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Understanding Triangular Fibrocartilage Complex (TFCC) Injuries: Causes, Rehab, and Recovery
The Triangular Fibrocartilage Complex (TFCC) is a critical structure in your wrist that acts like a cushion and stabilizer. Located on the pinky side of the wrist, it connects your forearm bones (radius and ulna) and plays a vital role in wrist stability, especially during twisting, gripping, or weight-bearing activities.
If you've been diagnosed with a TFCC injury—or suspect one—you might feel concerned about your wrist’s future. This post will break down what you need to know, focusing on how injuries happen, rehabilitation options, and imaging choices. While TFCC injuries can be tricky, with the right approach, recovery is very achievable.
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What Is the TFCC and How Do Injuries Happen?
The TFCC is a complex structure made up of cartilage and ligaments. Think of it as the "shock absorber" on the outer side of your wrist. It stabilizes your wrist during motions like:
- Rotation (turning a doorknob).
- Weight-bearing (pushing up from a chair).
- Grip-intensive tasks (carrying groceries or using tools).
How TFCC Injuries Happen:
1. Trauma:
Sudden injuries, such as falling on an outstretched hand, can tear the TFCC.
2. Repetitive Stress:
Activities like racquet sports, weightlifting, or even prolonged typing can gradually wear down the TFCC.
3. Degeneration:
Over time, natural wear and tear (often starting after age 30) can weaken the TFCC, making it more susceptible to injury.
Common Symptoms:
- Pain on the pinky side of your wrist.
- Clicking or catching sensations when moving your wrist.
- Weakness during gripping or twisting motions.
- Swelling or tenderness near the wrist.
Imaging Options for Diagnosing TFCC Injuries
If a healthcare provider suspects a TFCC injury, imaging can confirm the diagnosis:
1. X-rays:
While they won’t show the TFCC directly, they can rule out fractures or joint alignment issues.
2. MRI:
This is the gold standard for viewing soft tissue injuries, including the TFCC. Adding contrast dye (an MRI arthrogram) can improve the accuracy of the diagnosis.
3. Ultrasound:
A less expensive and accessible option to visualize certain TFCC tears, especially in skilled hands.
Your provider will decide which imaging is appropriate based on your symptoms and physical exam findings.
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Rehabilitation: The Cornerstone of Recovery
Rehabilitation focuses on restoring strength, mobility, and function while minimizing pain. Here’s how the process typically works:
1. Protect and Calm
- In the early stages, you’ll focus on protecting the wrist. This may include wearing a brace or splint to limit motion and allow healing.
- Manual therapy and specific exercises can help calm pain and reduce inflammation.
2. Restore Strength and Mobility
- Gentle range-of-motion exercises will help maintain flexibility without stressing the TFCC.
- Gradually, strengthening exercises are introduced to rebuild support in the wrist and forearm.
3. Reload the Wrist
- Once pain decreases, you’ll work on loading the wrist with functional movements that mimic your daily activities or sports.
- Balance between progression and avoiding aggravation is critical.
**Sample Exercises**:
- **Wrist curls and extensions** using light resistance bands.
- **Supination/pronation drills** to improve rotation strength.
- **Grip strength training** with tools like putty or hand grippers.
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Conservative Care: The First Line of Defense
For most TFCC injuries, surgery isn’t the first step. Conservative care is often highly effective, especially if you catch the injury early.
Why Conservative Care Works:
- Tissue Healing: The outer part of the TFCC has better blood supply, making it more responsive to rest and rehab.
- Rehabilitation: Proper strengthening and mobility exercises can restore function and reduce strain on the TFCC.
- Avoiding Surgery Risks: Rehabilitation allows you to avoid the potential complications of surgery, such as stiffness or prolonged downtime.
When Surgery Might Be Considered: If conservative care hasn’t improved symptoms after several months, or if the TFCC is completely torn in a way that causes instability, your provider may discuss surgical options.
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Be Realistic, But Stay Optimistic
Recovery from a TFCC injury depends on several factors, including:
- Severity of the injury: Partial tears or wear-and-tear injuries generally heal better than complete tears.
- How quickly you start treatment**: The earlier you address the injury, the better your chances of avoiding long-term issues.
- Consistency in rehab: Following a structured plan is key to success.
Most people with TFCC injuries can return to their favourite activities with time and effort. While the process might take several weeks to months, the goal is always to restore pain-free function without needing surgery.
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Key Takeaways
1. Understand the TFCC: It’s a crucial stabilizer in your wrist, and injuries often happen due to trauma, repetitive strain, or aging.
2. Don’t Skip Rehab: Conservative care, including targeted exercises and protection, is your best shot at recovery.
3. Be Patient: Healing takes time, but with the right approach, you can regain strength and mobility.
If you’re struggling with wrist pain that’s holding you back, seek help from a professional trained in conservative care and rehabilitation. The path to recovery might feel long, but each step brings you closer to doing what you love without limitations.
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For more guidance or support, reach out to schedule a consultation—we’re here to help!
-Dr Mark Murdoch, Chiropractor, MS Sports Medicine
Which running shoes do I need?
With so many options on the market, finding the best running shoes can be a challenge. Whether you’re looking for shoes to prevent injury or boost your performance, the key is to think of your footwear as a tool that supports your body—allowing your feet to function as they’re designed to.
How to Choose the Best Running Shoes for Injury Prevention and Performance
With so many options on the market, finding the best running shoes can be a challenge. Whether you’re looking for shoes to prevent injury or boost your performance, the key is to think of your footwear as a tool that supports your body—allowing your feet to function as they’re designed to.
In this post, we’ll explore some key factors to consider when choosing the right running shoes for your needs and highlight some popular brands that offer options for every type of runner.
What Makes a Good Running Shoe?
Here are the essential principles to keep in mind when selecting your next pair of running shoes:
Let Your Feet Function Naturally
Your feet are designed to move, flex, and absorb impact. The best running shoes will allow your feet to do this without unnecessary restriction. Minimalist shoes, like those from brands such as Altra and Vivobarefoot, offer a more natural running experience, allowing your foot to move freely with each stride. These types of shoes can be especially beneficial for runners who prioritize foot strength and natural movement.Offer Protection Without Over-Engineering
Running shoes should provide protection from the repetitive stress of modern surfaces, but it’s important not to overdo it. Too much cushioning or support can interfere with your foot’s natural mechanics, leading to inefficient movement and potential injuries. Shoes like the Hoka One One Clifton or the Brooks Ghost strike a balance between cushioning and support, offering comfort without completely taking over your foot’s function. These shoes are great for runners who want some extra protection while still maintaining a natural gait.Pay Attention to Your Everyday Footwear
What you wear when you’re not running is just as important as your running shoes. Tight, rigid, or poorly designed shoes worn throughout the day can cause long-term damage to your feet and affect your performance. Brands like New Balance and Merrell offer everyday footwear options that prioritize foot health, with wide toe boxes and flexible designs that support your foot’s natural movement.Trust Your Body—Self-Selection Works Best
Ultimately, the best shoe for you is the one that feels right. Studies have shown that self-selected shoes tend to reduce injury risk because your body knows what’s comfortable. Whether you prefer the zero-drop design of Altra or the plush cushioning of Asics Gel-Nimbus, trust your feet to guide you toward the right choice. Trying on different brands and running in them before making a decision can help you find what works best for your unique running style.
So… what are the key takeaways?
Choosing the best running shoes is about finding the right balance between natural foot function, protection, and comfort. Whether you’re a trail runner, road runner, or someone looking for everyday comfort, brands like Altra, Brooks, Hoka, and New Balance offer a variety of options designed to meet your needs.
Remember, your running shoes are a tool to help you perform your best. By focusing on shoes that let your feet function naturally and provide just the right amount of protection, you’ll be setting yourself up for better performance and fewer injuries.
- Dr Mark Murdoch
Chiropractor, MS Sports Medicine
Exercising During Wildfire season
While staying active is essential for overall health, it is crucial to prioritize safety during wildfire season by being aware of the air quality and the associated health risks. Taking appropriate precautions during training while staying informed can maintain your fitness routine without compromising your health.
understand the risks and when to move your training inside
We bailed on our run on the Rockwall Trail (58k) last week due to smoke from nearby wildfires. After months of training and prep, it was a heartbreaking decision, but Mark and I looked at each other and chose not to risk it. As someone who falls in the higher risk category, it didn’t make sense to put my body through this type of damage.
We all want to enjoy summer on the trails, but poor air quality during wildfire season can cause significant health risks that can overshadow the benefits.
But how significant is the risk?
Wildfires release a complex mixture of gases, fine particulate matter (PM), and volatile organic compounds(VOCs) into the air, seriously affecting respiratory and cardiovascular health. Exposure to these compounds can lead to irritation, inflammation and long-term damage to the respiratory system.
What do we know so far?
Research has shown that exposure to wildfire smoke can exacerbate respiratory conditions such as asthma and chronic obstructive pulmonary disease (COPD). A study published in BMC reports exposure to PM, with most evidence derived from studies of wildfire smoke PM, is a risk factor for adverse cardiovascular effects, especially among susceptible populations. The tiny particles can penetrate deep into the lungs, causing systemic inflammation and reduced lung function, which can be particularly dangerous during physical exertion when the oxygen demand is higher.
Can I train at a lower intensity to decrease my risk?
According to Dr. Michael Koehle, the director of the Environmental Physiology Laboratory at the University of British Columbia, there is no good evidence at this time that supports the idea that, at a given duration, higher-intensity exercise is more harmful than lower-intensity exercise during times of poor air quality.
How can I determine my risk?
Monitoring air quality is essential for those who wish to exercise outdoors during wildfire season. The Air Quality Index (AQI) is a valuable tool that provides real-time information about air pollution levels. Health experts recommend limiting outdoor activities when the AQI exceeds 100, particularly for sensitive groups. When air quality is poor, consider alternative indoor exercises such as using a treadmill, stationary bike, or yoga and strength training. You should choose strength training, cough, cough. Air purifiers can also help improve indoor air quality, making exercising safer.
When to move your training inside?
Running in poor air quality stresses the body, leading to injury or delayed recovery even if you don’t fall within the sensitive populations category. If the AQI is greater than 100 or you fall within the sensitive populations category, the risk is much higher. However, young and healthy athletes also struggle with the physiological demands of training in these conditions. Running a little less this week won’t set you back as far as the symptoms you may experience running at times of high wildfire smoke. Talk to your coach about options to cross-train.
While staying active is essential for overall health, it is crucial to prioritize safety during wildfire season by being aware of the air quality and the associated health risks. Taking appropriate precautions while staying informed can maintain your fitness routine without compromising your health.
References:
Chen H, Samet JM, Bromberg PA, Tong H. Cardiovascular health impacts of wildfire smoke exposure. Part Fibre Toxicol. 2021 Jan 7;18(1):2. doi: 10.1186/s12989-020-00394-8. PMID: 33413506; PMCID: PMC7791832.
Rundell KW, Sue-Chu M. Air quality and exercise-induced bronchoconstriction in elite athletes. Immunol Allergy Clin North Am. 2013 Aug;33(3):409-21, ix. doi: 10.1016/j.iac.2013.02.009. Epub 2013 Mar 27. PMID: 23830133.
https://sportsustainabilityresource.ubc.ca/digital-museums/exercise-and-air-pollution
Training during bad forest fire season | Uphill Athlete. https://uphillathlete.com/forums/topic/training-during-bad-forest-fire-season/
Battling Wildfire Air Pollution: Strategies for a Safer Future | Dryad. https://www.dryad.net/post/battling-wildfire-air-pollution-impacts-and-strategies-for-a-safer-future
Chiropractic Is A Scam.
(most) chiropractic is a scam. In this post we debunk common chiro myths, help you understand what to look for in a chiropractor and the difference between traditional chiro and Base Camp
The Shocking Truth About Chiropractic Care: What You Need to Know
Chiropractic care often gets a bad rap. Many people believe that chiropractic care is little more than a scam, and for good reason.
Here’s the reality of what happens in many chiropractic offices:
Claiming to Be ‘Holistic Health Care’: chiropractors boast about offering holistic health care.
Spine Scares: They alarm you with stories about your spine being misaligned.
One-Size-Fits-All Treatment Plans: They place you on the same treatment plan they give to all their other patients.
Let’s dive into what this really means and how it compares to what we do at Base Camp Chiropractic and Sports Rehab.
The Cookie-Cutter Approach
Take Sarah’s story, for instance. She came to us after a frustrating experience with another chiropractor when she was dealing with lower back pain.
They told her she needed dozens of adjustments because her spine was “a disaster waiting to happen.” Despite the constant adjustments, Sarah didn’t see any real improvement and felt stuck in a never-ending cycle of visits.
This experience is unfortunately all too common. Most chiropractors use generic treatment plans, applying the same approach to every patient without considering individual needs.
It becomes more of an assembly line, with each patient getting racked-and-cracked, and then sent on their way.
Our Unique Approach at Base Camp
We don’t believe in the rack-em-crack-em model.
When Sarah came to us, we took a different approach:
- Listening First: We began by understanding her story and her unique challenges.
- Holistic Assessment: We looked beyond her spine to evaluate her sleep patterns, stress levels, nutrition, and movement habits.
- Customized Plan: Instead of a cookie-cutter plan, we crafted a personalized strategy tailored to her specific issues.
The True Meaning of Holistic Health Care
Holistic health care is more than just adjusting your spine. It’s about looking at all the factors that affect your health and well-being. Here’s what true holistic care involves:
Sleep: Good sleep is crucial for overall health. Poor sleep can lead to chronic pain and mental fatigue. We help you enhance your sleep hygiene to ensure restorative rest.
Managing Stress. Stress is a major contributor to health problems. We teach you effective stress management techniques to help you incorporate them into your daily life.
Optimizing Nutrition. Your diet directly impacts how you feel and perform. We provide nutritional guidance to fuel your body and aid in recovery.
Enhancing Movement. Exercise is vital for maintaining health, but it must be tailored to your individual needs. We develop personalized exercise plans to build strength, flexibility, and endurance based on your goals.
Success Stories: Real Results
Let’s talk about Mike, another patient who came to us with a different challenge. Mike was an avid mountain biker suffering from persistent neck pain. The previous chiropractor he visited focused on adjustments, did a tiny bit of soft-tissue work, and told him to “take it easy.”
Mike wanted more than just temporary relief; he wanted to get back to riding.
We didn’t just focus on his spine.
We examined his bike setup, riding posture, and training routine. We developed a comprehensive rehab plan that included strength training, flexibility exercises, and a gradual reintroduction to biking.
Mike is now back on the trails, stronger and more resilient than ever before.
Our Philosophy: A Personalized Approach
At Base Camp Chiropractic and Sports Rehab, we view each patient as a unique individual.
Our approach to holistic health care is not about optimizing your health. We consider all factors impacting your health and create a personalized care plan to address your specific needs.
Reclaiming Holistic Health Care
Holistic health care has often been reduced to a buzzword. At Base Camp, we’re redefining it. We reject cookie-cutter plans and instead focus on real, effective care tailored to you.
No scare tactics—just a comprehensive approach that works.
The Importance of Being Proactive
One of the key aspects of true holistic care is being proactive. Ignoring health issues can lead to more severe problems, requiring surgery, injections, or medications down the line. For example, a runner who dismisses knee pain might face surgery later.
Early intervention with a holistic approach can prevent such outcomes by addressing issues before they become critical.
Ready to Make a Change?
We’ve helped many patients like Sarah and Mike achieve their health goals, and we’re here to help you too. Whether you’re a runner, a mountain biker, or simply looking to improve your overall well-being, we’re committed to providing the best care possible.
Want to learn more about how we can help? Book a Discovery Call today to discuss how our personalized approach can benefit you!
See you out there.
Dr Mark. Chiropractor, MS Sports Medicine
Base Camp Chiropractic and Sports Rehab
Is that pain, or an injury?
How running injuries happen
How to Know When to Address Pain: Lessons from Hank
This week, I had an interesting conversation with a runner named Hank. He asked a question that many of us have pondered:
"But I’m sore so often from running and mountain biking... how am I supposed to know if it’s something I need to take care of or just power through?"
This is a great question and one that’s harder to answer than it seems. How do you know when something is truly wrong? If you’re an active person, you’ve undoubtedly experienced pain during your activities. But does that mean you should stop doing the things you love whenever there’s pain? Fortunately, no!
The I3 Model: How Overuse Injuries Happen
At Base Camp, we use the Incomplete, Incidence, Injury (I3) model to help determine when to take pain seriously and when it might not be a big deal.
Injuries happen and develop over three phases:
Incomplete mechanics or recovery
Incident
Injury
1. Incomplete Mechanics or Incomplete Recovery
INCOMPLETE MECHANICS:
Imagine trying to do high-level CrossFit, but you can’t get your arms all the way overhead. Or running a marathon when you can only do seven single-leg calf raises. These are examples of incomplete mechanics. While they don’t guarantee injury, they certainly set you on the wrong path in the injury cycle.
INCOMPLETE RECOVERY:
There are three primary domains for recovery:
- Sleep
- Nutrition/Hydration
- Stress Management
If any of these are below 80% (rate yourself on a scale of 1-10), you’re not fully recovering from your activities. It's always a combination of these two factors. Better mechanics can buffer for poor recovery, and vice versa.
CASE STUDY: Hank, runner with Achilles tendon pain
Hank was limited in his ankle range of motion and sleeps an average of 6 hours per night.
2. Incident: Check Engine Light
This is the first sign that something is wrong—the 'check engine light' your body sends to signal that something is off. Incidents include any symptoms or signs of pain and are often the hardest to interpret. Take these signals seriously. Part of why injury prediction is tricky is that the incident may not even be in the area of the actual injury. You may have a shoulder 'hot spot' that turns into a lower back injury or ankle stiffness that turns into knee pain.
CASE STUDY: Hank, runner with Achilles tendon pain
Hank has hamstring tightness that always worsens when he increases his volume.
3. Injury: Limiting
The word 'injury' can be hard to define. Can we call it pain? Well, we’ve all had pain during activity that went away on its own or was just part of the activity itself (looking at you, hill repeats). What about tissue damage? There are millions of people walking around with meniscus tears who don’t even know it and have no symptoms.
Here’s the definition we use at Base Camp: Any time you have a symptom that keeps you from doing what you WANT to do, or HAVE to do, then it is an injury.
- Tingling so bad you can’t carry your groceries in? Injury.
- Knee pain that only starts when you hit 22 km, but you’re training for a marathon? Injury.
CASE STUDY: Hank, runner with Achilles tendon pain
Hank triggered his Achilles pain after a hard hill session.
Take Home Lessons
LISTEN TO YOUR BODY. Your body will send you signs that something is wrong, and that you need to do something about it.
ACT EARLY. When you are injured, it's late in the game to take action. We can't focus on the incomplete mechanics or recovery until we get the pain under control. It is way more efficient to focus on your mechanics and recovery BEFORE they become an issue.
YOU CAN GET BACK TO YOUR ACTIVITY. Injuries suck, but they don't have to limit you forever. Most of the time you don't even have to stop your activity.
CASE STUDY: Hank, runner with Achilles pain
Hank and I are now working to calm down his tendon pain, while he is prioritizing his sleep. Next, we will shift to improving Hank's ankle range of motion, and improving his lower back stiffness (the cause of his hamstring tension). Finally, we will reintroduce volume, intensity, and elevation to his running.
Dr Mark Murdoch is a runner, chiropractor, and rehab specialist in Vernon, BC.
Every week he works with runners, mountain bikers, and adventure athletes who want to get back to their sport better than ever.
Ready to get back to running PAIN FREE?
Start with a free consult with Dr Mark here: CONTACT