Ulnar-Sided Wrist Pain in the Athlete

Crosby, Nicholas E.; Greenberg, Jeffrey A.

doi:10.1016/j.csm.2014.09.008

Cited by 13 publications

(11 citation statements)

References 14 publications

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“…Class 2A injury flexion and 90° shoulder abduction) but neutral or negative variance may also be seen (40). Pronation grip radiographs can confirm the impaction between ulna and ulnar carpus (30).…”

Section: State Of the Art: Sports-related Hand And Wrist Injuriesmentioning

confidence: 96%

Imaging of Sports-related Hand and Wrist Injuries: Sports Imaging Series

Cockenpot¹,

Lefebvre²,

Demondion³

et al. 2016

Radiology

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Hand and wrist injuries are common occurrences in amateur and professional sports and many of them are sport-specific. These can be divided into two categories: traumatic injuries and overuse injuries. The aim of this article is to review the most common hand and wrist sports-related lesions. Acute wrist injuries are predominantly bone fractures, such as those of the scaphoid, hamate hook, and ulnar styloid. Ligament lesions are more challenging for radiologists and may lead to carpal instability if undiagnosed. Overuse wrist injuries are mainly represented by tendinous disorders, with De Quervain syndrome and extensor carpi ulnaris tendon disorders being the most common among them; however, there are other possible disorders such as impaction syndromes, stress fractures, and neurovascular lesions. Finally, finger lesions, including closed-tendon injuries (mallet and boutonniere injuries, jersey finger, and boxer's knuckle), flexor pulley injuries, and skier's thumb, should also be detected. (©) RSNA, 2016 Online supplemental material is available for this article.

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Section: State Of the Art: Sports-related Hand And Wrist Injuriesmentioning

confidence: 96%

Imaging of Sports-related Hand and Wrist Injuries: Sports Imaging Series

Cockenpot¹,

Lefebvre²,

Demondion³

et al. 2016

Radiology

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“…Ulnar-sided pain in the wrist in athletes is not a new condition and has been described as a challenging issue for the hand surgeon. 9,11,12,23,50,51,73 Rios-Russo et al 51 and Dineen and Greenberg 12 have stated that it is common in sports that require repeated pronosupination (pronation and supination), radial/ulnar deviation in the wrist, axial loading, and gripping equipment. All of these variables are involved in climbing as well.…”

Section: Discussionmentioning

confidence: 99%

Wrist Injuries in Climbers

Schöffl,

von Schroeder,

Lisse

et al. 2023

Am J Sports Med

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Background: Acute and chronic injuries to the wrist are among the most common sport-related complaints of climbing athletes but have not been extensively evaluated in this population. Therefore, it is important to categorize climbing injuries to the wrist, analyze risk factors, and assess treatment outcomes. Purpose: To evaluate the distribution, outcomes, and influencing factors of wrist injuries in climbers. Study Design: Case series; Level of evidence, 4. Methods: Climbing athletes with wrist injuries who presented to our specialized sports medical center over the course of 4 years (2017-2020) were selected. All had prospectively completed questionnaires including their climbing-specific background (years of training, climbing level, training methods, etc). Injuries were analyzed (International Climbing and Mountaineering Federation [UIAA] grade and diagnosis), and treatment methods and outcomes were retrospectively assessed with a minimum follow-up of 2 years. Parameters included the climbing score, visual analog scale for pain score, Patient-Rated Wrist Evaluation (PRWE) score, and shortened version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) score including the sport component (DASH–Sport) score before and after treatment as well as time to return to climbing. Results: A total of 69 patients (25 female, 44 male) with 78 wrist injuries were identified and analyzed. Of these, 7 injuries were bilateral, occurring at the same time, and 2 injuries were independent reinjuries to either the same or the contralateral side. In addition, 24 injuries (30.8%) were acute, while 54 (69.2%) were chronic. Overall, 2 injuries had a UIAA grade of 3; all others had a UIAA grade of 2. The most frequent injuries were synovitis of the ulnocarpal recess, ulnar impaction, bone marrow edema of the lunate, wrist sprains (joint capsular pain with stress, with no pathological finding on magnetic resonance imaging), and wrist ganglion cysts. Nonoperative treatment was performed for 61 of the injuries, while 17 were treated surgically. In 51 cases (65.4%), injuries healed without consequences; in 27 cases (34.6%), discomfort remained. The visual analog scale pain score decreased from 4.8 ± 1.9 before treatment to 0.7 ± 1.0 after treatment ( P < .001), the PRWE score decreased from 53.6 ± 24.9 to 10.3 ± 13.1 ( P < .001), the QuickDASH score improved from 53.0 ± 16.6 to 20.0 ± 20.2 ( P < .001), and the DASH–Sport score improved from 82.0 ± 16.1 to 38.1 ± 23.5 ( P < .001). The climbing score improved from 2.5 ± 1.1 to 4.3 ± 1.0 points ( P < .001). The patient-reported number of days with pain was negatively correlated with changes in the PRWE score ( r = −0.351; P < .001), QuickDASH score ( r = −0.316; P = .007), and climbing score ( r = −0.264; P = .025) as well as the number of days without climbing ( r = −0.266; P = .025). The number of days without climbing was positively correlated with changes in the PRWE score ( r = 0.369; P < .001). Conclusion: Wrist injuries in climbers constituted a diverse set of diagnoses. Ulnar-sided injuries were most common, and many patients had >1 diagnosis. Outcomes for all treatment methods (surgery and nonoperative care) were favorable, but approximately one-third of climbers had persistent wrist discomfort after treatment, underscoring the need for accurate diagnoses and acute and expert care.

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“…Ulnar-sided wrist pain or distal radioulnar joint symptoms (as opposed to global or mid-dorsal pain that is typical of the current study population) can be addressed using evaluation and treatment strategies well described in the literature. 24 , 25 , 26 , 27 , 28 , 29 , 30 Sources of dorsal/central wrist pain, such as scapholunate injury, ulnar abutment from distal radius growth arrest, Kienböck disease, or Madelung deformity, are often discernable on physical examination and plain radiographs. 31 , 32 , 33 , 34 , 35 However, no consensus exists regarding strategies to further evaluate chronic, nonspecific global and mid-dorsal wrist pain with negative radiographs.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of a Grip-Strengthening Algorithm for the Initial Treatment of Chronic, Nonspecific Wrist Pain in Adolescents

Dorich

Cornwall

2022

Journal of Hand Surgery Global Online

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Purpose: Chronic, nonspecific wrist pain in adolescents can be challenging to assess and treat. We hypothesized that an algorithmic approach beginning with grip strengthening can alleviate pain, improve function, and identify patients in need of further intervention. Methods: We retrospectively reviewed the results of a grip-strengthening protocol for adolescents with chronic, nonspecific wrist pain. Before and after treatment, grip strength was measured using handheld dynamometry, and patient-reported pain and function were measured using the adolescent selfreported Pediatric Outcomes Data Collection Instrument's (PODCI's) Pain/Comfort and Upper Extremity Function domains (PODCI/pain and PODCI/UE, respectively). Results: Thirty-two patients (28 female, 4 male) were included, with a mean age of 14 years (range, 10 e18 years) and the dominant hand affected in 19, nondominant hand in 9, and bilateral impacts in 4. The mean symptom duration prior to presentation was 9 months (range, 1e63 months); 17 patients had undergone prior immobilization and 5 prior occupational/physical therapy. Grip-strengthening treatment, lasting a mean of 40 days (range, 21e82 days) with a median of 4 therapy visits (range, 2e6), was associated with significantly improved grip strength (mean, 32e48 lbs), PODCI/pain scores (mean, 49.0 e78.2 points), and PODCI/UE scores (mean, 78.2e91.2 points). Improvements in grip strength correlated with improvements in PODCI/pain and PODCI/UE scores (r ¼ 0.64 and 0.70, respectively). Eight patients (25%) had either no or incomplete pain relief: 5 underwent successful further intervention (2 ganglion cyst excisions, 1 triangular fibrocartilage complex repair, 1 arthroscopic debridement, 1 steroid injection), 2 received ongoing pain management for generalized pain syndromes, and 1 was lost to further followup. No pretreatment variables were identified that predicted failure. Conclusions: Grip strengthening relieves pain and improves function in the majority of adolescents with chronic, nonspecific wrist pain. Systematic use of this protocol helps to identify patients who require further intervention. Type of study/level of evidence: Therapeutic IV.

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Ulnar-Sided Wrist Pain in the Athlete

Cited by 13 publications

References 14 publications

Imaging of Sports-related Hand and Wrist Injuries: Sports Imaging Series

Imaging of Sports-related Hand and Wrist Injuries: Sports Imaging Series

Wrist Injuries in Climbers

Evaluation of a Grip-Strengthening Algorithm for the Initial Treatment of Chronic, Nonspecific Wrist Pain in Adolescents

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