TFCC problems

I have TFCC problems in both wrists, diagnosed on MRI, after I had been experiencing ulnar sided wrist pain on wrist extension. It started about 8 months ago in the left, and gradually came to involve the right wrist too (although not as bad). The cause was H1 work, specifically FTP and to a lesser WP. I've managed it with rest and then strapping (after seeing a sports doc and hand OT), and it's been going OK, but I have noticed 'niggles' during handstand work, as well as weight-bearing F1 work like pushups and planche leans. In the last two weeks it was aggravated by what I can only put down to some incorrectly performed wrist prep exercises combined with overzealous wrist rehab. This is on a background of hypermobile joints, which makes it unfortunately easy to push joints too far in their ROM. 

I've decided to stop everything which causes anything above ZERO pain indefinitely until this acute flare resolves. I'm seeing an MSK physio and going to discuss with her about whether it's realistic for me to hope to continue with GST, knowing that as the progressions increase, the demands on the wrist likewise increase. In the meantime I'm going to be taking it easy, and doing some gentle wrist rehab and strengthening. 

TFCC surgery has an unpredictable outcome, so I will never go down that road. Steroid injection didn't help because it was about 6 months after the onset. So I'm left with conservative measures, and honestly questioning which exercises in GST I can and cannot do. For example, maybe it's time for me to give up on FTP and WP. And is it time to give up on ever achieving planche or manna?

Has anyone else had experiences with TFCC issues? How has your progress tracked along? With rehab, how have you managed? This injury really sucks, and makes me depressed about the future, but the wrists are too important to jeopardise anymore. 

Vinay, there are a couple of mistakes that stand out to me when reading this:
 

1) You went to FTP/SE4 far too early in your training. Impatience is the number one predictor for injury.

2) When you started having issues in one wrist you continued business mostly as usual until the other wrist began having problems.

3) Your focus is on working around the issue rather than breaking completely to resolve it to the full extent possible. 

Where was the actual damage? It makes a significant difference in treatment whether it is a wrist sprain or the cartilage. Only once you have finished a proper treatment should you worry about training handstands again. Continuing to work around your wrists is begging for even greater problems.

First off, let's begin with the fact that this sounds as though it was completely avoidable (unless you have a previously undiscovered congential defect).  You simply did too much, too soon.  And then this poor situation was further excerbated by being overzealous during rehab.

And then WTH were you doing continuing to do weight bearing movement (handstands, planche leans, pushups etc) on a damaged joint?  

Let me give you some advice: STOP.  Stop pushing so hard.  Stop training thru pain.  Stop treating mobility work as conditioning.

It is not simply GST which is at risk here.  It is all athletic endeavors if you don't learn to listen to your body, pay attention to what it is telling you and then take appropriate action.

Hopefully the TFCC is mild and will respond to rest and rehab.  But unless you change your approach to training, these issues are going to continue to worsen.  And be joined in the near future by a plethora of new problems.

Yours in Fitness,

Coach Sommer

Unfortunately you have pushed too hard for your wrist joint and are looking at along road to recovery. Have you had an orthopaedic surgeon review your wrist?

You can possibly get back to these exercises depending upon the structural damage you have. You could be looking at 1-2 years of rehab to get back to this level.

I have personally taken over 2 years to build up to doing 3x3 wrist push ups. It is slow, but sometimes that is what is needed.

Today's been a big wake up call.

Thankfully, my TFCC issues are very mild. The MSK physio gave me a well-deserved scolding over not looking after myself, and told me to stay the hell away from things like fingertip pushups and wrist pushups. I don't know if I'll ever return to handstand work, and at this point it's a moot issue. My body's health is more important than anything else. 

Thanks for all your replies.

Before you give away these wrist exercises. How much experience does your Physio have with training in gymnastic exercises or with treating gymnasts?

I am a Physio myself and have found these exercises very beneficial and recommend them to my patients. My livelihood is dependant on the health of my hands and having strong fingers from fingertip push ups has helped my day to day work. If you show your physiotherapist the exercises in Foundation and handstand they would most likely tell you not to do those either.

I have learnt more from Coach in terms of exercise and when to progress exercises than any Physiotherapy course I have done.

If you follow the program, be patient and progress when your body is ready you will not get injured.

I appreciate Vinay that you put yourself out there, thanks. The repsonses you got also helped answer questions I had (and in agreement with advice I got from a GB coach) with tenditis issues I'm having. Not GST born, I came here with it. Frustrating to have to stop as I worked hard to progress as I did but things I was doing outsdie of GST I think made things worse. The alternative tho is to possibly have to quit if I don't listen to my body as well. Thankfully I can train around it so not a total loss. Good luck with your recovery.

No worries Sean. I've been very stupid, to a degree I doubt most other people could be... Now for a slow, steady convalescence. Best of luck to you too.

Vinay...Agreed and thanks.

Mark Could I ask you since your a physiotherapist familiar with GST...with rotator and suprspraspinatous issue Im assuming I should stay away from my handstand work, RCPE1 and HBPPE2, but wonder if scap shrugs might still be ok?

When pain free then start over with the previous mentioned PEs regressed? Or just test them and move on to where I was if pain free?

I am going to pursue physio but I know they know jack about GST and offer little to no advice usually. Currently I'm doing near daily stretching with bands for shoulders/chest, lat stretching, band rotator work and dislocates without weight. Feels pretty good thus far, doesn't seem to aggrivate anything. Thanks in advance...

If you have a reactive/aggravated tendon normally two weeks will settle the symptoms. If you have a chronic tendon injury with structural change then you are stuck with it for life. In that case you can still train these exercises but make sure the pain in the tendon does not exceed a 5-6/10. It is normal for symptoms to be aggravated for 24 hours. This is how you adjust your intensity. For example you may be able to do 3x6 of RC1 but 5x6 causes pain for 48 hours. So you stay on 3x6 for another 4 weeks and then retest 5x6. Keep doing this process with all of your exercises. You will progress slower but will get there in the end.

Chronic tendons like to be exercised and will usually be symptom free in 6 mths to 2 years.

Thank you for taking the time to respond Mark as i know your not obligated to and giving medical advice in a public forum is iffy but I respect it. We didn't discuss whether a chronic or acute situation actually just focused on rehab movements. At least you provided some hope should this be the worse case situation.

I was told that in addition I had some scap disfunction because physio was able to limit or reduce some pain by bracing/manipulating my scap in an over head reaching position. When I explained about GST the advice was to do what I could as long as it didn't cause pain. HBPPE 1 never bothered me but PE2 started to. I've also taken to stop doing any other extra stuff so that I can systematically determine what makes it worse or does not bother at all by gradual inclusion over time.

As I've been thinking on this perhaps its a blessing as the PEs I do well with are the ones that seem to aggravate it. So this might just give me the time to focus on other lagging movements and bring them up while I hopefully heal. Male ego can be a dangerous thing to the human body and ones own progress. Prevents me from accepting when enough is enough and tempts me to think that I've done more than enough to move on sooner than I should

I thought I'd post an update. It's been more than a year since I've stopped GST. I've had my wrists reviewed by an orthopaedic surgeon, and am going to be operated on beginning of next year. After that I'll see. It's hard dealing with an injury because it forces you to reevaluate everything. If I ever do pick GST up again, in a year or two, I think I will need to find a coach who can actually guide me through things hands on. Difficult to find, probably, but I'll see when the time comes. 

Good luck, Vinay.