Wrist Sprain & TFCC Injury

Overview

The wrist is made up of eight small bones held together by a network of ligaments, with the two forearm bones meeting them from above. A wrist sprain is an injury to one or more of these ligaments, most often from falling onto an outstretched hand — on a wet pavement, during sport, skateboarding, or coming off a bike. Sprains range from a mild stretch to a complete tear, and in more severe cases the bones can shift out of their normal alignment.

A particular structure worth knowing about is the triangular fibrocartilage complex, or TFCC. It is a small disc of cartilage and ligaments on the little-finger side of the wrist that cushions the joint and stabilises the forearm bones. It can be injured by a fall, by a forceful twist (opening a stiff jar, a racket mishit, a push-up gone wrong) or by repetitive loading in gymnasts and weightlifters. TFCC injuries cause pain on the little-finger side, often with clicking and weakness when twisting the forearm or pushing up from a chair.

Mild sprains usually settle within a few weeks. More significant ligament and TFCC injuries take longer, and because the wrist is easily re-injured if returned to load too early, a graded rehabilitation plan is important. Any wrist injury from a fall should be checked for a fracture, as some wrist fractures — particularly of the scaphoid — are easy to miss and can cause long-term problems if untreated.

Causes and risk factors

• A fall onto an outstretched hand
• Contact and ball sports, skateboarding, snowboarding, cycling
• Forceful twisting of the wrist
• Weight-bearing on the hands: gymnastics, yoga, push-ups, handstands, weightlifting
• Repetitive wrist loading in racket sports
• A previous wrist injury, or naturally loose ligaments

How we may be able to help

After a fall, our first priority is to assess whether a fracture or significant ligament injury is likely. We check for specific tender points, swelling and loss of movement, and if there is any doubt, we can arrange an online private GP consultation for an X-ray or MRI and, where needed, a specialist referral. We do not provide casting or splinting; if a wrist needs immobilising, we will direct you appropriately.

For sprains and TFCC injuries that are suitable for conservative care, physiotherapy follows a staged plan: protecting the wrist and controlling swelling early; restoring pain-free movement with gentle mobilisation of the wrist bones; and then progressively rebuilding grip strength, forearm rotation control and the ability to take weight through the hand. Kinesiology taping can provide support and a feeling of stability in the early weeks, particularly for TFCC injuries where twisting is painful.

Interferential therapy and therapeutic ultrasound may be used in the early phase to ease pain and swelling. As healing progresses, dry needling and IASTM can address the forearm muscles that tighten up protectively after an injury. Return to sport, gym or weight-bearing yoga is planned in stages so the wrist is tested gradually rather than all at once.

What you can do at home

• For the first few days, rest the wrist, apply ice wrapped in a cloth for 10–15 minutes several times a day, and keep the hand raised when possible
• Avoid pushing up from chairs or leaning on the hand until advised
• Keep the fingers, elbow and shoulder moving to prevent stiffness
• Begin gentle wrist movements within comfort once the sharp pain settles
• Use a wrist support from a pharmacy for heavier tasks if it helps in the early weeks
• Build up grip and weight-bearing gradually — a sudden return to push-ups or lifting is the most common cause of a setback