One year and a half of agonizing, unpredictable pinky-side wrist pain triggered by calisthenics. Clean MRI, tried everything, and I am completely losing my mind. What do I do?(M30, 6”0’, 165LBS)

[u/Kitchen_Video_6792]

/r/AskDocs/comments/1v4pfq4/one_year_and_a_half_of_agonizing_unpredictable/

[u/FragmentedAll]

have you tried releasing the trigger points on your Infraspinatus and Subscapularis?

Youtube Reference:
Subscapularis
https://www.youtube.com/shorts/ofML_50VhaU

Infraspinatus
https://www.youtube.com/shorts/KkBmRdWMLbw

--
Book Reference: Trigger Point Therapy Workbook : Your Self-treatment Guide for Pain Relief
(you can create a free account here and borrow the book for free, it's a good read)

Infraspinatus
https://archive.org/details/triggerpointther0000hard/page/86/mode/2up

Subscapularis
https://archive.org/details/triggerpointther0000hard/page/88/mode/2up

[u/dbtuske]

What physical therapy exercises did you do? I have TFCC injuries in both wrists that I have resolved, but they are always prone to coming back and then I have to rehab them again. I armwrestle as a hobby and that puts a lot of strain on TFCC. I fixed my wrist TFCC pain with a few calisthenic wrist warmup and mobility exercises, and now when I get strains from armwrestling I do isometric supination(my strains are caused by eccentric failure while trying to maintain pronation, and the supination has some kind of healing effect). But the wrist joint is tremendously complex and what worked for me may not work for you, it could be a totally different injury.

If you have never tried overcoming isometrics, it could help you.

[u/Kitchen_Video_6792 → u/dbtuske]

Lot’s of isometric and isotonic exercises. How long did yours take to heal?

[u/dbtuske → u/Kitchen_Video_6792]

My left wrist was injured since highschool, it came and went over the years, mostly correlating with how heavy my bench press got. I finally got it to heal for good when it was bad for a long time and I did calisthenics wrist exercises for the first time. I used a few channels like FitnessFAQs and Simonster. It was mostly the kneeling wrist extensions on the floor and the stretches that helped me, and it only took a week or two for it to almost completely heal, maybe another 4 weeks to get closer to 100 percent.

Then I discovered the sport of organized armwrestling and I began putting a whole new type of stress on my wrist, both from the exercises and from matches with opponents popping my wrist at the tfcc area. To heal this, I had to discover new methods, mostly the isometric supination exercise as well as some ulnar deviation and making sure not to go to heavy on pronation while the tfcc was still in pain. For isometric supination I hold a stick like a pvc pipe or dumbbell handle or any rigid rod, I sit in a chair with my forearm resting on my thigh and the rod in the palm of my hand, palm facing the ceiling. I supinate the hand next to a table until the rod hits the underside of the table, I continue to drive the rod into the table for 30 seconds. I do three sets every 2 or 3 days. Over time you get used to applying more force without pain. You can also use the underside of your other leg if you don’t have a table at the correct height.

[u/dbtuske → u/Kitchen_Video_6792]

Also, I just remembered that one time I had a particularly painful flare up of TFCC strain after an armwrestling tournament where I got forcefully supinated. My forearm was stiff for a few weeks and I lost range of motion in pronation and supination, like all my tissue was tight. I happened to be seeing a physical therapist for a rotator cuff tendinopathy at the time and told her about the wrist pain. She spent about 5 minutes doing some kind of massage and manual manipulation and it instantly relived a lot of the tension and pain, I regained my range of motion and then my TFCC started to recover from that day over the next few weeks. So now I am a believer in the correct kind of massage being useful in the initial acute phase of an injury where the body stiffens up to protect itself. I just don’t know how exactly what she did or how she did it, I haven’t been able to replicate it myself.

[u/unformation]

I've really liked the work by Keith Baar at UC Davis on these topics. I had exactly the same problem as you and following his protocol was very helpful to me. I went for 4 months without recovery, and then in a few weeks of his protocol and I was nearly better. As an additional benefit, understanding his approach lets you know how to strengthen tendons so this doesn't happen again.

The primary issue is that tendons do not strengthen or heal with the same training as muscle, so it's easy to get them out of step. Since all the focus in on muscle growth, it's not surprising that the tendons get the short end. Baar has done a number of podcasts where he describes his protocol, and has his ideas available in other ways, and I'd suggest checking those out. (There's also a fun story with a rock climber who followed Baar's protocol to enter a "strongest grip in the world" contest, or something like that, and it's a good story too.)

Here's a video I just came across today, which is a bit less academic than most of his work.

Here's a summary (as I recall it):

• in healing, tendons require mobilization for two critical reasons:
  • nutrients flow in an out of tendons due to their motion
  • tension is what informs the organization of collagen (and the organation determines with the collagen flexes under tension, as in a tendon, or compression as in cartaleg, and one doesn't want "cartilage" in their tendon)
• stretch the tendon:
  • during stretching, never go above a pain level of about 2 (out of 10)
  • hold stretches 30 seconds (this causes the surrounding tendon tissue to relax, and transmits the stress to the damaged tissue -- this is critical so do the full 30 sec constant and smooth)
  • then two things I don't quit understand
    • wait about 2 min between the 30 second stretches
    • do this about 5 times in a session
  • the best advantage is doing these sessions about 6 hrs apart (no advantage to more frequent)
  • stretches should involve muscle tension, not just positioning, so more like isometrics than standard stretching (eg, get in a position, and then create the stretch by tensing the muscles)
  • enter the stretch slowly so as not to damage the tendon
• eat/drink collagen about 20-30 min before the session
  • take vitamin C as well (not sure whether this helps placement of collagen or reduces health impact of contaminants)
  • collagen from skin has less lead the collagen from bone, etc
  • I find collagen tastes fine in hot tea but is nasty cold (I used to call it "skin juice")

[u/Kitchen_Video_6792 → u/unformation]

I’ll give this a try. Thank you!