ECU? Wrist Pain / Help?!? Pretty Please? (;

Discussion in 'Health & Fitness' started by ddayani, Apr 11, 2010.

  1. ddayani

    ddayani New User

    Apr 2, 2010
    Hi all!

    I have quite the mystery injury and was hoping someone can help me diagnose this.
    A brief summary:
    *I have pain in my right wrist when I supinate, ONLY when I supinate, I can pronate all day long with no pain..
    *The pain originates along the ECU tendon, over the Ulna bone, I think.
    *No clicking or noise of any sort when I pronate or supinate.
    *I have NO pain when I try to bear weight on it or do a pushup
    *I'm able to go about 90% of my daily functions without pain, however my one passion in life - tennis - is unbearable due to the required supination on my forehand side (topspin shots etc..), backhand is fine...
    *If play for long enough, the pain slowly starts to decrease while playing, like once the wrist is 'warmed up' enough so to speak..
    *Here's the kicker, if I put pressure with my left fingers on the tip of the Ulna bone (where the pain is), I'm able to fully supinate with NO pain. To me, this should be an invaluable piece of troubleshooting, however all 3 specialists I've spoken to seem to nod it off like it's not relevant to my problem...

    Here's the history:
    -September 2008 - Pain in right wrist starts, lots of tennis and had started ramping up fitness training around this time as well (pushpus, weights etc that def. stress the wrist)
    -October - November 2008 - Referred out to a Ortho specialist, had xray and MRI done, both returned unremarkable (no obvious issues), at this point I went for a 2nd and 3rd opinion. All 3 specialists suggested getting a cortizone shot into the ECU tendon sheeth (which i was hesitant in doing, hence the 3 opinions) but I ended up doing it in December. Within a week or so of the shot, about 95% of the pain was gone, I was able to return to tennis without issue for the next year
    -November 2009 Just when I thought I was in the clear, I ramp up fitness training and again the problem comes back. However not AS bad as initially
    -November 2009 Was talked into another Cortizone shot, this time only about 75% effective
    -March 2010 Ortho specialist sends me for an MRI where they inject dye beforehand to better see the joints/tendons etc, again results come back unremarkable.

    I've been slowly trying to play tennis again, and have acquired OCD when it comes to heating the wrist before I play, and icing after I play, which I think is helping.

    Any suggestions? Braces I should look at? What does this sound like to you?

  2. Orion

    Orion Semi-Pro

    Dec 25, 2006
    Sounds like what I had last year. Admittedly, I never went to the doctor to get it looked at.. just because I generally don't trust a doctors diagnosis. I started weight lifting when I got back into playing after an 18 month layoff. I believe I ruptured a tendon. I had excruciating pain when I hit my forehand. The pain was on the outer side of my right wrist. Upon impact it it was like a nerve was being pinched in my wrist. It affected my entire game. Like the idiot that I am I kept playing through it and was getting tossed around the court like a rag doll. I noticed that it felt better when I rested but I was so anxious to get back to form that I just toned down my weight lifting and tried to play though it.

    When fall came around, I scaled back playing to about once a week and all but eliminated my weight lifting and noticed I was hitting pain-free for the first time in about 8 months. I went through a few racquet changes, was using the Head MG Rad Pro then switched to the Donnay Pro One OS then the Head YT Rad Pro. The MG Rad Pro was what I was using when I injured my wrist. I got a the Donnay Pro One OS as a rehab stick because it was a flexy OS. I finally settled in on the Dunlop 4D 200.

    I started doing a rehab workout after the pain subsided:

    Wrist Curl 3 20-20-20 25 lbs
    Arm Curl 3 10-10-10 25lbs

    My biggest help was wrapping my wrist with self-adhering athletic tape (Walmart, Academy....some Target's sell it) before playing. It added support to the wrist that the wrist supports don't give. I had at least four different brands of wrist support but found all of them uncomfortable to play with.
  3. charliefedererer

    charliefedererer Legend

    Feb 13, 2009

    Moving to palm facing up is supination, moving to palm facing down is pronation.

    I'm puzzled by your saying that the pain only occurs during supination on your forehand.

    But the predominant movement on the forehand is pronation. So are you describing that the pain occurs during your backswing? Or are you confusing supination and pronation, as the predominant movement in the backhand of the dominant arm is supination?

    Also, "Injuries of he extensor carpi ulnaris tendon occurs more frequently in the nondominant hand of players with a double-handed backhand and pain is felt hitting backhands. Pain of the flexor tendons is more often during the snap of the serve and when hitting forehands." And another condition, "A subluxating extensor carpi ulnaris tendon is charactereized by a painful snapping of the wrist over the back of the small finger side of the wrist, especially on foreannand ratation. It results from a tear or stretching of the retinaculum (roof) of the extensor carp ulnaris tunnel. This allows the tendon to move allows the tendon to slide back and forth, in and out of the mormal position in the groove of the tunnel, The injury may result from a single sudden movement or repetitive movements of the wrist, with the palm of the hand turning upwards and sideward, such as when hitting a slice forhand, low volleys and topspin serves." - From BreakPoint to Advantage by Pluim and Safran.
  4. Racer41c

    Racer41c Semi-Pro

    Jul 5, 2007
    I've been almost where you are, minus the cort shots. I was to the point where I was going to have to stop playing because I just couldn't play without severe pain. All I could do is spray the ball all over.

    Today, I'm pretty "clear" with the hand/wrist. Here's what I did:

    1. I figured out that the original racquet that caused 1/2 the problem had a butt cap that was too big and had too sharp of a step. I have a habit of holding the racquet with the butt in the middle of my palm and the cap would dig into the ulnar nerve near the hamate. I switched to a dunlop which has a much slimmer butt cap which resolved that problem. It took about a year for this to clear up.

    2. After the MRI which showed no structural or ganglion cyst issues I decided I would massage out any soreness/stiffnes from the elbow to the fingers. As with my knees, I find that when joints hurt it's because something is too tight and needs to be loosened up. I found weird little spots where it just hurt like hell. I rubbed out the pain until it was gone. Some of the spots took every day for a week, others it was once and that was it. This basicly "fixed" the problem for me.

    3. So what caused the forearm/wrist tension/tightness for me? 3 things really: 1. Mousing so I switched to mousing with my left hand. 2 typing, so I bought an ergo keyboard (typing a notebook kills my wrist) 3. Not using the square pad thing on the notebook, which will make my wrist hurt within 1 minute of using it.

    I hope any of my experience helps, as of today my hand/wrist are great and I even went back to a stiffer racquet and have no issues.
  5. ddayani

    ddayani New User

    Apr 2, 2010
    Thanks for the responses everyone! I will def. pick up some of the tape you suggested Orion. Racer, I agree with the computer mouse/trackpad dilemma. I'm really trying to switch to my left hand for ALL computer related activities... (it's hard though, I work at a computer for 12 hours a day on days I work...)

    "I'm puzzled by your saying that the pain only occurs during supination on your forehand."
    It's the supination required at the end of the take back during preperation, to get your wrist/raquet in a position to fully pronate over the ball upon impact.. If you use a semi-westren grip, pretend to hit a forehand in slowmotion right now... See how you're sort of supinating the wrist before you start to take your arm forward for the shot?

    So I've been religiously icing it on/off repeatedly after playing (and heating it up with a heat pack before I play) and it's really holding up well.

    Also, Racer, I think you're on to something with the massaging. I've had two deep tissue massages since I wrote this initially, and that alone helped my wrist more than all the times I was sent to professional rehab for it...
  6. Maroon_Tenniskid

    Maroon_Tenniskid Semi-Pro

    Jan 8, 2011
    I am having the same problem right now! I am afraid of taping my wrist because I heard it made it weaker, is this true? I've been Icing my wrist a little bit after hitting, but I haven't had any results. I might try the massage thing because I can feel a little bit of tightness in the underside of my forearm. I can't rest my wrist as long as I'd like due to my schedule, and I really love tennis too, so I'd like to know how to beat this for good! Is your wrist all better now ddayani or anybody else who has suffered this annoying pain?

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