TFCC Central tear debridement recovery time

[Bbuky]

Hello all,

I'm 25 days post op from an arthroscopic debridement of a large central tfcc tear in my left non-dominant wrist from hitting an awkward two-handed backhand. I'm not sure if bad technique (usually take the backhand a bit late) contributed or not. My MRI showed that there was no damage so I tried conservative therapy for over a year including cortisone. After that didn't help I went under the knife. Range of motion is coming back steadily as I do rehab but pronation/supination and ulnar deviation are all still quite painful, particularly ulnar deviation. I'm just wondering if anyone else who had the same procedure can elaborate on their recovery time and time it took before you could return to tennis. My backhand was my money shot so I'm really hopeful I'll be able to hit them again. Thank you for any responses!

 

[dimbmw]

as far as I know debridement is the simplest procedure with the shortest recovery, basically nothing is done other than some clean up, so i'd expect 1 month...

however if there is still pain on ulna side I'd study the "uc split tear" possibility, as it might have been overlooked by the inexperienced surgeon

 

[Bbuky]

Yes debridement should be quickest recovery time based on what I've read and what my surgeon said. My surgeon did a fellowship at mayo clinic and trained under the surgeon who discovered the UT split tear (Dr. Berger) so I don't think that's it as we discussed this as a possibility before surgery. He also was part of the team that operated on Del Potro so I think he's a very experienced surgeon. My guess is that because so much time has passed between the initial injury and the debridement it's just going to take longer to recover. About a year and a half passed between injury and surgery. It will be a month since surgery on Tuesday and pain is just not improving. Just hoping to hear some other experiences....

 

[Stantastic]

I had the same surgery done just over a year ago, 5/31. It took me 11 weeks to return to a tennis court at all and that was for minor hitting of 15-20 mins. In my case forehand didn't botnet me as much as backhand, even with two hands, due to the supination involved; that was unexpected. I went through lots of rehab, but it took a long time for full range of motion to return. I had some scar tissue from the surgery on the radial (non-tfcc side) as well. Be sure to work with rehab to push through any scar tissue early on while you can, if nec. I was able to play with a pro 2-3 times per week to control the type of hitting and got back to limited competition in about 2.5-3 mos from the back to tennis point, or 6-6.5 mos from surgery, though still with some pain and overall weakness. I had to take 3 weeks off 2 more times while put on meloxicam, a fairly strong anti-inflammatory because the pain would just not fully stop. At 7.5-8 months out I finally got rid of just about all sorry wrist pain and was able to hit relaxed forehand and serves that throw your wrist back, alla lag. Of course that only allowed me to now start working on full other strokes, leading to taking my time with sore biceps tendon and rotator cuff due to inactivity. Those latter were relatively minor and fitness- related, but my point is that you will likely have to be careful with while body as your play resumes. I got quite stiff post-surgery and it took time and regular effort to get loose and in shape. Even now I just had a calf pull, with likely plantaris tear while leg was a bit tight and I ran forward hard for a drop shot, but wrist is about fine with some slight pain on high forehand volleys remaining (may be due to remainingslight weakness on radial side from surgery...awesome). I hope that gives you a reasonable timeline from someone 4.5 level, late 40s, very motivated, yet still it takes time and lots of careful, regular effort. With those, you should certainly get back to relatively pain free play one da not too too far off, but feeling like forever, just don't rush it. Best of luck!

 

[Bbuky]

Stantastic thank you for such a detailed response. I'm now just beyond the 6 week mark and have no pain with pronation/supination and still a bit of pain with ulnar deviation. My wrist is still a bit "creaky" but I guess that will probably never go away. ROM is almost normal just need a few more degrees with ulnar deviation and a ways to go with flexion as scar tissue is impeding that a bit. I also have some unexpected radial pain. I see a physio twice a week and also do ultrasound and hyperbaric oxygen sessions to speed healing. I have just started on strengthening and I have a feeling I will have to take this part very slow and steady as I'm extremely weak. My surgeon seemed very pleased today and said I can try hitting backhands as soon as I have plateaued with strengthening. Don't want to be too optimistic but recovery seems to go going ok. I just don't want to rush returning to hitting two-handers. When you came back did you have to modify technique or change equipment? I use fully poly (hyper g at 53/51) in a yonex ezone dr 98 weighted to 12.2 ounces (mostly in handle with 4 gm at 12 o'clock.) Strangely before surgery I found poly to be easier on my wrist because I did not have to brush up to control my shot. Thanks again for sharing your experience.

 

[Stantastic]

Hey there. Technique-wise I had to give it time to get full range of motion back, so technique definitely changed. Do what you can to not over extend or force some off balance shot, but you'll figure out where you are. Forehand volleys were a problem for some time, but though that pain has lessened, I now have an awesome swing volley I developed to help with the initial pain from injury on classic FH volleys.

It's a good idea to soften shocks while recovering. I myself switched to gut/poly for a bit to help with some extra softness and power while maintaining some control. Of course cost becomes a bit of an issue then and you can search lots of threads for combinations to have tension last in the poly to make it worth it, but I went with VS Team (17G) and 4G Soft, which is quite a nice combo that lasts reasonably and is not too too harsh, even if the 4G soft is not exactly sodt, but didn't feel uncomfortable to me. I also found that RPM Blast or Team strings are not too harsh if you hit with an angled stroke because the strings seem to slide well on each other for a softer feel. Hitting straight-on flat shots with RPM can feel a bit stiffer.

The DR98 is a great choice all-around and provides good comfort. I in fact used that same racquet last year while recovering. I have since switched to a Head Extreme Pro for tennis reasons (non injury related), but also feel that it is not a harsh racquet for me despite being stiffer, and I do have a year old recovery under me. I currently use Hyper G 17 and pain is not an issue, though I did feel some initial harshness using it in another racquet a few months ago even if I played well with it. I love Hyper G in the ExtPro now though. I also tried a Black Magic mains and NXT Duramax 15 crosses combo a teaching pro was using and that was pretty good, though it moves some and I don't need the protection as much now, so back to Hyper G. So yeah, definitely reduce shock, take your time, lots of rehab, also careful with too heavy a racquet while recovering, but that's player specific.

 

[Chas Tennis]

Get your 'operative report' and see specifically all that was was done to your wrist. Tendons? ligaments?, bursa, bone, bone spurs, everything. Dr's observations...

I had shoulder rotator cuff surgery done end of March. The torn tendon is cleaned up and reattached to the bone. Recover is 9 months. PT very slow when the tendon might fail. [Rotator cuff surgery failure rates are 5% small tear, 20% large tear, up to 50% for largest tear.] I believe at 9 months I can do some serious exercises to regain shoulder strength. Also, I need to recondition the rest of my body for running, etc. I'd assume any tendon re-attachments might take a long time. At the end, you have tendon tissue that has increased strength after a long healing time with controlled stress. But the new tendon scar tissue is not as good as uninjured tendon.

Follow the Dr and physical therapy as long as possible. Find information on the time for tendons to heal and all other tissues.

There are many wrist threads in the Health & Fitness Forum. The wrist is one of the more difficult injuries to resolve.

I believe that Belinda Benicic is out after wrist surgery. You might look at her two handed backhand and see what you can learn about how she was injured.

If you have any videos of your strokes compare them to better two hand backhand techniques.

 

[SC in MA]

I had a non-tennis caused TFCC wrist injury on the ulnar (pinky) side of my dominant wrist which happened around 2 years ago, which ended my tennis playing.

After trying rest for a year and a cortisone shot, which were largely ineffective related to allowing me to play tennis, I had a debridement surgery procedure one year ago.

While the procedure helped somewhat overall, I still wasn't able to play tennis because of the discomfort, until out of desperation, I tried a 2 handled racket a few months ago. Just the slight angle change of this racket handle was enough to allow me to play again.

I'm extremely grateful for this racket and would highly recommend anyone who can no longer play because of a wrist injury to give it a try.

 

[Berkeley Tennis Guy]

I had a non-tennis caused TFCC wrist injury on the ulnar (pinky) side of my dominant wrist which happened around 2 years ago, which ended my tennis playing.

After trying rest for a year and a cortisone shot, which were largely ineffective related to allowing me to play tennis, I had a debridement surgery procedure one year ago.

While the procedure helped somewhat overall, I still wasn't able to play tennis because of the discomfort, until out of desperation, I tried a 2 handled racket a few months ago. Just the slight angle change of this racket handle was enough to allow me to play again.

I'm extremely grateful for this racket and would highly recommend anyone who can no longer play because of a wrist injury to give it a try.

Hey SC in MA: I realize your post is several years old but it prompted me to order a double-handled racket. I am 6 weeks out from debridement procedure, have three torn ligaments (including TFCC) in wrist, and while it's better than it was, I am not confident I can go out and play more than once a week or so at this point, and even then in a somewhat guarded manner. Went out in July 2023 with severe pain and almost no rotation. Realizing from all of these posts that the outlook on these injuries is not all that great. Hoping the Freestyle racket is of some help, or that with the passage of time things will get better. Might also go to Mayo and get a consultation there and see if there is anything else that can be done. Wondering how you're doing five years later -- are you still playing?

 

[SC in MA]

Hey Berkeley Tennis Guy. Sorry to hear of your wrist issues. I'm just heading out so I'll respond more fully later.

 

[SC in MA]

Hey SC in MA: I realize your post is several years old but it prompted me to order a double-handled racket. I am 6 weeks out from debridement procedure, have three torn ligaments (including TFCC) in wrist, and while it's better than it was, I am not confident I can go out and play more than once a week or so at this point, and even then in a somewhat guarded manner. Went out in July 2023 with severe pain and almost no rotation. Realizing from all of these posts that the outlook on these injuries is not all that great. Hoping the Freestyle racket is of some help, or that with the passage of time things will get better. Might also go to Mayo and get a consultation there and see if there is anything else that can be done. Wondering how you're doing five years later -- are you still playing?

So, since my last comment back in 2018, I'm happy to say that my wrist improved enough over time for me to play mostly pain-free for a few years now. The wrist is not 100% normal and it's very susceptible to some level of pain from either twisting/torquing or overdoing it, so I have to KT Tape it and use a wrist wrap while playing. As long as I do this and don't overdo it and don't do anything excessive to strain the wrist, I can play mostly pain-free, with nowhere near the level of pain I used to have which made playing impossible.

Besides the debridement, I think the key to getting my wrist to a state where I could play mostly pain-free was through physical therapy that focused on loosening the muscles in my forearm, as well as the muscles in my upper arm and shoulder to some extent. I think it was a few months of the PT before my wrist pain finally started to lessen. As time went on it gradually improved. Before the improvement, I never thought it would ever get better, which I'm sure you're probably going through. Hopefully, your wrist will improve with time.

I also thought about consulting with Mayo, as they do have wrist expertise related to tennis players, but never took that step.

As for the two-handle racket, it helped initially which I was very thankful for, but after a few months, I found that I was able to go back to a regular racket as my wrist slowly got better. Also, there were times when the racket would torque my wrist, so the racket wasn't perfect. Also, as much as I tried, I never did get the hang of the two-handled racket, so I was extremely happy that I was able to go back to a regular racket.

Anyway, best of luck to you! Let me know if you have any other questions.