The triangular fibrocartilage complex (TFCC) is a small structure located between your ulna (a long bone of the forearm) and the lunate and triquetrum (small cube-like bones in your wrist). The TFCC is located on the pinky finger side of your wrist, right where the wrist creases when you move it. The main structures that form the complex are two ligaments, a tendon, and an articular disc that sits between the bones. Its location, in the space between the ulna and wrist bones, implies its function: providing stability and cushioning at the wrist joint. A TFCC injury can result in an unstable and painful wrist, an often frustrating injury as we use our wrist in almost all of our daily activities. There are two main typesof TFCC injuries: traumatic, where there was a clear incident that started thewrist pain, or degenerative, where the injury developed slowly over a period ofmonths to years. The most common traumatic injury mechanism is a FOOSH injury,also known as a “fall onto an outstretched hand”. It can also occur with racketsports when contacting the ball. Degenerative injuries, on the other hand,mostly result from wear and tear over time. Some people may be predisposed toTFCC degeneration if their ulna (forearm bone) is longer than normal. TFCCinjuries are further subdivided into categories based on what structures of thecomplex were damaged. Determining the type of injury is important as it largelyguides how the TFCC injury is managed. Regardless of the type of injury, there are common signs and symptoms that suggest a TFCC injury. As with any injury, depending on the severity, you may have a few or all of these signs and symptoms. People with TFCC tears typically report pain on the pinky finger side of the wrist. Pain is worsened with weight-bearing activities like pushups and by movements that involve twisting (technical term being pronation and supination) the wrist/forearm. Common aggravating activities include using a screwdriver, opening doorknobs, and turning a key in the lock. It may also feel like your wrist is clicking and/or catching when you move it. Lastly, it may feel like your wrist movement is limited and that your grip strength is reduced on the affected side. If you suspect a TFCCinjury, physiotherapy can help ensure you receive the correct treatment. Thephysiotherapist will complete a thorough assessment, ask questions about yourwrist pain, examine strength and range of motion, and likely complete somespecial tests to confirm the diagnosis. Ruling out other conditions isparticularly important with traumatic injuries due to the risk of a fracture.When considering treatment, the first step for almost all TFCC injuries is fourto six weeks of physiotherapy. These first weeks consist of wrist splinting,activity modification, and exercises to keep the surrounding areas strong andhealthy. After a period of immobilization, your physiotherapist will guide youthrough exercises and hands-on therapies that help regain your range of motionand strength. Additionally, some people may benefit from wearing a very smallbrace that provides wrist compression, keeping the wrist supported and healthy.While most people respond well to physiotherapy, some TFCC injuries do notresolve with physiotherapy alone and may require surgery. Your physiotherapistwill monitor your progress and communicate with you and your family physicianif it is appropriate to consider seeing a surgeon. While a TFCC injury can befrustrating, your physiotherapist will guide you through the injury, fromdiagnosis to return to activity, and ensure you receive the best possible carethroughout the process. If you suspect a TFCC injury, visit a Panther Physiotherapyclinic near you!What is the TFCC and how is it injured?
How is the TFCC injured?
Signs and Symptoms of a TFCC tear.
Physiotherapy for a TFCC tear. What to expect?
