Wheelchair Use and Wrist Pain: TFCC Injuries Explained

Many wheelchair users experience wrist pain caused by overuse or issues like TFCC irritation. Changes to the wheelchair setup can alter wrist positioning, increasing stress on the joint.

Causes of Wrist Pain While Using a Wheelchair

Common causes include overuse, poor hand and wrist positioning, and repetitive loading from propelling the wheelchair. These factors can contribute to acute or chronic wrist strain if not addressed early.

Role of TFCC (Triangular Fibrocartilage Complex)

The TFCC is a load-bearing structure between the lunate, triquetrum, and ulnar head. It actually acts as a stabiliser for the ulnar aspect of the wrist and as a result it is at risk of acute or chronic injury.

Generally, if you have injured your TFCC you will present with ulnar-sided wrist pain that may present with clicking or point tenderness between the pisiform and the ulnar head.

Video: Test to see if your TFCC is injured

How Wheelchair Adjustments Can Affect Wrist Position

You can often get lateral wrist pain when self-propelling a wheelchair. Especially around times that alterations are made to the chair. These alterations can ultimately change the position in which your hand strikes the chair. Often the wrist is placed into further extension and ulnar deviation which causes stress on the triangular fibrocartilage complex (TFCC).

Video: Tips for patients with wrist pain when using a wheelchair – changing the settings of a wheelchair

Taping and Managing TFCC Injuries

If you have injured your TFCC it is important to avoid the irritating activity. In some cases, such as self-propelling a wheelchair this is unavoidable. Therefore, you could use a number of taping techniques to avoid aggravating it further. Below are two options that you may find useful. The second of the two is far easier to master and many clients actually prefer this one:

Video: Taping option 1

Video 3: Taping option 2

Other Considerations

Additionally, to taping it is often beneficial to discuss this condition with your GP as NSAIDs are often helpful. If NSAIDs combined with unloading the wrist does not settle the problem, you may need to resort to a cortisone injection.

As a result, it is understandable that prevention is better than a cure. Therefore, when making alterations to a wheelchair we need to take a page out of a podiatrist’s book. When getting a new pair of orthotics, you shouldn’t move straight into wearing them for 8 hours a day instead you should slowly increase the use of them to give your body time to adapt.

Don't let injury hold you back. Trust the experts at Body Fit Physiotherapy for all your Sports Physio needs today.

Written By

Tim Delvins

NDIS Physiotherapist