As crossfitters, we’re accustomed to a lot of acronyms…
WOD. AMRAP. HSPU. SDHP. TFCC. KBS. MU.
Wait, what? One of these things is not like the other.
TFCC. Triangular Fibrocartilage Complex
What is it?
More popularly known as the wrist meniscus; a kind of shock absorber for some of the joints in your wrist. The TFCC can tear with rotational movements, like an awkward fail on a heavy Turkish getup or falling out of a hand stand.
What does it do?
Remember, your wrist is collection of many joints that roll and glide, allowing you to bend, straighten, twist, and move side-to-side. The TFCC is connective tissue shaped like a triangle that gives stability to all the aforementioned motions.
My wrist hurts, how do I know if it’s the TFCC?
Some common signs and symptoms of a TFCC tear are:
- Pain, localized to the ulnar (pinky) side
- Pain that gets worse with simple gripping and rotation movements (opening a door or using a can opener)
- Clicking, snapping, or crackling (crepitus)
- Sensation as if something is “catching” inside the joint
- Positive fovea sign
A TFCC definitive diagnosis takes history, mechanism of injury, and imaging. Even with MR Arthrograms, the dye can leak and produce a false positive. The most accurate way to determine damage is through arthroscopy. Nifty, because your surgeon can fix the issue right then and there!
Is it always surgical?
Not always, mild to moderate tears can scar down if immobilized in a cast or splint for 4-6 weeks followed by physical therapy. Surgical treatment is based on the type of injury. It may involve a cleaning up “debridement” or a reattachment with wires/screws to help hold the tissue in place as it heals.
How is it going to affect my WOD?
Clean & jerks and snatches are probably out of the question, along with thrusters. Consider front squats if you are able to hold the bar like this:
Goblet squats or double kettlebell front squats are also a good substitution to avoid putting your wrist in an uncomfortable position.
Pushups can be modified if you’re OK doing them on your fists.
For HSPU you can use paralettes or heavy dumbells (but stack up plates/abmats so you aren’t doing deficits).
Muscle ups might get dicey, especially if you use a false grip and rely on your upper body strength to get over the rings. A big kip that carries you higher into the dip position will lessen the forces on the wrist, but be especially careful since the rings are already an unstable apparatus; combine that with wrist instability and you’re looking at a sloppy fail. If you absolutely must keep doing muscle ups, doing them on the bar is a better choice, but you may want to exclude them all together and focus on pulling and pressing strength with your wrist in a more neutral position.
What can I do to manage this on my own?
Keep in mind that a TFCC injury is a stability issue, so motor control within the appropriate range of motion is important. If you already have full, normal range of motion, then doing wrist mobility exercises will not help. However, maintaining function and grip strength through that range of motion will keep the musculature supporting your wrist (forearm muscles) in good working order. Try making your own wrist roller with pvc pipe and a rope to roll up (concentric contraction) and lower down (eccentric contraction) a light plate (about 5#).
Be sure to use a thumb hook grip when doing deadlifts to lessen the load on your forearms. Similarly, don’t death grip the handle when rowing. Wearing wrist wraps or taping for compression may provide the extra support to keep you pain free during a WOD.
Ultimately, you can work around a mild TFCC injury if you maintain grip strength and can control the range of motion you have. If pain persists, be sure to seek appropriate medical attention.
Written by Liz Caruso