Chronic Wrist Pain?

[SloanTheSloth]

I've had some wrist pain lately, it almost feels like a sprain/over extension. I fear I may have injured it permanently, from soccer. I've recently switched from playing half Keeper Half HalfBack, to a full time keeper. I'm still not used to stiffening my wrist, or making a fist, whenever the ball goes flying to my side where I cannot quite put my body infront of it, so my hand is the only defense against it. Recently this has caused many over extensions of my wrist, because the ball has so much force it pushes my hand back. I've gotten it treated many times, and the pain would usually go away within a week. But recently, my wrist has started to hurt again, mainly when the slightest bit of pressure is put on it. I have not had any more overextensions or anything else I could think of, but it's been hurting the last 3 weeks even after using compression wraps, different kind of splints and small casts. It doesn't seem to be healing, and I'm worried if I go out and overextend it at soccer, that it may just snap or get fractured.

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[Dr Damien]

Dear Sloanthesloth

First of all i wouldnt worry too much about it being fractured if you can move your wrist and there isnt any obvious deformity. Having said that, you probably still have growing bones and there might be a bone swelling however this is unlikely from your description. If it is reoccuring my guess you have either torn a ligament or cartilage in your wrist and its become quite unstable. It is difficult to say what you may have injured. sometimes people suffer a little bone fracture in the wrist called the scaphoid bone and this can also happen in teenagers...it doesnt show up quickly because of the nature of the growing bones in the adolescents...

as there are a number of possibilities, i would ask some questions and if the answer is yes...then the next step would be suggested...

do you have a tender/painful snuffbox? (the hollow area between the big thumb and the wrist when the made to stick upwards)...if the answer is yes, then maybe you have broken the scaphoid bone...you would need x-rays to confirm this, most times they dont show up on x-rays easily until after a few weeks from the injury...so maybe a repeat x-ray may be needed, otherwise an MRI/CT scan can be done...either way its probably gonna be a case of re-casting the area for 3-4weeks...

where is the area of the pain? is it on the little thumb area? if it is, do you get pain when you bend your wrist so that your fingers are pointing towards the little finger side of your hand?
if the answer is yes, then you probably have torn a ligament/cartilage that supports your wrist and acts as a shock absorber...we call this type of injury the TFCC injury...you may need an MRI to confirm this, either way you would have to splint the wrist...for a few weeks, needless to say no more goal keeping...
this type of injury is notorious for reocurring and causing some instability in the wrist when you extend, you may find it difficult to turn knobs, hold heavy objects...if this is the problem it may be a good idea to visit a specialist in orthopedics as recurrent instability may require some surgical intervention...

do you get any clicking sensation when you move your wrist?

if you are unable to move your wrist...then this is an emergency as you may have dislocated or fractured a long bone...however i doubt this

these are the two likely problems you might have based on the description of the trauma you went through...

so what treatments have you had so far and which ones made it better?

[SloanTheSloth]

No on the snuffbox thing. All the pain is on the back/top of my wrist, where it actually bends. The pain only occurs when pressure is put on it when it is bent, even the simpliest, like when you fold your arms over and bend your wrists against the opposing upper arms. Or when you're trying to sit up and use your wrist for support. There is a "Clicking" Sound/sensation when I move my wrist around, but it doesn't hurt. Mainly when I bend my wrist forward or back, or moove it in large circle does it click multiple times

I haven't visited a doctor since my first sprain, which was about 3 months ago. Since then every time it got sprained I'd just put it in a compression wrap or splint. But since it's started to hurt again, even without any overextension, I've tried wraps and splints, rotating heat and ice and keeping it elevated, all the things thath ad previously worked. But nothing seems to work this time.

[Dr Damien]

dear sloanthesloth

cheers for replying...

you didnt say whether side to side movements causes pain as well...
any weakness in the wrist?
clicking wrist may suggest a loose body, torn cartilage perhaps... if bending forward or back with pressue causes pain...the following may be the issue...a dislocated carpal bone (small bone in the wrist, perhaps one of the middle ones)...is there a deformity, swelling or contour at the point it hurts? it there is does did countour increase or decrease with bending forward and backwards€? if there is, does it feel soft or hard?

worst case scenerio, you may have a growth plate issue...is the area tender on deep pressure...?

considering your age, it is perhaps best you have that wrist x-rayed first since it is not yielding to what worked for you before,,,best to support it in a splint and visit you GP

[SloanTheSloth]

Sorry, thought I mentioned, Side to Side movement does not hurt in any way. There are no deformities, or anything odd looking about my wrist. Reall no matter the amount of pressure, my wrist still hurts the same, so I don't believe its the Growth Plate thing. What do you mean by weaknesses? I guess I'll go get it checked up on tomorrow. Ask for an X-ray of some sort.