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Muppet 02-26-2013 03:55 PM

What should I do for my strained wrist?
 
My right forhand wrist has been getting strained during sessions of a clinic I'm taking. I've had to leave early twice. I even sat out for two weeks to rest it, to no avail. I didn't go so far as to make it a severe strain. The reason for it is a combination of things.

1) I played without a vibe damp when I should have been using one.
2) I have been on the computer and mousing a lot.
3) I had to shovel a lot of snow while it was aggravated.
4) I'm learning a new grip and I may be a little too wristy.

I really want my wrist to be ready for the outdoor season (May around here.)
-Should I forgoe the remaining four sessions of my clinic (weekly?)
-Should I get physical therapy?
-Glucosamine Chondroitin worked for my knees in 2003. Would it help with my wrist?
-Is there a name for my malady? Is it tendonitis?

Thank you for any help.

Chas Tennis 02-27-2013 03:44 AM


Del Porto had wrist surgery in 2009. In 2012 his wrist was injured and he consulted Dr Berger for a diagnosis. Did he have the newly discovered Split UT Ligament Injury? He did not have that injury. He was cleared to play in Davis Cup but later pulled out.

--------------------------------------------------------------------------------------------------------------------------------

You have an undiagnosed injury and it sounds as if the new forehand technique that you are performing in the clinic might be the cause. ??

If you know what a proper forehand stroke looks like you might be able to see obvious stroke technique flaws with high speed video or even with 30 or 60 fps video. This is the most important use of high speed video. See serve example below.

I'm not sure that it was my serving technique that was causing my wrist pain, but, in any case, I don't want that wrist angle in my serve. I was also practicing the 'current' forehand with a new ball machine. The forehand could also have caused the stress and pain. I stopped practicing both forehands and serves and the mild wrist pain gradually went away. This spring I'll start again with more angle between my forearm and racket on the serve and more attention to my forehand technique.

If you have quit your clinic twice already it sounds as if you have a more serious injury than I had so you should not stress it by playing. Best to see a Dr also.

Some replies with information on wrist injuries-

See especially. http://tt.tennis-warehouse.com/showt...known+forehand

Quote:

Originally Posted by Chas Tennis (Post 7208297)
Last summer, I had some mild wrist pain, ulna side, when trying out some new forehand and serving techniques. One possibility, it looked as if my wrist might have been at the wrong angle on the serve as described below. ?

Yesterday, I came across these very interesting videos from a Mayo Clinic hand surgeon, Dr Berger.
Split UT ligament -
http://www.youtube.com/watch?v=0HjFr5QieXU Astonishing, candid video!
http://www.youtube.com/watch?v=9qwLNCQm6bg
http://www.mayoclinic.org/ulnar-wris...?mc_id=youtube

He is saying that he discovered that a ligament on the ulna side of the wrist can have a split that runs along it. If I understand the first video, in the past when he looked at it arthroscopically he would see blood vessels and thought that they were defects on the outside of the ligament. He would then clean up the blood vessels as diseased tissue. But actually the ligament had a split that had opened up and he was looking inside the ligament. He found a very easy test of pressing on the side of the wrist to diagnose this specific injury that does not show on MRIs.

I hope that you can understand the videos and ask your Dr his thoughts. The Mayo Clinic Dr sounds as if this was a recent discovery.

USTA Wrist injury information-
http://www.usta.com/Improve-Your-Gam...rist_Injuries/

Thread with replies on known wrist injuries - see CharlieFedererer reply #11.
http://tt.tennis-warehouse.com/showt...known+forehand

Wrist stress by questionable serving technique from another thread -

Example of technique flaw picked up with high speed video.
Quote:

Originally Posted by Chas Tennis (Post 7154284)
MYTH: Practice, practice your serve to get a strong serve.

REALITY: If your technique is not effective for a strong serve you will be learning the wrong muscle memory and technique. However, you will probably hit the ball more reproducibly and that may allow you to improve your serve's reliability and pace up to a point. First, learn an effective technique without any biomechanical flaws that would prevent an effective serve. Or hire a well-qualified instructor that can train the proper techniques.

This is one reason that I hate to practice and avoid it. Maybe an effective practice method using high speed video would be to video just 1 - 3 strokes and immediately look at the videos and analyze them. Find flaws, they are very easy to spot. Make corrections. Repeat. Looking at videos of every 2 or 3 strokes is very, very cumbersome. Is it better to practice for an hour and then to go home and view the videos only to find that you never use leg thrust, or that your wrist has a bend in it that might cause injury.

For example, I think that this wrist angle at impact is wrong and stressful. This technique might have contributed to the slight wrist pain that I was experiencing at the time that the video was taken. Compare to pro servers wrist angles viewed from behind on other videos.
http://vimeo.com/21512296



Pro server.
https://vimeo.com/27528701



AYone 02-27-2013 03:56 AM

Depending on how bad your strain is, you can likely continue to play if you secure your wrist. I suffered a mild-moderate strain and once I felt ready I played with a wrist support from McDavid. It really helped. I feel your frustration. Nothing worse than having to sit out with an injury and worry about aggravating it more when playing. After your wrist feels 100% start a regime of strengthening and stretching your forearms and wrists.

Chas Tennis 02-27-2013 04:07 AM

Quote:

Originally Posted by AYone (Post 7239058)
........................ Nothing worse than having to sit out with an injury and worry about aggravating it more when playing. .................................................. ..............

Developing a chronic condition that could have been avoided is much worse.

Sitting out might always be best......?.....

" I really want my wrist to be ready for the outdoor season (May around here.)"

MeHere2PlayTennis 02-27-2013 05:42 AM

A couple of years ago, I made the mistake of playing in 2 events in a very large tournament and strained my wrist. I ended up taping it up, but it never really healed until I stopped playing a couple of weeks and focused on icing and stretching it. I don't know if it works or not, but this guy told me about 'active' stretching of the wrist and it did seem to help. It might have been a placebo effect, but it tricked me!

I'd take time off, like chas said, it is gets worse you could be looking at something chronic or even surgery.

ollinger 02-27-2013 05:47 AM

Would agree that sitting out is imperative. The wrist is a special kind of injury because the carpal tunnel is very rigid with no room for expansion (i.e. inflammation) inside it. So playing through an injury and risking further inflammation where there's no room for it is particularly foolish and can really do damage. I suspect it's why I know so many people (many of them secretaries who did it typing) whose carpal tunnel syndromes seem to have become permanent.

Muppet 02-27-2013 10:27 AM

Thanks for all the replies. It has occurred to me what technique I was doing wrong on the night the wrist started kicking up. We were practicing volleys. When I first started volleying in the early 90s, on the forhand side I would use my eastern grip. I liked it that way because I could nail it further out in front than with the continental grip. I still hit the forhand volley out front, but with a continental grip. To do this, I have to lay my hand back and it can take a pretty sharp blow sometimes. It's a great shot, but it's taking me out of the game for a bit. I'll be sure to relax and take that ball further back from now on.

I have my wrist wrapped in a layer of tourna grip and a layer of thin medical tape. It gives a little support and is comfortable. I think I'll go in for PT though. I don't want to miss any of the Summer season.

Thanks again.

Chas Tennis 02-27-2013 10:40 AM

Quote:

Originally Posted by Muppet (Post 7239969)
........................... I think I'll go in for PT though. I don't want to miss any of the Summer season.
.............................

By 'PT' do you mean physical therapy from a medically trained therapist and prescribed by a Dr after diagnosis? On occasion, 'PT' is used for physical training offered by trainers who are not medically trained.

Muppet 02-27-2013 10:57 AM

Quote:

Originally Posted by Chas Tennis (Post 7239989)
By 'PT' do you mean physical therapy from a medically trained therapist and prescribed by a Dr after diagnosis? On occasion, 'PT' is used for physical training offered by trainers who are not medically trained.

Yes, I meant Physical Therapy. Thanks for the clarification.

mikeler 02-27-2013 11:28 AM

Quote:

Originally Posted by Muppet (Post 7240020)
Yes, I meant Physical Therapy. Thanks for the clarification.

I'd get a doc to diagnose and then ask him/her at the appointment about what physical therapy he recommends. You'll feel better just know what is going on.

Muppet 02-27-2013 12:52 PM

Quote:

Originally Posted by mikeler (Post 7240081)
I'd get a doc to diagnose and then ask him/her at the appointment about what physical therapy he recommends. You'll feel better just know what is going on.

That would be good advice, but around here everyone's a specialist. The PT people practice at a very high standard and I'd rather go with their plan. Thanks for the suggestion though.

mikeler 02-27-2013 01:51 PM

Quote:

Originally Posted by Muppet (Post 7240224)
That would be good advice, but around here everyone's a specialist. The PT people practice at a very high standard and I'd rather go with their plan. Thanks for the suggestion though.

As long as you are getting quality care that is the bottom line.

Muppet 03-10-2013 12:03 PM

The doctor I went to for an evaluation wants to send me around their hospital for further evaluations. This after I asked him to send me to the OT/PT office of my choice.

The two injuries I have can easily be handled at the place where I want to go. This is ******* me off. I'm leaning toward just getting some nice Superfeet insoles and Merrell shoes and hike myself into shape. Western medicine forces the body to perform in certain ways too much (often invasive.) Rather than pay a bunch of co-pays and have to go to the appointments, I may be better off just taking care of myself.

That damn walk-in clinic doctor said that I can get a wrist brace that I can wear overnight. He was purposely attempting to create a problem. Hey, all the more insurance money for them! And when I tried asking the outside office if I could be seen without a doctor's order, I found that I couldn't. I'm sure it would be the same run around with my primary care. She's at the same hospital.

I got a wrist brace, but I'm only using it for activities when I need it (computer, shoveling snow, etc.) And I'm taking a break from tennis until the wrist is 100% back. Luckily, my injuries don't keep me from weight training.

Thanks for listening. I guess my signature isn't applying right now.

Muppet 03-10-2013 05:28 PM

Some of you may have noticed that I've been running into poor customer service around town lately (from my point of view.) My explanation for this is that it's not about 'how I am' as much as it's about 'who I am.' It's complicated. So I guess I've been comming on here ranting more than expecting your help. Sorry about that. I guess I'll just feel my way through it.

Triskadekaphilia 03-13-2013 05:38 PM

Get a second opinion and don't see a surgeon.

charliefedererer 03-14-2013 08:54 AM

Quote:

Originally Posted by Muppet (Post 7263058)
The doctor I went to for an evaluation wants to send me around their hospital for further evaluations. This after I asked him to send me to the OT/PT office of my choice.

The two injuries I have can easily be handled at the place where I want to go. This is ******* me off. I'm leaning toward just getting some nice Superfeet insoles and Merrell shoes and hike myself into shape. Western medicine forces the body to perform in certain ways too much (often invasive.) Rather than pay a bunch of co-pays and have to go to the appointments, I may be better off just taking care of myself.

That damn walk-in clinic doctor said that I can get a wrist brace that I can wear overnight. He was purposely attempting to create a problem. Hey, all the more insurance money for them! And when I tried asking the outside office if I could be seen without a doctor's order, I found that I couldn't. I'm sure it would be the same run around with my primary care. She's at the same hospital.

I got a wrist brace, but I'm only using it for activities when I need it (computer, shoveling snow, etc.) And I'm taking a break from tennis until the wrist is 100% back. Luckily, my injuries don't keep me from weight training.

Thanks for listening. I guess my signature isn't applying right now.

Is the "doctor I went to for an evaluation" a hand specialist/surgeon?

If so, he is the one who treats most wrist problems, and is the one who ends up seeing all the wrist injuries in your area that don't get better on their own over time.

Most walk-in clinic doctors and primary care physicians have limited knowledge taking care of wrist injuries- ESPECIALLY LIMITED for tennis players (like no experience at all, unless it gets better by itself).


Where on the wrist is the pain?

Could it be a TFCC injury?



You may find it helpful to read through this page on wrist injuries from the USTA:
Wrist Injuries http://www.usta.com/Improve-Your-Gam...rist_Injuries/

charliefedererer 03-14-2013 09:05 AM

Quote:

Originally Posted by Triskadekaphilia (Post 7271893)
Get a second opinion and don't see a surgeon.

The medical person who takes care of the hand, wrist and forearm up to the elbow is a hand specialist or "hand surgeon".

There is no corresponding medical "non-surgeon" person who gets the training for the hand and wrist.

Most hand surgeons, and most surgeons, don't operate on the majority of the patients they see.

But they can make the diagnosis of what is wrong, institute therapy, monitor progress/lack of progress, and alter therapy.


Still, I share your suspicion that there may be a tendency for a "surgeon" to recommend an operation too easily.
But as you indicate, patients can always at least ask for a second opinion, and certainly persist in a rest/rehab direction for anything other than a clear cut torn ligament/tendon or broken bone.

Muppet 03-14-2013 06:10 PM

Quote:

Originally Posted by charliefedererer (Post 7273907)
Is the "doctor I went to for an evaluation" a hand specialist/surgeon?

If so, he is the one who treats most wrist problems, and is the one who ends up seeing all the wrist injuries in your area that don't get better on their own over time.

Most walk-in clinic doctors and primary care physicians have limited knowledge taking care of wrist injuries- ESPECIALLY LIMITED for tennis players (like no experience at all, unless it gets better by itself).


Where on the wrist is the pain?

Could it be a TFCC injury?



You may find it helpful to read through this page on wrist injuries from the USTA:
Wrist Injuries http://www.usta.com/Improve-Your-Gam...rist_Injuries/


C Fed,

From the graphic you posted, it looks to me like I crunched the cluster of bones just above the wrist. I have no swelling, just pain; and it seems to be subsiding. I'm going to make an appointment with a sports medicine doctor tommorow. I'll also cancel the appointments I have at the hospital I usually go to.

The doctor who gave me the evaluation was on shift at the walk in clinic. It's part of general internal medecine that is open late so that those who have primary care in the hospital won't have to use the ER. Quite frankly, trusting my injuries to a hospital is scaring me. Thanks for your help.

charliefedererer 03-15-2013 08:39 AM

You're smart to get it checked out by a sports medicine specialist.

You were also smart to get it checked out in a timely fashion, and for many that means seeing an ER physician.

I didn't mean to bash ER physicians or your hospital.

ER docs usually have great talent to take care of life threatening emergencies, and at least evaluate problems to decide if they constitute an emergency.
So many of the non-emergency wrist problems they see are "minor" strains and sprains, and most get better with rest, splinting and time.

But as you are a tennis player, it is more important to make sure there is not something "more" going on, so you don't go back to play too early and just have an early recurrence, or worsen the situation.


Believe me, I still really hope this turns out to be something that will get better fairly quickly.

Let us know how you are doing.

Muppet 03-15-2013 06:01 PM

Quote:

Originally Posted by charliefedererer (Post 7277037)
You're smart to get it checked out by a sports medicine specialist.

You were also smart to get it checked out in a timely fashion, and for many that means seeing an ER physician.

I didn't mean to bash ER physicians or your hospital.

ER docs usually have great talent to take care of life threatening emergencies, and at least evaluate problems to decide if they constitute an emergency.
So many of the non-emergency wrist problems they see are "minor" strains and sprains, and most get better with rest, splinting and time.

But as you are a tennis player, it is more important to make sure there is not something "more" going on, so you don't go back to play too early and just have an early recurrence, or worsen the situation.


Believe me, I still really hope this turns out to be something that will get better fairly quickly.

Let us know how you are doing.

Thanks C Fed. I'll post up my progress as I go.


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