TFCC Treatment protocol
Weight Bearing Test results:
Weight Bearing = < 20 kg: Severe injury
Expected recovery time in this phase ~ 3 months
For proper healing, you must wait for X-Ray results to rule out a fracture BEFORE beginning the treatment outlined below. If your wrist is fractured, it must be cast so the bones can heal properly first.
The following treatment plan is for wrists without a cast, or after the cast has been removed.
- Wear your WristWidget 24/7
- Protect your wrist – No lifting anything over ONE POUND (yes, we mean 0.5 kilo)
- If you can get a referral for a Muenster Splint, this would help in your recovery. It eliminates motion of the elbow and rotation of the wrist. It requires a prescription and an oppointment with a hand specialist and/or handtherapist.
- If you don’t have a muenster splint, wear another stiff wrist splint/brace OVER the WristWidget to prevent flexion (bending) of the wrist. Make sure it doesn’t compress or squeeze the ulnar head (wrist bone). Use the wrist splint every night until your weight bearing tolerance is 20 kg.
- If you don’t have swelling, you can use a heating pad on the wrist, or alternate hot/cold water over it.
Weight Bearing = 20 - 29 kg: moderate injury
Expected recovery time in this phase: ~ 1-3 months
YAY! 20kg is considered a “functional” wrist. This means that you should be able to function around the home, for the most part. Things like dishes, dressing, making a bed etc. should not hurt.
This does NOT include carrying children, animals, heavy bags of groceries etc. This is a light functional wrist.
- Protect your wrist – No sports, heavy lifting or strengthening until results are at 29 kg.
- Wear the WristWidget 24/7. You do not need to wear the big wrist bulky splint.
- Your task is to protect your wrist. Let it heal. Don’t aggravate it!
Weight Bearing >29kg: mild injury
Expected Recovery time in this phase: ~ 1-2 months
Congratulations! Being categorized, as ‘Mild Injury’ means your wrist is stable and you can load it for athletic endeavors. This took over 10 years of research to determine! Don’t let this give you a false sense of security: you’re not healed. No push-ups, no bicep curls, no rotated pull ups. Yet. Beginning to exercise too soon will set back your healing process!
This next phase is important because often people think they are healed and go back to normal functioning without the WristWidget®. They fall back below 29kg for weight bearing tolerance and symptoms resurface.
It is imperative to the healing proces that you work to unwind all of the imbalances in your toso, shoulder, neck, elbow and lastly wrist. You need to stretch daily.
See https://www.wristwidget com/pages/videos
- You should stretch the spine, neck, shoulder and elbow ALL while integrating pronation and supination. Start with NO load and stretch everything. Then add a 0,5 kg weight. Then a 1 kg weight. Etc.
- You want all of your muscles to stretch equally and smoothly. What you will notice: there are certain positions (without moving the wrist( where you can get your wrist to subluxate. These are important to note.
During this time, you must avoid bicep curls, push ups, pull downs with the wrist supinated, and pectoralis strengthening. These are the muscles that need stretching! You need to elongate these muscles and strengthening does the opposite. Continue acupuncture and consider deep tissue massage to those muscles we are trying to elongate.
- Your goal is to take 2-4 weeks to focus on the imbalances that this injury caused and there are many, especially when you have had the injury for a long time.
- Strengthen instead: the triceps, the rhomboids, the lats and especially start planks on your elbows, not your hands. Get your core muscles working together. Squats and ab work helps a ton.
In this healing phase, you should continue wearing the WristWidget until your weight bearing is normal (equal to your uninjured wrist) and there is NO clicking. You are not done with the healing process yet.
The main goal is to be pain-free and with equal weight bearing tolerance on the injured wrist compared to the uninjured side.
You need to wear the WristWidget for ALL loading activities – essentially all day.
- You can remove it at night.
- Then on a daily schedule, start the 3 Stretches for TFCC Rehab & Recovery (Pronator Stretches)
- Conduct Weight Bearing Test on your wrists every 7 days.
Weight Bearing Test Results equal to your injured wrist.
Once a taped wrist matches the uninjured wrist, then remove the WristWidget and continue the weekly testing until both wrists are equal. And then:
Congratulations! You now have a fully recovered TFCC injury. Appreciate your health because YOU have defied what we know in medicine to be the inability of these to heal. You have succesfully healed your TFCC! Enjoy the process. The body is amazing.