I’ve been nursing my wrist for two months now with no obvious improvement. Of course ‘nursing my wrist’ involves staying off the bike which isn’t helping with my training for the Fred Whitton…

My physio ruled out tendinosis but was then unable to diagnose anything more specific than ‘a joint thing’. Didn’t stop her suggesting a follow up appointment of course.

After 6 more weeks off nursing it, trying to decide if wearing a splint helps or not and taking ibuprofen on and off, I ask my GP who is perhaps even more vague and useless than the physio. All she managed to offer was that it probably wasn’t a fracture, could take several months to heal and her only advice to assist in this healing was to try and use my mouse left handed.

So…. several months off the bike hoping that my undiagnosed injury *might* eventually heal. Wonderful.

Has anyone had any experience of sharp pain located around the pisiform when flexing the wrist against resistance (i.e. pushing up from a chair sort of movement?). I’m guessing ligament damage as I haven’t knocked it or fallen on it.

Can anyone recommend an Edinburgh GP or otherwise that actually knows something about wrists?

her only advice to assist in this healing was to try and use my mouse left handed.

actually, for me this proved key to sorting out a wrist problem that had been with me for a couple of months.

Beyond that – ask your GP for a referral to a hospital. I got one for my knee and ended up with an MRI and directed physio.

You need to ask your GP to refer you to a specialist who, er, specialises in wrists and hands. Can you go private? Even a private session might be worth it; it’s about £80 to £150. Look on the BUPA website for specialists.

“My physio ruled out tendinosis but was then unable to diagnose anything more specific than ‘a joint thing’. Didn’t stop her suggesting a follow up appointment of course.”

Why did you not take it? You may have been referred for further tests and examinations by now.

AFter I broke mine, I rode with a wrist brace for a while to support it. Was OK as long as I didn’t try anything silly or spend too long out of the saddle.

Past experience of physios milking extra appointments out of me even when they DID know what was wrong makes me reticent to go back to one who very obviously DIDN’T know what was wrong.

wwaswas, that’s reassuring at least, just hope my employer puts up with a month or two of wonky CAD drawings!

Globalti, I did phone a specialist who quoted £150, I balked at it as I didn’t think I could get it on my work’s healthcare (as a ‘pre-existing condition’) but I might just have to suck it up. It’s the lack of any sort of diagnosis or meaningful advice which is frustrating me so far…

Unicycle?

I wouldn’t rule out a broken scaphoid unless you had an X-Ray 1 or 2 weeks after the injury. And if it is that, you want to get it fixed asap. Don’t ask how I know 🙁

More recently, I had a similar experience with my son after a BMX fall. He went to A&E and got it X-rayed – all clear. Weeks later I noticed he was often holding and rubbing it and he said it was sore when he did jumps and things. Back to GP for a referral which was a battle to get. After that, X-ray confirmed a scaphoid break that had not been picked up at the time. Cue attempts to heal with a splint for a few weeks – no good. Then cast for a few weeks – still no good. Eventually he had to have op and a screw inserted to pin the 2 halves together.

My recommendation would be see GP and push for a referral to get it checked by X-ray, since if it is this and its not treated you will have real problems in later life as it will not heal.

I don’t know if it will help, but an indication of if the pain is related to a scaphoid problem is to hold your hand as if you are giving a thumbs up, extend your fingers and then press the depression that you can see at the base of your thumb on the back of your hand (the anatomical snuffbox). If there is pain there, that can indicate a scaphoid problem. Use your OK wrist as a reference. Here’s a link to some more details: http://en.wikipedia.org/wiki/Anatomical_snuffbox Check the clinical significance part

Good luck!

Have heard good things about Edinburgh Uni’s sport physio for weird knee things – perhaps this might extend to weird wrist things. A few runner friends who used them said the big difference between them and the NHS physios was that they understood how important it is to be able to do some sport so didn’t fob them off with ‘rest it a bit and wait’. I also *think* they might have cheaper rates for alumni.

Was going to say suspect scaphoid too. I didn’t realise I’d broken mine for about 2 months after a crash. It was just a dull ache that didn’t improve, and I only went for an xray because my doctor recommended it. You might have missed breaking it…

.. just noticed you said you hadn’t fallen – but it can take a while to show up, so I wouldn’t rule out an earlier fall you have forgotten about. The scaphoid is such a stupid design it can break easier than you think

Edit: what he just said^

Just on the off chance

my wrist turned put to be largley refereed pain from thoracic joints. The right physio can work wonders on this

Sounds like scaphoid to me.

I opened this thread just to get some entertainment and feel that it wasn’t just me, but…

I have pain at my ulnar joint (where you describe) post an injury and fixation.

I would take a photo of my wrist and show you, but just try this for me.

http://www.wristwidget.com/weight-bearing-test-for-wrist-pain.html

If taping your wrist tight with say, zinc oxide tape works, it’s very possible you have a TFCC tear.

Will, why would it be scaphoid, thats the other side of the wrist?

What sort of physio?

NHS/gp referral seems to be interested only in getting you off the list. Find someone in your area to recommended a sports physio and you might see better results.

Its the wrong side for scaphoid isnt it?!….all my assessments for scaphoid injury revolve around tenderness at the ‘anatomical snuff box’ at the base of the thumb/radius and ‘telescoping’ said thumb in and out to provoke pain at the scaphoid area….the pisiform is on the side of the little finger/ulna.

The pisiform forms part of the border for the carpal tunnel though, have you had any classic symptoms for this like numb hands, loss of power etc?

If (and in my opinion a big if) its your scaphoid it should show in an Xray now, generally they dont show for a couple of weeks and we advice people with symptoms to return to the fracture clinic in 2 weeks time for confirmation…another classic scaphoid sign is that the wrist will just give way when you try to put pressure through it, so many motorcyclist’s racing careers have been ended through scaphoid injury as they cant brace against the bars as they brake anymore.

From what your physio and Dr are saying i’d say soft tissue injury too, ligamentous injuries can take longer than fractures to heal and the wrist is incredibly complex.

Gentle rehab type exercises (youtube them), analgesia/anti inflammatories as required….and the boring one: time.

You may have to reconsider the ride (sorry).

i had the hurty wrist when bent back and loaded. pushing myself up onto a wall flat hands was AGONY. basically i had fluid bubbles in my tendons. (one moved to make a lump on my wrist which freaked me out) went to docs and they said ‘dont do anything and wait till it calms down’. bugger that. in the end i worked out the crappy shaped bars and poor body positon on te bikemade it worse loading my arms too much. especially with forks locked out. this was reaffirmed recently when i got a new bike and my wrists started hurting again. quick trip to the bike shop and all is good again.

its inflmmation of the tendons. itsa basterd as its actually quite debilitating.

mine got to the point where it hurt to hold a pint!

i also use gloves with palm pads now. and a special wonky mouse. mouse was 12 quid.

Isn’t this forum brilliant?

if you haven’t fallen on it then you won’t have caused a fracture or ligament damage. These sort of injuries take force.

It’s more likely that you’ve got a tendon problem as you say it hurts when you apply resistance to it. I would suggest that it may be your flexor carpi ulnaris and given the length of time probably a tenosynovitis.

Check out http://www.wheelessonline.com/ortho/flexor_carpi_ulnaris

I work in the NHS and if you had been my patient with no improvement with conservative methods I would have referred you to my hand colleague for injection.

My punt in the dark would be your triangular fibrocartelage disk.

Thanks all, good input and I’m at least over my initial frustration after the unhelpful GP visit (although not before posting a whine on FB which I always regret doing an hour later, FB is only supposed to be for gloating! 8) ).

Anyway, very sure it’s not scaphoid or carpal tunnel due to wrong location/lack of any other symptoms.

No fall but I am suspicious of some over enthusiastic CX with some big jolts and bumps including one big enough to write off a new frame! If you imagine your hand on the drops and braking, the pain is located right where your wrist would be most strained.

Am getting used to left hand mousing so will persevere, several people vouchsafing that it would be a good idea for healing and for ruling out RSI.

Would love to be trying some rehab exercises but only once I know what it is I’m trying to rehab! Was trying some decentric exercises with a theraband which felt fine but were completely of my own devising so god knows if they were doing me any good…

Had two unrelated people recommend the same physio/doctor who was very good for wrist complaints, his usual fee was £70 but the receptionist recognised my name from having attended the practice before for this issue (different physio though) so gave me a reduced rate 🙂

wanmankylung, is that the joint/cavity behind the pisiform? The term rings a bell from an article which seemed to describe my symptoms.

Yes, pretty much.
http://www.wheelessonline.com/ortho/triangular_fibrocartilage_complex

Think yourself lucky. I appear to have managed to tear both my medial and lateral menisci in my left knee.

Find yourself a good remedial Masseur and let them see if it is anything muscular………..usually a good place to start.

Jonathan Martin

This website looks good. Simple and to the point. Nowt faffy and in Edinburgh

You have absolutely nothing to lose by trying!

I can’t comment on fixing it but you can reduce the loads going into your wrists.

Your wrists aren’t designed for the impacts you get riding an mtb. Try a riding position that reduces the load on them, ie more upright. Also consider swept back bars to have your wrist at a more comfortable angle. Perhaps even dropbars (set up high for an mtb, not down at the axle like a roadie) – it’s not the drop that’s important, it’s because they are parallel.