13 yo girl wrist injury immobilized 5 months

by Concerned Mom
(USA)

My 13 year old daughter injured her right wrist in a fencing tournament last September. She and another competitor clanged bells.

Later in the tournament she experienced extreme wrist pain when her opponent beat on her blade repeatedly. (35 inch blade with pistol grip, weighs approximately 8-10 ounces) She had also mentioned at the beginning of the day when she was preparing for competition that she moved her wrist and it felt weird (this was before any competition and she wasn't holding anything or picking anything up).

We were told by the EMT at the tourney it was a sprained wrist. We taped it, iced it and withdrew her from the next days competition.

She saw a chiropractor several times who did massage with a metal thing that looked kind of like a fat butter knife. She did not train for 2-3 weeks and then when back slowly. We told her to stop if she felt pain. She would wear a wrist brace most of the time for about a month. When she started competing again about 6 weeks later, we taped her wrist for support before bouts and used ice to prevent inflammation.

We noticed that she would be fine in the 12 yo division, but when she fenced up, she would fatigue quickly during direct elimination (14 division fences for a longer time period than 12 in direct elimination)

The pain seemed continually to nag at her during competition and a pediatrician father suggested in February that it might be an injury to the growth plate. We withdrew her from competition and went to see a pediatric orthopedic surgeon. X-ray was done and negative for growth plate. Finkelstein test indicated DeQuarvain's Tenosynovitis (sp?). The ortho put it in a hard cast isolating thumb straight out from knuckles to forearm for 6 weeks during March-April.

Cast came off and still pain. Prescribed physical therapy. Hand specialist exam indicated very loose ligaments in carpal bones on thumb side and a loud (audible across the room) clicking in the wrist on the pinky side when she isolated that muscle. She described pain on both side of the wrist and on top (back of hand side). They seemed to think dequarvain's was secondary to the underlying problem. They suggested we see a hand surgeon for further diagnosis.

Hand surgeon did MRI which he said showed no indication of tendon or ligament issues. One view had tiny spotting and due to her continued pain, he thinks may be Kienbock's Syndrome, but not definitive. He said the treatment was the same for tendon, ligament, or Kienbock's and put her back in a hard (but removable) splint. He prescribed immobilization and to come back in a month.

Went back for follow up two weeks ago and due to continued pain, he gave her a cortisone shot on the thumb side of her wrist. Prescribed continued immobilization and a followup MRI in November (6 months from 1st) to evaluate possible Kienbock's development.

One other history note: She played violin from age 3-10 years old and experienced a clicky thumb in her bow hand (right hand) from time to time during that time.

Thank you for your insights.



----



Joshua Answers:

Hi CM.

Oh, that makes me so MAD!

While IMMOBILIZATION is the 'treatment' they use, it is NOT actually a treatment.

Technically maybe it is, but immobilization doesn't fix or help anything, and in fact, can and does make things worse.

See: Wrist splints and braces


So...where to start here...


1. Make sure you read this page to understand what Tendonitis is.

2. Make sure you understand about the Process of Inflammation.

3. Make sure you understand the Pain Causing Dynamic


That's the meat and potatoes of all this.

Then we'll talk about variables like loose joints, how 12 year olds can have tendonitis related problems, various nutritional aspects, and the Kienbock's thing, play a role.

Let me know when you've read those and we'll continue.




----------------------
Please reply using the comment link below. Do not submit a new submission to answer/reply, it's too hard for me to find where it's supposed to go.

And, comments have a 3,000 character limit so you may have to comment twice.
-----------------------



Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com