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Hall of Fame
- Extensor Carpi Ulnaris (ECU) Tendon Injuries
- deQuervain’s tenosynovitis,
- Triangular fibrocartilage complex (TFCC) tear,
- Intersection syndrome
- Dorsal Carpal Ganglion Cyst
- Hook of hamate fracture
Wrist pain can be divided into two main types: radial (thumb-side) and ulnar (pinkie-side) injuries. Many players experience ulnar pain in their non-dominant hand during two-handed backhand strokes. During these strokes,the upper hand is placed in extreme ulnar deviation and extension while moving from supination to pronation.
Extensor Carpi Ulnaris (ECU) Tendon Injuries
Ulnar-sided tendon injuries most commonly involve the extensor carpi ulnaris (ECU), which is the tendon lying across the edge of the wrist. Injury to this tendon can involve inflammation (tendonitis) or subluxation (partial dislocation) of the tendon. Tendonitis is an inflammation of the tendon, and usually occurs in the non-dominant wrist in players with a two-handed backhand. Treatment for most tendonitis involves rest, ice, splinting, anti-inflammatory medications and/or cortisone injections. Subluxation or snapping of the tendon occurs when there is a rupture of the sheath or tunnel that the tendon passes through at the wrist. The tendon then slides in and out of its groove and causes snapping. The treatment of a snapping ECU tendon begins with immobilization in a cast or splint. In recalcitrant cases, surgical repair of the sheath may provide the best outcome.
The first is tendonitis—an inflammation of the tendon, caused by excessive rotation and extension of the forearm. This is primarily observed in the non-dominant arms of players who use the double-handed backhand—a technique we’ve discussed previously.
The second type of injury—partial dislocation of the tendon—is a much more serious issue and may require more immediate measures. If the tendon is indeed dislocated, it will slide in and out of its sheath upon movement, causing snapping. Immediate fixation is necessary, and surgical treatment may be required as well.
deQuervain’s tenosynovitis,
A painful condition affecting the tendons on the thumb side of the wrist.
Repetitive hand or wrist movements can make the condition worse.
The main symptoms are pain and tenderness in the wrist, often below the base of the thumb.
DeQuervain’s stenosing tenosynovitis is the most common tendonitis affecting the tennis wrist. It is the result of trauma from repetitive gliding of the two tendons at the base of the thumb. The inflammation causes the tunnel around the tendons to swell, making thumb and wrist movements painful. DeQuervain’s leads to pain directly over the affected tendons and with tendon stretching. Treatment starts with activity modification, a splint that limits movement of the involved tendons, anti-inflammatory medications, and/or a steroid injection into the tendon compartment. If the symptoms persist despite these treatment modalities, surgery to open the compartment is recommended.
Triangular fibrocartilage complex (TFCC) tear,
- Pain, at the base of small finger side of the wrist.
- Pain worsens as the wrist is bent from side to side.
- Swelling in the wrist.
- Painful clicking in the wrist.
- Loss of grip strength.
Intersection syndrome
Intersection syndrome is much less common than de Quervain tenosynovitis, the syndrome
Wrist Pain: Conditions and Treatments | HSS Orthopedics
Wrist injuries are a common problem of the upper extremity. Getting symptoms assessed early by a hand surgeon may save you a lifetime of pain and disability.
www.hss.edu
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