Wrist pain when using a wheelchair?

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 stresses the The triangular fibrocartilage complex (TFCC).

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. Below is a nice test to determine if your TFCC is irritated:

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. Therefor you could use a number of taping techniques to avoid aggravating it further. Below are 2 options that you may find useful. The second of the 2 is far easier to master and many clients actually prefer this one:

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 cure. Therefor when making alterations to a wheelchair we need to take a a lief out of a podiatrists book. When getting a new pair of orthotics you do not move straight into wearing them for 8 hours a day rather you slowly increase the use of them thereby allowing your body time to adapt.

Written By

Tim Delvins

NDIS Physiotherapist

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