Do you think it would hurt to speed up my rehab program for a repair of the TFC in the wrist? The surgeon says no sports for at least 4 months. I'm not having any pain. I have full motion. And I feel strong enough to get back in the game. It's been about six weeks since the surgery. Isn't that long enough?
There is some debate about how aggressive (or conservative) to be following surgical repair of the wrist triangular fibrocartilage (TFC). The little band of tissue may be small, but it is tough and serves a wide range of purposes.
It holds the bottom part of the radius and ulna (bones of the forearm) together while also providing a buffer between the ends of these bones and the wrist bones. The TFC includes a thin, egg-shaped fibrous disc for the wrist joint. It helps spread the forces put on the connecting surfaces of wrist bones during repetitive or forceful wrist motions.
Besides increasing the stability of the joint, the TFC also helps move synovial fluid to areas of the joint cartilage that have the most friction. So you can see why a strong TFC is needed for athletes who rely on their wrists for strength, stability, and/or motion.
A typical conservative approach is to immobilize patients for six weeks after surgery. After that, range of motion and strengthening exercises can be started. Usually, athletes work with a physical therapist who is familiar with the type of surgery done and the healing process. There's no point in stressing a surgically repaired structure beyond what it can handle. You can end up with a reinjury.
Full return-to-sport at the end of three months gives the athlete time to specifically train for his or her particular sport. Sports-specific exercises often include proprioceptive activities to retrain the joint's sense of its own position. Proprioceptive training will help your wrist respond faster to the slightest change in position or pressure. Most athletes depend on this more than they realize.
Surgeons say it is very important to stay out of the game until full recovery has taken place. If you just had dÃ©bridement (cleaning the area out of any frayed edges or fragments of loose cartilage), faster return to sport could be allowed without increasing your risk of reinjury. But it sounds like you might have had a full repair procedure, which is a different situation.
To find out for sure, make a follow-up appointment with your surgeon and ask directly. It could be you really are ready to get back into action. But that decision must be made in conjunction with the surgeon who knows your history, severity of injury, course of treatment, and any potential risks you may be facing with early return to sports.
Timothy R. McAdams, MD, et al. Arthroscopic Treatment of Triangular Fibrocartilage Wrist Injuries in the Athlete. In
The American Journal of Sports Medicine
. February 2009. Vol. 37. No. 2. Pp. 291-297.
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