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Not Enough Wrist Cartilage


SoMDel
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Hey everyone,

I recently found out I don't have enough cartilage in my wrist. But before I delve into that, I'll give a quick preface to the situation.

I'm 17 years old & I've been doing Gymnastic Strength Training™ for the past two years, competitive soccer for eight. About four months ago I finished a soccer game and noticed I had a sharp pain on the outside of my right (dominant hand) wrist (between the bone in the forearm that protrudes and the start of the hand). As I said before, I didn't realize the pain until after the game, so I have no recollection of what incident caused this during the game, but I assume I must've fallen and broke my fall with my wrist.

The pain was rather sharp at first, but subsided within a week. I started training again but noticed a slight, but irritating pain whenever I put weight on wrist when it was bent backwards. This was especially frustrating for handstands, and many other movements. As a result, I had to put these exercises to rest for a while. So three months later, the pain was still there, but only when doing pretty heavy exercises as described above (Handstands, L-sits/Planches on floor). In other words, pushing a door open would not hurt in the least bit. Doing Planches/L-sits on a bar apparatus would not trigger the pain.

So I went to see an orthopedic whom specialized in hands & wrists. He took an X-ray of my hand and diagnosed the following:

imageWrist-01.jpg

Between forearm bone B, bone T and bone L, the cartilage has worn away. He suspended such bent-wrist exercises indefinitely and I'm checking back in with him in 4 weeks.

Is there any hope for eventually being able to do bent-wrist exercises or regenerating this cartilage?

Cheers,

Stefan

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The answer to that is way beyond my pay grade, but I sure would be interested to know if you do find an answer.

The body is incredibly adaptable, so even though I don't think that kind of regeneration is possible, it very well may be your wrist will be able to adapt to the training load if you move forward very methodically. Very small increases in how much weight you ask your wrist to bear over time. Using delayed onset of pain as a gauge. When the pain comes, deload for a week or so and then more carefully moderate the load.

Obviously the same will go for the wrist prehab in general baby steps with everything and lots of patience.

As always this is in no way medical advice, just an educated opinion.

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Alessandro Mainente

from an hystological pov the carthilage in young boy can regenerate itself to repair possible damage...for adult and guy where the puberty is ended there is a very little probability to have a regeneration and may it possible get scar tissue and this because some hormones as triiodothyronine, tiroxyne,testosterone and growth Hormone are producted in more quantity and these stimulate the carthilage growth from preichondrium to chondroblast.

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VeganMartin

Did the orthopaedic surgeon mention anything about stem cell therapy? Some people have regenerated their own cartilage after having injections of their own stem cells. It can take a long time to recover properly afterwards.

It's unusual for someone so young to have worn away their cartilage.

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Alessandro Mainente

Vegamartin this is an interesting thing...here in italy the use of staminal injections cannot be made for some contrast with church, so now the terapy is permised only with organ-specific-staminal cell and not embryofetal staminal..unfrtunately the cartilage staminal cell is generated from mesodermic sheet in the puberty where the bones gain mass from cartilage and where there is an elevated hormones production! so...no dubt that embryofetal staminal cell can solve the problem, you have to see if it is permised in your country and if you get some scar tissue around the area tha must be healed

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VeganMartin

Hello Alex87. The therapy I read about was based on someone's own mesenchymal stem cells. I don't think embryo stem cells could be used in the UK or US - and I wouldn't be happy with the idea if they were.

I think the procedure has only been done with knees, which might be why the surgeon didn't raise the possibility. It would also be expensive in the US - but would be free to the patient here in the UK. 8)

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Did the orthopaedic surgeon mention anything about stem cell therapy? Some people have regenerated their own cartilage after having injections of their own stem cells. It can take a long time to recover properly afterwards.

It's unusual for someone so young to have worn away their cartilage.

He had mentioned that, if pain persists, I could get a steroid injection, but didn't mention stem cell injections. He also offered surgery if the steroid injection didn't alleviate the pain. Yeah, I'm shocked at this 8(

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Disclaimer: I'm not a doctor, just a injured student trying to find a solution. This might not be what is going on, but it seems likely based on what your doctor described.

I have been experiencing a similar pain in my wrists. Mine was caused by an open handed impact. After extensive wrist anatomy research, I've self diagnosed my injury as a triangular fibrocartilage complex (TFCC) injury. I fit all the symptoms and the mechanism of injury is exactly as described in the literature.

The short list of symptoms is pain on the ulnar side of the wrist above the ulnar styloid process (bony thing on the outside of the wrist). It only hurts when bearing weight at full extension and when fully flexed (like a false grip, but applying force in the other direction).

Prognosis for this type of cartilage injury varies and depends on the extent of injury. Much of the information available online is biased towards severe cases due to a variety of factors. It is often terminal because of the lack of blood flow to the TFCC. Tears on the interior may have little to no blood flow and may never heal.

I've been severely adjusting my training to work around this. No more dumbbell or barbell presses. I can basically only do dips for upper body push. All support FSP work is done on paralletes (in a few weeks I think I'll be able to get above the rings again).

trifibcc.gif

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Alessandro Mainente

i had passed this injury 2-3 weeks ago...without using the wrist in dorsi flexion movements i'am healed at 100% in 5 months...

now the rehab process take me time to regain the flexibility...fortunately i was able to use rings and bar and perform pbars handstand and skill with neutral grip but not skill where i have to lean forward like press to hs or planche

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Joachim Nagler

Alex, what protocol did you use to heal your injury?

at OP: Pete Egoscue says in his book "Pain Free" that cartilage is always built and that you have to get rid of your dysfunction that's constantly destroying the cartilage faster than it can be built. I don't know if thats true but it makes a lot of sense... There's this theory that the body replaces every cell in a number of months (i don't recall how many at the moment), so why wouldn't cartilage be replaced as well? You may want to read the book and see for yourself.

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Alessandro Mainente

i didn't do any exercise that involve minimal dorsi flexion of the hand until 3 months after i started to do strength exercises for extensor and flessor, and rotational movements everyday plus proprioceptive table to walk around the wrist joint, i had increased the stretching only at the 4th months also if it was limited at the edge of pain..

in my diet i see a great improvements when i started to eat 5 caps of oil fish omega3 (before was 2 a day).

when the pain was passed and the ROM restored i return to handstand acfivity progressively starting from th 10% of the volume before the injury and increasing it but 25% every 2 week! now the wrist is ok, i returned to pommel, to advanced breakdance skill but i usually alternate skill where there is a great stress on wrist and skill where i don't use the wrist...

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Joachim Nagler

alex, thank you for your answer!

I'll try that fish-oil advice to see how it helps.

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