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Make or Break: the internet diagnosis thread (Read 2206 times)

Paul B

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Make or Break: the internet diagnosis thread
January 26, 2020, 04:58:11 pm
Is anyone else's favourite reading this time of year either Make or Break or One Move Too Many:tumble:

This time my wrist has failed me when pinching something wide and sloping. It fits pretty well with what's described in MoB as a 'triangular fibrocartilage' injury (pg 152).

MoB makes reference to taping of the wrist being notoriously difficult and up until this point I'd been using up the remainder of my k-tape moving onto the stiffer wide metolius stuff yesterday (this was better). Taping definitely seems to help as I tried a fairly steady problem after removing the tape and my wrist felt incredibly unsupported (it was the end of session which didn't help).

Can any of UKB's knowledgeable types point me towards any resources which are useful for getting the taping correct (you're going to say go and see someone no doubt)? I don't particularly want to make it worse and I want the damn thing to be OK for a week of cycling in late Feb (leaning on the bars currently causes it to ache after an hour or so ATM).

Coops_13

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My wrist problems have recently been confirmed as not TFCC caused but have been taping my wrist like it was that helped. Google wrist widget for more info but you basically just need a thin strip relatively tight either side of the head of your ulnar so thereís pressure in the correct places but not on the bone

SA Chris

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I can add "Climbing Injuries Solved" by Lisa Erikson, I'll see what it says in there tonight if you want?

Paul B

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I can add "Climbing Injuries Solved" by Lisa Erikson, I'll see what it says in there tonight if you want?

Please.

My wrist problems have recently been confirmed as not TFCC caused but have been taping my wrist like it was that helped. Google wrist widget for more info but you basically just need a thin strip relatively tight either side of the head of your ulnar so thereís pressure in the correct places but not on the bone

Thanks.

Paul B

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My wrist problems have recently been confirmed as not TFCC caused but have been taping my wrist like it was that helped. Google wrist widget for more info but you basically just need a thin strip relatively tight either side of the head of your ulnar so thereís pressure in the correct places but not on the bone

So I tried this at the weekend and the wrist seemed a lot less 'supported' and I was experiencing quite a lot more pain when compared with a wide tight strip around the wrist. I'm guessing it might be time to go and see someone knowledgeable :tumble:

SA Chris

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Forgot, I haven't got book out for a look yet.

Coops_13

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My wrist problems have recently been confirmed as not TFCC caused but have been taping my wrist like it was that helped. Google wrist widget for more info but you basically just need a thin strip relatively tight either side of the head of your ulnar so thereís pressure in the correct places but not on the bone

So I tried this at the weekend and the wrist seemed a lot less 'supported' and I was experiencing quite a lot more pain when compared with a wide tight strip around the wrist. I'm guessing it might be time to go and see someone knowledgeable :tumble:
oh bugger, hope they can tell you something useful. Iíve had four different things wrong with this wrist, three of which Iíve never received a proper diagnosis (MRIs involves each time). All Iíve learnt is theyíre very complex things :(

Paul B

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Perhaps it's the year to push the cycling  :-[

duncan

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My wrist problems have recently been confirmed as not TFCC caused but have been taping my wrist like it was that helped. Google wrist widget for more info but you basically just need a thin strip relatively tight either side of the head of your ulnar so thereís pressure in the correct places but not on the bone

So I tried this at the weekend and the wrist seemed a lot less 'supported' and I was experiencing quite a lot more pain when compared with a wide tight strip around the wrist. I'm guessing it might be time to go and see someone knowledgeable :tumble:
oh bugger, hope they can tell you something useful. Iíve had four different things wrong with this wrist, three of which Iíve never received a proper diagnosis (MRIs involves each time). All Iíve learnt is theyíre very complex things :(

That's interesting. I can see if you were looking for a clear-cut diagnosis it could be a bit frustrating. My interpretation would be that the lack of positive MRI findings is great news. It's generally best not to have obvious structural damage!

Ru

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That's interesting. I can see if you were looking for a clear-cut diagnosis it could be a bit frustrating. My interpretation would be that the lack of positive MRI findings is great news. It's generally best not to have obvious structural damage!

I've had/got something like this. Pain, occasionally lots, in the TFCC area. MRI clear apart from a little effusion, TFCC clinical tests negative. Had on and off for over a year. Would love to know if I can fix it.

SA Chris

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Perhaps it's the year to push the cycling  :-[

Are you old enough to get MAMIL classification yet?

Paul B

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Age is a state of mind, so yes.

tommytwotone

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Well after the stubborn refusal of my body to respond to physio after shanking my shoulder back at the end of last year, sounding like (according to my physio) a) he's not discounting a labral tear(?) and that b) ultrasound and potential surgery seem the next steps.

Thankfully (and another "the power of UKB" incidence!), sounds like the wonderfully-named Professor Funk is the man to see. Now I just need to convince my works' private healthcare to stump up for it...

teestub

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T3 sorry to hear this dude. Thereís a few Trainingbeta podcasts about labrum injuries, as the host has had both of hers (I think) operated on over the past few years. Pretty sure she discusses it with Esther Smith who is a physio as well as her surgeon.

Thereís a lot of conflicting advice, but there seemed to be little evidence that any of the surgical options provided a better outcome than physio in a lot of cases. Iím sure someone more knowledgable than myself will be along to fill in some more details.

tommytwotone

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Thanks - I've been reading up and seems to the the case. I'm 3 months in now and no better (still pain even when lifting bin bag into wheelie bin for example), and no way I could even climb now even if I wanted to, which I don't, which is probably a sign in itself.

Reading the Funky Prof's website it sounds like a fair few people have been to see him and (thanks to his expertise seemingly) managed to avoid a surgical intervention. If that's where it ends up then happy days, but feels like next step is at least a scan and a second / more expert opinion.

Will check out the podcast tip as well!



Ru

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Funk is very good, as are the team that work with him, but not cheap if you are paying yourself. My injury turned out not to be anything that needed surgical repair so I can't vouch for him from that point of view but his reputation is very good. Your first port of call is an MRI.

duncan

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How to best help people who appear to have a SLAP lesion is a tricky decision even when there is a 'clear' diagnosis. MRI-demonstrated tears are present in people with no shoulder pain and vice versa.

The current best evidence is that surgical repair is not better than good rehab. in the long term. Of course this is an average of lots of people's experience and no-one is average, some people seem to respond to surgery having not responded to good rehabilitation.

I had a SLAP repair from a world-reknowned surgeon in ~2001, I'm not convinced it was any help for me.

I'm not saying do not have surgery but I would make sure you feel you have given a rehab. programme emphasising functional strengthening a very good go before considering it.

tommytwotone

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Cheers Ru / Duncan...

Echo your sentiments here - think MRI is absolutely necessary for diagnosis as I'm c.6 months down the line and no better, but when it comes to treatment everything I'm reading / hearing (also having listened to Stubb's podcast recommendation last night) seems to be saying that surgery is a last resort.

Having broken my left humerus back in '04 (which has never been completely right since surgery), I could do without compromising my one good arm!

Fortunately this will all be done under my employer's very generous private healthcare scheme.








sheavi

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Just be aware that MRI findings don't necessarily identify the cause of your symptoms, even if a labral tear is shown. I'd advocate seeing a specialist for a further opinion. Always give good functional rehab a good go before surgery is considered - 6 months minimum I reckon.

Just for illustrative purposes I know two high level climbers that had labral repairs with no benefit - one later ID'd as a spinal nerve compression issue, the other central sensitisation.

Stewart

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Online diagnostic or shared experience please. Bit of a WTF? injury.

Trying a problem at the wall, first moves are campusing. After a few failed attempts I suddenly noticed a golf ball size swelling on the tip of my elbow. No pain. Over the next few days I realised this must have been a haemotoma as my skin has turned black with bruising from bicep to wrist as the blood dissipates through my arm. Very sore to put pressure on any swollen bruised area and a sharp pain in the tip of elbow with any resisted elbow flexion..

No idea if this is very uncommon or how it occurred. I'm guessing a ruptured vein while campusing??

Anyone seen anything similar or any medics care to estimate if it should be a straightforward return to climbing once the bruising has gone or if there may be underlying issues??
Many thanks

Paul B

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Perhaps it's the year to push the cycling  :-[

Prescient?

Anyhow, I've just had a very productive Zoom physio session and it's seemingly not TFCC and is looking to be the flexor carpi ulnaris insertion. I'm amazed how easy and productive the online session was.

I've now got a series of isometric exercises to complete and some do's and don'ts :dance1:

thekettle

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Tommy just to echo other comments , I can also recommend Prof Funk, he has operated on labral tears to both my shoulders, and I've been treated conservatively by him since.
It's worth knowing for others - or if your health insurance doesn't cover it - you can see him for an initial consultation privately (about £250) and then go with him through NHS for MRI and surgery if it's advised. Saved me at least £6K

Ru

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Perhaps it's the year to push the cycling  :-[

Prescient?

Anyhow, I've just had a very productive Zoom physio session and it's seemingly not TFCC and is looking to be the flexor carpi ulnaris insertion. I'm amazed how easy and productive the online session was.

I've now got a series of isometric exercises to complete and some do's and don'ts :dance1:

Who did you see Paul? Although my wrist doesn't bother me that much it might be nice to try and sort it out.

Paul B

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I'll send you a FB message.

Coops_13

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Perhaps it's the year to push the cycling  :-[

Prescient?

Anyhow, I've just had a very productive Zoom physio session and it's seemingly not TFCC and is looking to be the flexor carpi ulnaris insertion. I'm amazed how easy and productive the online session was.

I've now got a series of isometric exercises to complete and some do's and don'ts :dance1:
That sounds roughly like what one of my injuries was, good luck with the healing!

 

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