An injury to the Triangular Fibrocartilage Complex (TFCC) occurs at the outside part of the wrist, between the ulna bone in the forearm, and the pinky finger side of the wrist. The TFCC is a strong structure made up of multiple parts, including ligaments and cartilage, that is situated between the ulna and the wrist bone. It acts as a stabilizer for the joint and helps the wrist to move through its full range of motion.

Injury to the TFCC can be caused by sudden force on the TFCC, such as by a fall onto an outstretched hand, or by a gradual wearing down through forced ulnar deviance. This could be caused by regularly swinging a bat or a racket. At MOTUS, we find that TFCC injuries are most common in baseball players, whose wrists undergo a heavy load during batting. We also see TFCC injuries develop in sports with repetitive weight bearing on the wrist, like gymnastics.

Symptoms of a TFCC injury are straightforward. Patients experience a pain in the ulnar side of the wrist at the base of the hand. The pain worsens with movements like rotation and flexion and increase with more activity. Sometimes, TFCC produces a clicking sound in the wrist, instability to the area, or weakness in the grip.

When we examine a patient for possible TFCC injury, we will first discuss the mechanism of injury. Learning exactly how the injury happened, and gathering information

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about the patient’s normal activity level, will help us determine whether the TFCC injury is isolated or connected to another injury, such as tendonitis in the forearm. MOTUS is a clinic dedicated to looking at the big picture, so we always want to focus on the body as a whole in order to treat an injury as efficiently and effectively as possible.

There are also several tests — such as a TFCC stress test — that our clinicians can perform to get a better understanding of the condition of the injury. During these tests and a physical examination, we will learn more about the individual injury and what is required for recovery.

Most TFCC injuries do well with conservative treatment. We’ll start by bracing the wrist for immobilization in order to let the ligament heal. After that, we will create a routine of exercises and stretching to help strengthen the nearby muscles and tendon and help gradually reintroduce a normal range of motion.

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