Triangular Fibrocartilage Complex Injury (TFCC)

By Steven TranSydney CBD Chiropractor

Wrist pain, clicking, popping and weakness? You may have a TFCC Injury. What is a TFCC tear? What are the symptoms of a TFCC injury? What causes TFCC?  How is TFCC diagnosed?  What can you do right now for TFCC? Keep reading to learn more about TFCC injuries.

The triangular fibrocartilage complex (TFCC) is a complicated structure, which comprises of ligaments, tendons, and cartilages in an area between your arm bones; radius and ulna. The TFCC’s function is to stabilise and cushion the wrist when you grasp something with your hand or rotating your forearm. The TFCC is a complex structure, which is prone to injury.

Injury to the TFCC is seen in this area:

Anatomy of the TFCC wrist pain, clicking, popping and weakness
Source: Elatmani s

What are the symptoms of a TFCC Injury?

The main symptom of a TFCC tear is pain along pinky side of your wrist, however you might also feel pain throughout your entire wrist in the early stages.

Other symptoms can include:

  • Tenderness or pain when touching or moving the wrist
  • A clicking or popping sound when you move your wrist
  • Wrist Swelling
  • Instability
  • Weakness in the wrist

If your think you may be suffering from a TFCC Injury we advise getting assessed by a health professional such as a chiropractor, physiotherapist or osteopath.  

What cause a TFCC Tear?

There are two types of TFCC tears, these include:

TFCC tear – Type 1:

Type 1 tears are caused by trauma or injury. For example, falling and landing on an outstretched hand can damage the ligaments, tendons or cartilage in your TFCC

TFCC tear – Type 2:

Type 2 tears are caused by breakdown of the cartilage in your TFCC over a prolonged period of time, commonly due ageing and inflammatory arthritic conditions.  

There is also higher risk of developing a TFCC tear in athletes who repeatedly put pressure on their wrist, such as golf players and tennis players.

How is a TFCC Tear diagnosed?

The most reliable used clinical test used to diagnose TFCC tears is the fovea test, also known as the compression test. To do this, your chiropractor, osteopath or physiotherapist will apply pressure to the outside of your wrist and record any sensation of pain or tenderness. For comparison the unaffected wrist will be also be tested. TFCC compression test / fovea test:

Furthermore, your therapists will assess your wrist movement, moving through various ranges of motion of the wrist.

If required your therapist may also refer for an x-ray of MRI to rule out any broken bones in your hand or forearm or to further assess the severity of the tear.

What you can do right now for TFCC injury?

TFCC can be managed with the use of reduced inflammation, splinting/bracing, avoiding aggravating activities and exercises.

Initially with an acute TFCC injury the aim is to reduce the inflammation and pain around the area.  Simply using an icepack (avoid direct skin contact) 10 minutes on, 20 minutes off. You may also consider applying topical anti-inflammatory gels; this will assist in decrease of inflammation and in turn reduce pain levels.

Avoiding aggravating activities is in the early stages of healing is important as wrist motions may easily aggravate the wrist, thus it is important to stop or change the activities that are causing symptoms.

Wrist brace used for TFCC injuries - Astir
Source: Astir

In the initial phase of healing you may be given a temporary brace or splint to wear for 4-6 weeks period. The purpose of the brace is to hold your wrist still to allow appropriate tissue repair at the site of injury.

To help the healing process of your TFCC tear, there are several exercises you can do during the recovery period at home. These may include but not limited to:

  • Slowing in a circular motion move your wrist, in both clockwise and counterclockwise direction — 3 times each way
  • Stretching your wrist by bring your wrist down towards the ground, and then up towards your forearm — hold for 20 seconds repeat 2-3 times
  • Strengthening your wrist by repeatedly gripping a tennis ball — grip and hold for 5 seconds and repeat 10-12 times
  • Below is a video of our Physiotherapist Ryan Dorahy showing us some other strengthening options:

To begin, it is important to not overexert your wrist, only do a few of these exercises at a time and progressively increase your load or repetition. If any of these activities severely aggravates your symptoms, stop doing them and speak to a health professional. 

Surgery for TFCC injuries:

Residual laxity may remain after non-operative treatment of a TFCC injury. If conservative care is unsuccessful, persistent joint laxity and instability can lead to degeneration of the joint’s articular cartilage. Too much force or compression on either side of the joint can lead to pain and altered movement patterns. If non-surgical treatment is not effective then surgery may be needed to restore normal wrist movement

Surgery is generally needed for those tears that don’t heal or respond to the conservative treatment. Some tears can be “fixed”, simply by “debriding” or cleaning the torn edges and damaged tissue off. Other tears can be directly repaired using sutures. Following surgery, recovery is usually about 6 weeks in a cast to keep your wrist from moving. Once your cast is removed, manual therapy and rehab is required to help regain previous wrist strength and function.

Osteopath or chiropractor assessing the wrist for a TFCC injury
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