Possible Wrist injury?

[selkirk]

About 3 weeks ago I was climbing a finger crack and tweaked my wrist a bit. I had both feet pop off so I basically hanging off a finger lock and crimp, pulled hard on the finger lock and felt this little "pop" and it felt like something kind of slipped (kind of hard to describe) and then this warm, not quite burning sensation in the first 6 inches between my wrist and elbow. It hurt a little bit, but it was more burning/warm than painful????

 

Since then when I'm trying to pull on awkward facing holds awkward side pulls usually . It's fine for pulling straight down on with a straight wrist, it seems like I have to pull down, with my fingers cocked (like a finger lock)

 

Does anyone have any idea what the hell I did? I'm more curious than anything else. Trying to take it a bit easy.

Cheers

[layton]

It's almost impossilbe to diagnose this over the internet.

Describe exactly where you feel the pain/warmth to help zero in on the structure(s) damaged.

Does it hurt when you flex or extend your wrist and or fingers against resistance? If so, where does it hurt.

Does it hurt to passively more your wrist or fingers into flexion or extension at the end range of movement, and is there any abnormal movement, motion, excessive motion, or restricted motion...if so where and how?

Have you noticed a decrease in strength?

Have you noticed any swelling, discoloration, numbness, or tingling?

 

My best guess is your completely ruptured a finger pulley tendon since there is no pain.

[selkirk]

The warmth/pain started at the juncture between my palm and wrist on the inside of my hand. It extended maybe 5 or 6 inches up my arm towards my elbow. Pain is almost too strong a word, warmth is probably more accurate

 

No pain flexing or extending my wrist with resistance at my fingers.

 

No asymmetric pain or discomfort moving my fingers in flexion or extension under no load. No abnormal movement, motion or anything else asymmetric.

 

No noticed swelling, discoloration etc. Occasional minor tendonitis from too much work at a computer w/ a mouse but it's symmetric and predates the climb. Relatively mild.

 

No noticed decrease in strength.

 

Really the only time it seems to twinge/burn a bit is when the wrist is cocked and I pull down on it. (think pulling straight down on a high finger lock.) In that position, under load there is some tingling and warmth.

 

Thanks Mike!

Is it something I should actually get looked at? or just ice, and tape the damn thing for a few months?

[layton]

Ok, from that I'd have to guess (and it's just a guess), that you quickly dislocated/relocated your lunate, which is the most unstable carpal bone in your wrist. It makes sense based on your history and need to flex your wrist when pulling down.

 

You can go a few routes.

1. do nothing and see if it gets better or worse

2a. see your family doc --> get anti-inflamm, or pain killers, or both -->get diagnosed with mild wrist sprain. Doc says come back if it gets worse.

2b.Doc refers you to a physical therapist, PT does muscle work, mobilizations, and ultrasound.

2c.Doc refers you to Orthopedist, hopefully a wrist specialist. Orthopod x-rays your wrist and does orthopedic tests. Maybe an MRI, but doubtful unless you don't get better. Orthopod calls it a wrist sprain, prescribes anti-inflamm, a wrist splint, and suggests you see a PT (see above).

3.You see a chiropractor who does wrists, harder to do in Washington since they are a bit more old-school in that lots only do spines. Look for a "sports chiro" or one with a sports med diplomate. Chiro does exact same thing as Ortho minus the anti-inflam and MRI (unless he/she thinks it's a tear of the triangular fibrocartilage or grade III strain---grade III strains are complete ruptures and are painless sometimes). Chiro evaluates your carpals and looks for an incomplete reduction of a dislocation (aka subluxation) and pops the carpal back into place. Chiros in WA don't do PT electrical modalities (they do in every other state and should in WA soon) but will work on the muscle/soft tissue just the same.

 

So if I were you and wanted to get it looked at, I'd see a sports chiro first, and not just cuz I'm studying to be one. They will be cheaper and offer a bit more conservative treatment than your other options. A good place to start and see if it can be managed w/o drugs or surgery. If the chiro didn't think they could fix it, they'd refer you to an orthopedist, like your MD would. So basically a chiro is going to do most of the orthopedic and PT stuff for cheaper and less appointments/driving between two places (ortho and PT). I hate to say it, but I'd try and skip your MD on this one.

 

If you're going to fix it yourself (and mind you, you can't fix a grade III tear...which you may or may not have...i doubt it w/o any swelling...but you never know) yes, ice, tape, self massage, and buy a cock-up wrist splint at fred meyer to wear for a couple weeks just to be safe.

[layton]

I forgot to ask, "any NEW clicking poping or grinding now when you circle your wrist around?"

[layton]

Crap I've got a bit more, sorry for the verbage. This doesn't directly relate to the problem above, since I don't think there is instability going on. But it's a common wrist injury in climbers (instability that is).

 

I've tweaked my wrist climbing before and get sharp stabbing pains randomly, like picking up my coffee cup or turning a doornob, but not always. I felt a signifcant restiction of my ulan on my carpals so I self adjusted it. I got a big painful POP, and I iced it and put a wrist splint on for two days, then used it only when driving my powerless-stearing truck. Now it's better.

Of course many wrists can become unstable and can click and pop all over the place. Adjusting probably isn't a good idea here (unless a significant restriction is making other bones have abbarent motions). Strengthening the flexors and extensors, pronators/supinators evenly, and maybe a brief period of immobilization is a good idea for the unstable wrist. Finally, prolotherapy is a 2nd to last resort, surgery being the end all of things to try last.

 

A lunate dislocation (VISI) can cause severe carpal instability and lead to carpal collapse, a no no.

[selkirk]

Thanks again Mike!

 

An no, no asymmetric clicking, popping etc that I can tell. If anything my uninjured wrist pops a bit more. I'll watch for a couple of weeks, and maybe pick up a wrist splint. Definitely won't go the family doc route. I gave up going to them for any type of sports or joint type injury years ago. I've known a few cases where they're misdiagnosis cost people entire seasons. They just don't see enough of this type of stuff.

 

I've gotten in to see sports med types at the UW medical center before and can probably do that directly without the referal process so I'll either go that route or the chiro route.

[layton]

you can see me for free in portland if you want!

[selkirk]

Would love to but it's an awful long commute for a 30 minute appointment