a bit of relief. Gonna keep after those. Any other ulna sided strentghening exercises please throw at me!
Anything that strengthens your ulnar extensor and flexor muscles. That's only dynamic stabilization. And seeing how the wrist doesn't rely too much on dynamic stabilization as the shoulder, there's only so much you can do exercise-wise apart from directly strengthening your ligaments.
So, how do you strengthen a ligament?
First, you need to have some kind of injury at the site of the ligament.
Then, this injury needs to heal properly.
Problem: ligaments don't heal very well. How well they end up after healing depends on a lot of factors, such as
- class of rupture
- rehab, aka striking the right balance between loading and unloading (both in training and daily life)
- sleep
- nutrition
So, in such a scenario, certain drugs can speed up the healing process and/or improve collagen (the stuff ligaments, amongst other tissue types, are made of) cross-linking integrity.
A complementary way of strengthening lax ligaments is prolotherapy. I urge you to research this treatment option, seeing how it is minimally invasive, doesn't really force you to lay off training (although adaptations and modulations should be made) and is pretty promising. After all, wrist ligaments, especially those responsible for ulnar stabilization, are rather short. The shorter a ligament is, the faster prolotherapy strengthening can set in (which makes sense from a mechnical point of view).
A good starting point would be to read up on how wound healing takes place and where prolotherapy fits into that.
Then, the different options within the prolotherapy field might good to know about, most of all the different types of proliferants (dextrose, morrhuate sodium, phenol, pumice, platelet-rich plasma etc.).
After that, you could benefit from reading about other patients' results with prolotherapy.
You can start with me:
I've had it done for my wrists, AC and SC joints. It works, but worked best so far with my wrists seeing how the ulnar wrist ligaments are smaller and easier to deload than, say, the SC joints.
The proliferant (injectable solution) consists of dextrose and lidocaine.
Honestly, the wrist injections hurt more than the shoulder injections, but it's really manageable. The wrist then starts to swell up on account of the injected proliferant and the inflammation. This visible swelling subsides after about 3 hours. I had no problem on a 3-hours drive home after that. Also, I weight-lifted the day after.
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fisch
Level 4
Join date: Jun 2008
Location: Nebraska, USA
Posts: 704
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FattyFat wrote:
fisch wrote:
Hey FattyFat, I have a question. You said you had ECU Subluxation but the docs couldn't do anything for you. Did they give a reason why? I had that happen in my right wrist 2 years ago and it took 6 months to be diagonsed, tried to fix it by a full arm cast then surgery once that failed. Im curious as to why surgery wasn't/isn't an option for your wrist?
After examination, they simply didn't deem a surgery necessary.
Still, I kept on inquiring as to what they based this verdict on. Lol, turned out they DIDN'T KNOW of any surgical procedure to alleviate ECU subluxation.
There you go, it was incompetence all along ;)
fisch wrote:
For me they took another tendon from my arm and used it to make a new tunnel. Im not sure on how successful the surgery is because I haven't been able to continue lifting as regularly as normal due to other health issues.
1. I'm interested in the procedure: could you shed more light on it?
fisch wrote:
And on a kind of related note, I have a "complication" from that surgery. If my hand is pronated and I do a lat pulldown/pull up movement (sometimes even with DB bench or a curl) I get a snap/numbness/slight pain by the tendon located near the inside of my elbow. My surgeon is completely confused as to why I have this issue now. I guess I just want to see if in all your research/reading/experience about wrist issues and surgeries if something like this has ever shown up.
2. The snap/numbness/slight pain by the tendon located near the inside of your elbow, does it occur in your extensor or flexor carpi ulnaris? I've never heard of that, either.
Unfortunately im not sure how to break up the quotes very well so I can't interject my comments where they belong, but I numbered the 2 questions of yours im responding to if I mess up.
1. I don't remember a lot of the specifics unfortunately, but I'll do my best to give what I do know and the basic idea. From what I remember/understand of my pre-surgery appointments, the surgery was pretty straightforward. What they do is since the Subluxation is where the tendon is out of the sheath/cartilage tunnel, they take a tendon from another place on your body and basically wrap it around the area where the subluxation occured. I don't know exactly how they secure it, it might be stitches/fasteners of some sort but I know there is NO metal involved. It creates a new tunnel to prevent the tendon from slipping out again.
The tendon they take depends on the person. For most people (60% according to my doctor) we have an extra tendon that flexes your wrist, it is not necessary because there is another tendon in the wrist that performs the same function and takes most of the load. That is the tendon that was used in my case. To tell if you have it is pretty simple, clinch your wrist fairly hard and curl your hand up (supinated position if that wasn't clear). If you see 2 distinct tendons you have the extra one.
If you don't have the extra tendon they can take one from your leg because its the same scenario, it's not required. I tried to google to find a better explanation of the surgery but my time right now is limited and the first few links I tried didn't have good descriptions. I will look again in a couple days to see if I can, I'll let you know.
Post op was 1 month in a full arm cast for me, then I was moved to a wrist brace for a couple months with a full arm splint at night to prevent movement of the wrist. If you have ever been in a full arm cast for a length of time you'll know why, everything was extremely tight and especially since it was surgically repaired more so then I thought it would be. Basically once the cast came off my doctor wanted me to stretch it for 5 minutes every hour every day to get the motion back. No PT because he didn't believe I needed it, though from researching him I found out he's not a believer in it. Knowledgable/friendly doc otherwise though.
The recovery was kind of rough because if I bumped anything with my wrist it would be painful do to the tightness, and if I turned my wrist to close to its new tight limit of range of motion it was extremely painful. Eventually after about 6 months post op I was told I could start light lifting in supinated positions only, then slowly work my way back to lifts with pronation. My full ROM returned about 7-8 months post op.
My wrist felt great returning to lifts, would be sore/hurt a bit sometimes afterward but that has steadily decreased over time. I eventually started doing everything but barbell moves and then worked those back in about 1 month ago (so 9 months post op). I think I got a little to ambitious and tried to do lateral raises my old way (more explosive, not as controlled) and I think at the top when I started going back down I sort of "caught" the weight as it fell rather then lowered it and my wrist hurts again for 2 weeks, but after 2 weeks off its close to pain free again. Stupid move, lateral raises are basically the last thing my doc wanted me to return to.
My surgeon said there is roughly a 15% chance this injury will occur again, whether that will be 6 months from now or 50 years he doesn't know. He said the types of activities I do would have little effect on whether or not it happens again. I personally believe he is wrong here but that is just my own thought out logic.
It took until the 3rd doc for me to even get diagonsed for this, the other two had no idea what ECU Subluxation was. There are definatly docs who don't know this. I know you didn't ask for the post op but I figured as much detail about what this entails I can give you the better. I will try to post back in the next 2 days, I really am out of time. I know I didn't give much info about the surgery itself, I can call my doctor on Monday and ask him for a brief explanation again if you would like, I actually want a refresher about the procedure anyway so if I do call I will be sure to post if he says anything relevant.
I don't know if I would call the surgery a complete success yet, due to a hip/foot problem I will be unable to lift for another 2 months at least, maybe longer. I would guess it was at least partially effective, the pain I used to get tryin to curl any weight supinated is mostly gone.
By the way, I did not proof read this. If something is unclear/seems weird let me know. I'll respond to 2. when I post again.
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fisch
Level 4
Join date: Jun 2008
Location: Nebraska, USA
Posts: 704
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Well my committments fell through for the night so I guess I have time now to finish answering part 2. Still, I decided to wait until at least Monday to call the doc because I want to know if you have anything specific you want me to ask about. I plan on just asking about the general procedure, how the tendon was held in place basically. I assume the docs are willing to re-tell me that.
I am very very bad at the actual technical names of everything in the body (why? I don't know, it's one of the few things my usually excellent memory can't grasp) so I apologize in advance (and in my previous post) if I avoid them and just use explanations, I will try to post links to pictures that show the area I am talking about.
Anyway:
2. From google imaging the flexor carpi ulnaris, the majority of the snapping/pain doesn't seem to occur there. As for extensor I couldn't really find a picture for that so im unsure. However, from the picture:
http://www.proprofs.com/...ad/a5001431.jpg
the snapping/numbness occurs almost exactly where the line ends for the flexor carpi radials (though my hand is pronated so it may not be the same muscle but it is right where the arrow points), maybe SLIGHTLY more towards the thumb side. Just that major tendon/muscle you can see really easily if you do pronated/hammer curls. It starts from down there near the elbow joint and depending on how hard I am flexing (it's very bad if I am doing pull ups) will shoot down all the way to my thumb, which is why I think it could be a nerve getting pinched.
I don't think I mentioned it either, but my TFCC was NOT repaired with this surgery. The TFCC was damaged when the ECU Subluxation happened, but my doctor was sure the cause of my pain was the subluxatoin itself not the TFCC damage. I don't know how badly it is damaged, I just know it is noticable to a doctor because the first 2 docs thought that was my issue and sent me to this third doc (surgery guy) who said it was not the actual issue.
Additional note for my last post: Any pain I have or had have has always been on the ulna side of my wrist, the more supinated hand position the worse the pain. For a while I could not even fully supinate my hand because it would hurt, even with no force applied.
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FattyFat
Level 0
Join date: Apr 2008
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fisch, I hope your doc could shed some more light on your wrist issue.
fisch wrote:
2. From google imaging the flexor carpi ulnaris, the majority of the snapping/pain doesn't seem to occur there. As for extensor I couldn't really find a picture for that so im unsure. However, from the picture:
http://www.proprofs.com/...ad/a5001431.jpg
the snapping/numbness occurs almost exactly where the line ends for the flexor carpi radials (though my hand is pronated so it may not be the same muscle but it is right where the arrow points), maybe SLIGHTLY more towards the thumb side. Just that major tendon/muscle you can see really easily if you do pronated/hammer curls. It starts from down there near the elbow joint and depending on how hard I am flexing (it's very bad if I am doing pull ups) will shoot down all the way to my thumb, which is why I think it could be a nerve getting pinched.
Correct me if I'm wrong, but if your hand is pronated, the arrow wouldn't point at the FCR at all, but at one of the extensor muscles in your forearm.
I actually don't know what might be the underlying cause to all of this.
fisch wrote:
I don't think I mentioned it either, but my TFCC was NOT repaired with this surgery. The TFCC was damaged when the ECU Subluxation happened, but my doctor was sure the cause of my pain was the subluxatoin itself not the TFCC damage. I don't know how badly it is damaged, I just know it is noticable to a doctor because the first 2 docs thought that was my issue and sent me to this third doc (surgery guy) who said it was not the actual issue.
I'm not sure if there is any one surgical procedure to really repair the TFCC. Usually, it's either shaving (to smoothen the cartilaginous surface and preventing further self-iritation) or doing some stitching together, which doesn't usually hold.
I've read about Adequan being rather successful in cartilaginous pain management and restoration of function - which would point to some kind of repair having occurred.
Bear in mind, though, that this is anecdotal evidence.
Platelet-Rich Plasma (PRP) injections are also purported to help in that regard.
Then there are mesenchymal stem cells ...
The way I see it it's either trust run o' the mill procedures or self-educate to better be able to appreciate risks associated with uncommon treatments.
fisch wrote:
Additional note for my last post: Any pain I have or had have has always been on the ulna side of my wrist, the more supinated hand position the worse the pain. For a while I could not even fully supinate my hand because it would hurt, even with no force applied.
Yes, I also used to have that problem.
My ECU subluxation symptoms have been greatly reduced after three prolotherapy sessions (spaced apart 2-3 months, each) with dextrose as proliferant, each. See my post at the top of page 2 of this thread for more information on prolotherapy. My wrist has become more stable, supination doesn't hurt anymore and I feel more confident loading it.
The choice to have prolotherapy done on my ECU subluxated wrist was a shot in the dark, actually. At first, the doc was reluctant to do it because he couldn't see how it might help. So, he tried chiropractic manipulation a few times which helped short-term only, though: after a few days my wrist would just snap back to its dysfunctional state.
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ajj6603
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Join date: Apr 2012
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@FattyFat-
Well I decided to go and fly back to the Mayo clinic on the 22nd to get it looked at...of course Im the ONLY one that has ever come back they made sure to tell me. Im pretty scared. I can see the laxity and more mobility on the ulna side...but its always been like this post surgery..so I dont think I did anything to the repair...its never felt right neither. I went ahead and scehduled my first Prolotherapy treatment on June 1st as long as there is nothing that Mayo can do. My question is could you "feel" the laxity in your wrist...like move your ulna and see that there is slightly more movement?
How bad where you before you had your Prolo injections? ANd how many did you have before you could see a difference and the convidence that you will be ok? Did you do PRP as well? I scared this wont work and ill always have a sore and clicky wrist....
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Smallfry69
Level 3
Join date: Apr 2009
Location: British Columbia, CAN
Posts: 439
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Just saw this thread now... How did things go OP? Did you end up seeing a specialist that has sports knowledge at all?
I had a problem 20+ years ago, but not with my triangular fibrocartilage... I was 19 or 20 and punched someone out and broke my scaphoid bone in my wrist... It hurt like hell when it happened, but I didn't think I broke anything at the time...
I saw my GP (AKA idiot), who never requested an X-ray or anything... He just "knew" it was tendonitis, so I was sent off to physio for ultrasound therapy for 3-6 months...
I continued to lift during all of this... I'll never forget doing heavy dumbell shrugs at Gold's... I'd do about 3-4 reps, put the weight down and literally slam scaphoid bone back into place and bang out another 8 reps...
After about a year of this, I woke up one morning and couldn't pick up an empty cereal bowl, so I know there was really something wrong (yeah, slamming a bone back into place just didn't clue me in)...
I flipped the bird to my GP and went to see a Sports Physician, who sent me in for an X-ray and a molecular bone scan... Turns out it had separated so far, that I would need surgery to repair it...
Off to an orthopedic surgeon and he had to put a screw in my scaphoid bone to pull it together...
Fast forward 20 years and I'm in the best shape of my life, hitting personal best lifts all the time... I don't have full range of motion in my right wrist (e.g. my left wrist can bend back nearly 90 degrees, but my right wrist can only do 3/4 of that)...
So after all this rambling, I just wanted to stress that you see a proper sports physician that knows what they're doing and I hope things work out for you in the end... I also totally get the depressed thing about not being able to lift... I was there and then some, but it gets better...
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FattyFat
Level 0
Join date: Apr 2008
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ajj6603 wrote:
@FattyFat-
Well I decided to go and fly back to the Mayo clinic on the 22nd to get it looked at...
Well done, very commendable of you to take matters into your own hands.
ajj6603 wrote:
of course Im the ONLY one that has ever come back they made sure to tell me.
Don't let that deter you. Maybe it's arrogance, maybe not.
I think it's kinda rude to doubt A patient requesting reevaluation, especially after such a surgery.
It's not like you're imagining things, besides, they also get paid for this.
ajj6603 wrote:
Im pretty scared.
I can see the laxity and more mobility on the ulna side...but its always been like this post surgery..so I dont think I did anything to the repair...its never felt right neither. I went ahead and scehduled my first Prolotherapy treatment on June 1st as long as there is nothing that Mayo can do.
Don't be. It's not like your current situation is going to be aggravated by the reevaluation. At worst, they won't find anything and you're going to have consult other physicians. Besides, there's still the possibility of ligament laxity being the main culprit - which might very well be fixed by prolothereapy, which you've already scheduled.
So, you also got a backup plan.
ajj6603 wrote:
My question is could you "feel" the laxity in your wrist...like move your ulna and see that there is slightly more movement?
Yes.
Laxity can usually be felt site-proprioceptively and by palpation.
Unless your other wrist is shot, use it as reference in a direct comparison.
ajj6603 wrote:
How bad where you before you had your Prolo injections? ANd how many did you have before you could see a difference and the convidence that you will be ok? Did you do PRP as well? I scared this wont work and ill always have a sore and clicky wrist....
It used to be bad.
Both, actually.
Loaded dorsiflexion was out of the question.
Same goes for shear forces.
Now I can do curls, lateral raises and stuff like that without problems - still, since ligament healing takes some time, I'm not 100 %, yet. My confidence definitely did go up, though and my wrists are constantly getting better.
You really should take a look at this: http://en.wikipedia.org/...i/Wound_healing
I haven't done PRP, yet - not for lack of trying, though: I just can't find a doc. I'm living in Germany and treatment modalities like prolotherapy are even less common over here than in the US.
Should you go the prolotherapy route, keep in mind that the injections mainly take care of telling the body to heal the injection site. You, as a patient, need to take care about provisioning, so to speak, i. e. live healthy.
- eat enough
- eat enough protein
- train, don't destroy, take your time with progression, progression shouldn't be governed by 1 RM PR chasing. Use pain tolerance, functionality/stability and confidence as progress metrics.
- sleep enough
- don't take anti-inflammatories (also no fish oil) for 10 days after prolotherapy injections (but I'm sure the doc will inform you on that one)
- up your vitamin C intake, shoot for 5 g a day, first
I've all but neglected the aforementioned guidelines for the better part of 6 months, so my progress was rather small and I hate a few setbacks. Once I fully complied, progress was awesome. It's kinda cool, since, as with training, you're the one in charge, in control of your own recovery.
Also, in case you want to contact me via PM: my PMs don't work, but you can use the email address specified in my hub.
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ajj6603
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Join date: Apr 2012
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@FattyFat-
You said your wrists where bad...can you eleborate on how bad. Mine is still slightly swollen and clicks and cracks all day...and it doesnt feel as tight as the other...like its more spread out on the ulna side if that makes any since. Towards the end of the day I get a slight burn. When I wake up they are swollen and stiff...once I stretch them they go back to click crack grind all day.
So where your wrists this bad??
I was misdagnosed for 20 months before Mayo found that I had severed both RU ligaments. I even won the Womens 2009 Bench Nationals apparently off a dislocated wrist and forearm...What im saying is I wonder if my whole wrist is shot and streched out do to all the training I did after injury since all drs said I was imagining the pain....This is whats scares me...Did you train like this on injured hands?
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FattyFat
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Join date: Apr 2008
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ajj6603 wrote:
@FattyFat-
You said your wrists where bad...can you eleborate on how bad. Mine is still slightly swollen and clicks and cracks all day...and it doesnt feel as tight as the other...like its more spread out on the ulna side if that makes any since. Towards the end of the day I get a slight burn. When I wake up they are swollen and stiff...once I stretch them they go back to click crack grind all day.
So where your wrists this bad??
No, not that bad, but still very bad.
ajj6603 wrote:
I was misdagnosed for 20 months before Mayo found that I had severed both RU ligaments. I even won the Womens 2009 Bench Nationals apparently off a dislocated wrist and forearm...What im saying is I wonder if my whole wrist is shot and streched out do to all the training I did after injury since all drs said I was imagining the pain....This is whats scares me...Did you train like this on injured hands?
Did you really severe both RU ligaments, as in completely torn ligaments or are we talking partial tears?
I didn't sever my RU ligaments, but my carpo-ulnar collateral ligament. As a result of this and me having lifted very heavy for about 1,5 years post-injury, my whole wrist became less stable and my TFCC got some tears.
Now, there's no doubt about your case being a lot more complex than mine. That doesn't mean you can't make a pretty good recovery, though. The fact alone that you did so well as a powerlifter *after* having torn your ligaments speaks volumes for how much dynamic stabilizers (forearm muscles) can contribute.
And, as I've made clear a few times already: if your wrist problems are caused by lax/torn ligaments, prolotherapy will definitely help you.
This should be the take-home message, so I'm gonna repeat it: if your wrist problems are caused by lax/torn ligaments, prolotherapy will definitely help you. How much it will help usually comes down to the technical skills of the doc and the proliferant (injection solution) used.
There's just one condition: prolotherapy works best on partial tears. There have been cases reported where prolotherapy also worked with complete tears, but then a few additional factors need to be taken into account, such as how close both ligament halves are.
In other words: if you're eligible for prolotherapy, it's only a matter of time until your wrist will get better.
I know this is easier said than done, but it's important for you not to despair and to stay positive. After all, you don't have any reason not to be positive, since you don't have exhausted all your options, yet.
I've been making pretty good progress on rehabbing a nasty injury that's taken a big toll on my quality of life for the last 2 years - until last week, when I was moving houses and carrying heavy stuff, I lost control over a heavy and unwieldy piece of furniture and pretty much nullified a quarter year progress. So what? I had no business carrying that heavy piece of shit in the first place. Is it aggravating and frustrating? Hell, yeah! But it's just a matter of time until this shit heals. I just made too many mistakes, had to self-educate along the way and basically integrate medical services (such as prolotherapy) into my own healing plan, so to speak.
Let me tell you a bit about how I dealt and am still dealing with a rather rare injury.
Most physicians I had been to just told me stuff like this:
"You have no business lifting weights, anymore. This isn't a problem, eh? Hey, just take to biking!"
"I don't see any problems. You're imagining things."
"You can't put your arm over your head? Well, just don't, then."
"You can't wiggle out of most t-shirts, pullovers etc. on your own? I don't believe you."
"Well, it's all your fault. Weight lifting isn't healthy in the first place."
"All I can do for you is take a bit of pain away."
"You can't go for a even a light jog, anymore? Go biking."
"You can't sleep in a lying position? How do you sleep, then? Sitting, with your arms crossed over your chest? Sorry, nothing I can do for you."
Guess what? I managed to improve said joint by a lot. And add some serious muscle to my frame in the process. Of course, I had to adapt: I couldn't train the way I used to, not by a long shot.
For the better part of 1,5 years, I couldn't even go down on my girl missionary-style, let alone engage in more active positions. Guess what? I can do missionary-style, again ;) Still working on getting back into other positions, as well ;)
Once, I went kite-running (or kite-walking, in my case): I enjoyed the shit out of it - and I felt my ligament tear after a sudden gust of wind jerked the kite around. Again, progress nullified.
Rehabbing this condition, I've fucked up a lot during the last two years, but still made some serious progress, progress most docs wouldn't have thought possible. If I had known 2 years ago what I know now, I'd be almost 100% in that regard, that I'm sure of. I had to change my lifestyle: sleep, eating habits, supplementation and also outlook on life. Since then, it's been going pretty well, despite some setbacks here and there.
Also, I had help along the way: I had found a guy on the internet with the same injury. He's also pretty active and lifts and was a great source of information.
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ajj6603
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Join date: Apr 2012
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@FattyFat-
Thanks for your help. Ive always been a gym rat. This is my first serious injury and its been very draining...at times I just wished my wrist was fused. Also very unimpressed with the medical field...the pain being in my head...the first surgeon missing 2 severed ligaments during the scope. Thinking I always have to live like this since nothing is wrong...anyhow. Lets just say my legs are VERY tired with all the extra attention they have been given.
The Prolotherapy dr is suppose to be one of the best in the country...they do PRP...Prozone. They said they will do that if needed. Just have to see.
Ill keep you updated. Again thanks for all your help and information.
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Codered92
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Join date: Jun 2012
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Its a very bad injury...
I injured my right wrist in 2011 April from a fight. The doctors are didn'n know my the cause of my pain and says the problem is on my head because my X-rays and MRI was show nothing. Finaly in January I found a great doctor who told me the diagnosis. I need surgery and he did it 2,5 month ago.(he did me artroscopy and remove a little injured part from my TFCC and shortened the ulna. I'm in full cast for 5 weeks and 2 weeks in simple medical bandage.
So Now I have nearly full range motuon. I do my rehab seriously. Go to PT 5 a week and tran my wrist 4 time a day. Its help a lot.I'm not powerlifter and not competitor. I'm a simple man who likes gyming but i like lift heavy. I have some qouestions for this forum mebers!
How much time is the wrist back to normal?
When Can I start lifting weights again?
If you have surgery when did you start the training?
Can you lift heavy again?
Lots of thanks if you answer!
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ajj6603
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Welp Ive come to the conclusion that I have a very high pain tolerance. I went back to Mayo and my right wrist is pretty much on its last leg. Not only did my DRUJ reconstruction fail but I also have ulnocarpal instability, DRUJ INSTABILITY and ECU subluxtion (the tendon was found on the palm side of the wrist!). Mind you I fly to see the best hand surgeon in the USA and he wasnt even sure if he could fix it. He wound up doing a modified version of an existing surgery. Made a tendon sling that would support the ulnocapal sag and re-stabalize the DRUJ. He took 10" of my FCU tendon for the repairs and used the left over amount for a new tunnel for my ECU tendon. Pretty scary surgery because he had to widen the bone holes in my ulna from the previous reconstruction i had. He said there wasa very high risk he could crack the ulna head in doing this which would mean instant joint replacement. At this point i was in so much pain it was worth the risk. There is also a likelyhood i will require a DRUJ joint replacement in the future due to arthritis. I guess heavy bench press really took a toll on my wrists even though I never had any pain prior to my injury...but i guess that would have caught up with me sooner or later. Heavy Lifting is def out for me. I hoping some sort of light lifting will exist for me...but at this point i need pain free as possible use of my hand. Tennis, golf, racket sports probably a no no as well.
Oh yeah. I also have the same injury now in my left wrist if you can believe that!!! I went hiking and instead of possibily falling on my casted right arm I did a butt scoot across a rock with very static pressure on my left wrist to push myself. Maybe 30lbs of pressure? Anyhow some how that was enough. Felt a pop and the same instability and popping / grinding came back. Jesus I cant even go hikng without hurting self! Fairly sure have a peripheral tfcc tear since ive been pretty good at diagnosing myself. I fly back to Mayo tomorrow to get my cast off and do an MRI on the left wrist. Im sure my Dr will shit himself seeing I have 2 injured wrists at the same time...but at least I dont have to waste another 20 months of my life of Drs not beliving my injury!! Hoping the left will be alot easier to fix since i really didnt have a dynamic injury but if surgery is required I have to wait till the right heals first since day to day living would be too hard. Maybe the left one went out since its been overused sooo much since the right has been injured and that pressure was just enough for injury. Who knows.....
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FattyFat
Level 0
Join date: Apr 2008
Location:
Posts: 1352
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Glad to hear from you.
And very sorry for how things have turned out for you.
I know it's only words, but they're true nonetheless: you might feel like you've hit rock bottom, at the moment, but you will make a comeback. Not 100 %, but you'll make a comeback to chase PRs (maybe not 1RMs in pressing, but still).
Your primary concern is to heal. This is a job in itself, since the risk of reinjury or maybe even negating the surgeries' effects is rather high in day to day life (take your regrettable hiking experience, for example).
I speak from my own experience in this regard: just a month ago my injury seemed to be on the mend. After having spent two days sitting in cramped-up positions during a conference, I badly tore a ligament wiping my ass in an airport bathroom ;)
Spending your spare-time with outdoor activities, not to mention taking care of daily chores, is crucial. Just be aware that chronic pain might have affected your overall posture and proprioception by forcing you into disadvantageous biomechanical positions. In other words: be aware of your temporary biomechanical shortcomings and find the healthiest ways with respect to your injuries and specific movements.
Back to the healing aspect of your situation: take control of things you can control and don't focus on the rest.
- be as active as you can without compromising your healing process
- take care of your nutrition:
1. this is no time to go on a fat loss diet
2. eat complex carbs, eat healthy fats, don't get skimpy with your protein intake
- sleep!
- find a good physiotherapist with expertise in wrist rehab, preferably for athletes
- maybe weight-train your lower body and core - with machines allowing you to NOT involve your hands - you're a one-armed bandit, right now (without the arm). I'm no doctor and this is only an internet conversation.
- use doctors as tools, abide by their specific instructions as long as they're helping you. Defer to their superior anatomical knowledge, somewhat. But don't let a doctor tell you what you won't be able to do again, some day. Especially if he/she isn't an athlete.
I'm pretty sure you'll be able to pull some serious weight again - maybe you'll need straps, so what?
I wasn't able to do any serious pressing exercises for the last 3 years, overhead pulling is also out of the question, dito squats and deads. Still, I'm the most muscular I've ever been, albeit my 'muscle distribution' has become different. Also, I've become a lot more functional (core stuff) in terms of how I move.
I've had to find my own way to go about things, most stuff listed in T-Nation training articles (which are excellent) wasn't applicable to me. Now, I know a whole lot more about my body and can, to a degree, talk shop with orthopedists and physiotherapists. In other words: embrace self-education, self-observation and trial and error.
Would I like to overhead press 1.5 of my bodyweight? Or bench press 400 lbs for reps? Or do all-out tabata squats with 280 lbs? Hell, yeah! But I can't (right now, maybe never again). So I found other weight training outlets. I'm on my way to get to a beach-ready 220 lbs on my short 5'7" frame. I put on a good 30 lbs of muscle (some of it muscle memory) in the last 6 months applying a suitable mix of bodybuilding, strength training and conditioning, with my rehab governing my training intensity.
So, you may need to get to know your body better. Your old tools (e. g. your old staple exercises) might not be up to the task, anymore.
Observe, adapt, overcome.
All I can tell you is to be patient and take it step by step. You'll feel better 6 weeks from now. And even better 12 weeks from now.
You might feel helpless, right now, but you aren't: focus on what you can control. This is simple, powerful and important.
Stay strong. And patient.
ajj6603 wrote:
Welp Ive come to the conclusion that I have a very high pain tolerance. I went back to Mayo and my right wrist is pretty much on its last leg. Not only did my DRUJ reconstruction fail but I also have ulnocarpal instability, DRUJ INSTABILITY and ECU subluxtion (the tendon was found on the palm side of the wrist!). Mind you I fly to see the best hand surgeon in the USA and he wasnt even sure if he could fix it. He wound up doing a modified version of an existing surgery. Made a tendon sling that would support the ulnocapal sag and re-stabalize the DRUJ. He took 10" of my FCU tendon for the repairs and used the left over amount for a new tunnel for my ECU tendon. Pretty scary surgery because he had to widen the bone holes in my ulna from the previous reconstruction i had. He said there wasa very high risk he could crack the ulna head in doing this which would mean instant joint replacement. At this point i was in so much pain it was worth the risk. There is also a likelyhood i will require a DRUJ joint replacement in the future due to arthritis. I guess heavy bench press really took a toll on my wrists even though I never had any pain prior to my injury...but i guess that would have caught up with me sooner or later. Heavy Lifting is def out for me. I hoping some sort of light lifting will exist for me...but at this point i need pain free as possible use of my hand. Tennis, golf, racket sports probably a no no as well.
Oh yeah. I also have the same injury now in my left wrist if you can believe that!!! I went hiking and instead of possibily falling on my casted right arm I did a butt scoot across a rock with very static pressure on my left wrist to push myself. Maybe 30lbs of pressure? Anyhow some how that was enough. Felt a pop and the same instability and popping / grinding came back. Jesus I cant even go hikng without hurting self! Fairly sure have a peripheral tfcc tear since ive been pretty good at diagnosing myself. I fly back to Mayo tomorrow to get my cast off and do an MRI on the left wrist. Im sure my Dr will shit himself seeing I have 2 injured wrists at the same time...but at least I dont have to waste another 20 months of my life of Drs not beliving my injury!! Hoping the left will be alot easier to fix since i really didnt have a dynamic injury but if surgery is required I have to wait till the right heals first since day to day living would be too hard. Maybe the left one went out since its been overused sooo much since the right has been injured and that pressure was just enough for injury. Who knows.....
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ajj6603
Level 0
Join date: Apr 2012
Location:
Posts: 11
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FattyFat wrote:
Glad to hear from you.
And very sorry for how things have turned out for you.
I know it's only words, but they're true nonetheless: you might feel like you've hit rock bottom, at the moment, but you will make a comeback. Not 100 %, but you'll make a comeback to chase PRs (maybe not 1RMs in pressing, but still).
Your primary concern is to heal. This is a job in itself, since the risk of reinjury or maybe even negating the surgeries' effects is rather high in day to day life (take your regrettable hiking experience, for example).
I speak from my own experience in this regard: just a month ago my injury seemed to be on the mend. After having spent two days sitting in cramped-up positions during a conference, I badly tore a ligament wiping my ass in an airport bathroom ;)
Spending your spare-time with outdoor activities, not to mention taking care of daily chores, is crucial. Just be aware that chronic pain might have affected your overall posture and proprioception by forcing you into disadvantageous biomechanical positions. In other words: be aware of your temporary biomechanical shortcomings and find the healthiest ways with respect to your injuries and specific movements.
Back to the healing aspect of your situation: take control of things you can control and don't focus on the rest.
- be as active as you can without compromising your healing process
- take care of your nutrition:
1. this is no time to go on a fat loss diet
2. eat complex carbs, eat healthy fats, don't get skimpy with your protein intake
- sleep!
- find a good physiotherapist with expertise in wrist rehab, preferably for athletes
- maybe weight-train your lower body and core - with machines allowing you to NOT involve your hands - you're a one-armed bandit, right now (without the arm). I'm no doctor and this is only an internet conversation.
- use doctors as tools, abide by their specific instructions as long as they're helping you. Defer to their superior anatomical knowledge, somewhat. But don't let a doctor tell you what you won't be able to do again, some day. Especially if he/she isn't an athlete.
I'm pretty sure you'll be able to pull some serious weight again - maybe you'll need straps, so what?
I wasn't able to do any serious pressing exercises for the last 3 years, overhead pulling is also out of the question, dito squats and deads. Still, I'm the most muscular I've ever been, albeit my 'muscle distribution' has become different. Also, I've become a lot more functional (core stuff) in terms of how I move.
I've had to find my own way to go about things, most stuff listed in T-Nation training articles (which are excellent) wasn't applicable to me. Now, I know a whole lot more about my body and can, to a degree, talk shop with orthopedists and physiotherapists. In other words: embrace self-education, self-observation and trial and error.
Would I like to overhead press 1.5 of my bodyweight? Or bench press 400 lbs for reps? Or do all-out tabata squats with 280 lbs? Hell, yeah! But I can't (right now, maybe never again). So I found other weight training outlets. I'm on my way to get to a beach-ready 220 lbs on my short 5'7" frame. I put on a good 30 lbs of muscle (some of it muscle memory) in the last 6 months applying a suitable mix of bodybuilding, strength training and conditioning, with my rehab governing my training intensity.
So, you may need to get to know your body better. Your old tools (e. g. your old staple exercises) might not be up to the task, anymore.
Observe, adapt, overcome.
All I can tell you is to be patient and take it step by step. You'll feel better 6 weeks from now. And even better 12 weeks from now.
You might feel helpless, right now, but you aren't: focus on what you can control. This is simple, powerful and important.
Stay strong. And patient.
ajj6603 wrote:
Welp Ive come to the conclusion that I have a very high pain tolerance. I went back to Mayo and my right wrist is pretty much on its last leg. Not only did my DRUJ reconstruction fail but I also have ulnocarpal instability, DRUJ INSTABILITY and ECU subluxtion (the tendon was found on the palm side of the wrist!). Mind you I fly to see the best hand surgeon in the USA and he wasnt even sure if he could fix it. He wound up doing a modified version of an existing surgery. Made a tendon sling that would support the ulnocapal sag and re-stabalize the DRUJ. He took 10" of my FCU tendon for the repairs and used the left over amount for a new tunnel for my ECU tendon. Pretty scary surgery because he had to widen the bone holes in my ulna from the previous reconstruction i had. He said there wasa very high risk he could crack the ulna head in doing this which would mean instant joint replacement. At this point i was in so much pain it was worth the risk. There is also a likelyhood i will require a DRUJ joint replacement in the future due to arthritis. I guess heavy bench press really took a toll on my wrists even though I never had any pain prior to my injury...but i guess that would have caught up with me sooner or later. Heavy Lifting is def out for me. I hoping some sort of light lifting will exist for me...but at this point i need pain free as possible use of my hand. Tennis, golf, racket sports probably a no no as well.
Oh yeah. I also have the same injury now in my left wrist if you can believe that!!! I went hiking and instead of possibily falling on my casted right arm I did a butt scoot across a rock with very static pressure on my left wrist to push myself. Maybe 30lbs of pressure? Anyhow some how that was enough. Felt a pop and the same instability and popping / grinding came back. Jesus I cant even go hikng without hurting self! Fairly sure have a peripheral tfcc tear since ive been pretty good at diagnosing myself. I fly back to Mayo tomorrow to get my cast off and do an MRI on the left wrist. Im sure my Dr will shit himself seeing I have 2 injured wrists at the same time...but at least I dont have to waste another 20 months of my life of Drs not beliving my injury!! Hoping the left will be alot easier to fix since i really didnt have a dynamic injury but if surgery is required I have to wait till the right heals first since day to day living would be too hard. Maybe the left one went out since its been overused sooo much since the right has been injured and that pressure was just enough for injury. Who knows.....
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ajj6603
Level 0
Join date: Apr 2012
Location:
Posts: 11
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Hmm..not sure what happened with the last post. Anyhow got back from Mayo..cast is off and starting with ROM exercises...nothing like 7 weeks in a long arm cast...
I attached a pic so you can see how rebuilt my wrist is. Bottom pic is a Berger/Adams DRUJ Reconstruction done by Dr. Berger himself....I told you that I dont mess around anymore...I neef the best of the best with how complex injury is getting..I go right to the source itself now! Top pic is the procdure I had. Hui/Linscheid ulnocarpal reconstruction and DRUJ stabilzer. I apparently am the first person ever to have both procedures done..lucky me. Its usually one or the other...but my Dr was able to go through the existing bone hole channel in my ulna with my FCU tendon graft and wrap it around to create a new tunnel for my ECU tendon..pretty slick. I literally have the work of 4 famous wrist surgeons in my hand. Im trying to be positive of the unknown results but i have an extremely experenced dr on my side...He's fairly confident it ill work...but being the first Im a "wait and see". I should be able to return to some type of lifting if all goes well but I will never push it again. By Dec i should see some progress..if not the only thing left to do is full wrist fusion and DRUJ replacement.
Well on a good note my left wrist is calming down. Its moving better and the popping has stopped..it feels stable...just sore. Still nervous how I felt that pop. Ive never "sprained" anything...i just wind up severing ligaments from the bone instead...
Have you ever felt a pop from your wrist..palm side..sorta by the pisaform FCU tendon....or really anywhere on the ulna side...have it be sore for a few months and just get beter over time?
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DeeDuub
Level 0
Join date: Dec 2010
Location:
Posts: 13
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FattyFat wrote:
Hi,
I've received a few PMs regarding wrist and TFCC issues I replied to.
@OP
Wrist injuries usually boil down to ligament and cartilage damage, as with your TFCC injury.
My wrist injuries so far:
1. partial (2/3) ligament rupture in ulnar wrist + TFCC damage
Got it thanks to a botched clean and press attempt.
Consulted with two sports physicians who only X-rayed my wrist, did very little in terms of palpation and diagnostics and told me it was just a sprain, I should keep on lifting as long as it wouldn't cause me pain.
And so I did, for about 15 months. Only noticed mild discomfort / pressure during pressing exercises, but no real pain. My wrist got very loose, though, so I consulted with a hand surgeon who did an arthroscopy and found the aforementioned partial rupture and damaged TFCC tissue. I guess I incurred the TFCC damage during the 15 months training post ligament rupture.
The surgery went fine, got a full cast on my arm for 4 weeks and a half-cast for another two weeks. My arm had atrophied a LOT (lost almost 4"), but it all came back pretty fast (after 5 weeks of training, give or take) thanks to the almighty memory effect.
I made a few mistakes, though:
- got into lifting too soon and too heavy
- didn't appreciate the importance of proper rehab: ROM exercises and self-massage to minimize scar tissue
- went too athletic too soon: push-ups, burpees, you name it - pretty dumb
6 months post-op I fell and tried to brace my then-200 lbs with my just rehabbed hand. Things went downhill from there and try as I might, I couldn't find a doc who could help me out.
2. ECU subluxation in other wrist
Got it two and a half years post-op during narrow-grip supinated 'bb speed rows' - I simply went too fast and my other wrist was too relaxed - I just wasn't focused enough, I guess.
My wrist lost a good deal of stability and sometimes there would be some swelling at the ulnar wrist, with rashes surfacing the back said hand.
Again, docs couldn't help me.
Now to the stuff that did actually help me:
1. TFCC damage
There's a cool wrist wrap called 'Wrist Widget' - I'd definitely give it a try.
Basically, it's doing the TFCC's job without taking stress off the muscles responsible for wrist stabilization. The inventor claimed it should be able to heal TFCC damage after wearing it for at least 6 weeks non-stop. That I did - and my wrist really got better.
I'd just stay off pressing exercises for at least 3 months and use straps for pulling exercises - better safe than sorry. Also, depending on wrist flexibility, I'd lay off barbell squat variations. Don't do exercises where force applies perpendicular to your wrist. Rows and shrugs should be fine, curls aren't.
2. Cartilage regrowth
Some people claim they managed to regrow cartilage by using Adequan. Just google it. It's an injectable for horses and canines, but inspired by its efficacy on their horses joint improvement some horse owners have taken to using it on themselves, too. The same substance used to be made for human use in the late 80s, but was taken off the market in the early 90s due to some complications (google for Arteparon).
Some forum locals have given Adequan a try. If I had severe TFCC damage, I'd give it a try.
2. Regenerative injection therapy aka prolotherapy / proliferation therapy
A very promising kind of treatment making use of the body's own healing capabilities.
Upon injury, your body starts healing the injury site. Sadly, this doesn't last forever. After 40-odd days the ground work has been done. This is bad news for avascular tissue like ligaments, tendons and cartilage.
Basically, regenerative injection therapy is just a means of externally stimulating the body to restart the healing cascade at an injury site. Usually, a dextrose solution is utilized, but there are other injectables.
Now, this procedure requires a doctor skilled in administering these injections: it's not a simple matter of needle-in, needle-out. This is a big topic on its own, though, so I won't delve further into it.
Just rest assured:
ligaments can be healed or at least stabilized using prolotherapy. I've had it done on my wrists (and other joints). But this takes some time and requires good eating and living habits, i.e.: eat well, get enough sleep.
I've had my first wrist injections 11 months ago and didn't eat or sleep enough (I averaged 4h a night). My wrists got better during the course of 6 months, but they still seemed somewhat delicate. For the last 5 months I've increased my sleep (I average 6h a night, now: still not enough, but definitely better) and also my caloric intake, most of all my protein intake. Additionally, I made sure to get a lot of vitamin C (improves collagen cross-linking integrity).
Some practitioners claim the same holds true for cartilage repair. I'm not sure if conventional prolotherapy can get it done, but I've read about PRP (platelet rich plasma) - based prolotherapy being promising in this regard.
To sum it up: if there were conventional treatment modalities, I'd use them. But after consulting with too many asinine docs who did nothing for me but telling me to maybe switch to cycling, I took matters into my own hands. I've found a doc who helped me a lot, but his practice is a 3h drive away.
My wrists are still getting better.
Currently, I'd rate them a solid 80%. There's no grinding anymore and only rare clicking.
I can do pain-free lateral raises which I hadn't been able to do since 2004.
The same with curls.
Making a fist doesn't end in clicking, grinding and hurting, anymore.
Hey there everyone
ive been doing my rehab
been awhile since i posted here since my first initial post
Ive sadly been in a state of depresison/negativity since the surgeon told me i would not heal
then after a second MRI to my right wrist,the more severely damaged wrist,he said i might heal
but its never going to be 100% which downright sucks as that means I'll be susceptible to further injuries in the future
Anyways
________________________-
If there is anyone that can understand my MRI reports(worded), and surgeon reports,that would be great
If there is any doctors,surgeons,people who who can understand such documentation (the doctors reports are straight forward but the jargon used is anatomical that i dont understand)
If anyone can give me their expert opinion, I would very much appreciate it.
Thanks people
It is attached
Many thanks
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Ray567
Level 0
Join date: Mar 2012
Location:
Posts: 91
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I'd like to weigh in on prolotherapy.
I'm currently performing it on myself (just diluted dextrose) and also got a treatment by a great doctor. My wrists were very bad, the TFCC was aching and popping all the time. I could push on my pisiform and move it over a centimetre, when it should be totally rigid. Already I'm experiencing more stability and pain is rare. My doctor and myself are confident I can fully recover in another couple treatments.
I'd recommend it to anyone with a TFCC injury.
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karydas91
Level 0
Join date: Nov 2012
Location: Greece
Posts: 8
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The wrist problem started this summer (I had bad form on my bench press). I got some rest and the pain was merely there. Now after two months into training I decided to add some gymnastic's exercices like L-sit, frog planche etc and the pain in my wrist came back. It was time for me to visit a doctor. He diagnosed: "Possible rupture of the triangular fibrocartilage (TFCC)". Now the doc told me to do 12sessions of Physiotherapy and by that time the pain should be gone. My question is should I continue my regular training (Except for gymnastic's of course) while doing these sessions or should I rest?
My routine is rippetoe's starting strength programm (im not doing the power cleans, doing pendlay rows). I have also added some dips and pull-ups here and there.
So list of exercises:
-Squat
-Deadlift
-Overhead Press
-Bench Press
-Pendlay Rows
-Dips
-Pull-ups
I know that the press movements are supposed to making things worse for my wrist but since I fixed my technique im not experiencing any pain while doing them.
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