Can a FOOSH Cause Tendinitis?

by Steve
(North Carolina)

Hello,

I am a 52 year old male in good health. On December 15th I suffered a FOOSH in a bike crash. My wrist felt somewhat bruised and sprained but not really painful unless I mechanically loaded it in the wrong way.

After the holidays it was still bothering me occasionally so I saw a hand specialist on Jan 6th. X-rays and all other examination tests were negative for major problems and diagnosed bruising of the palm and likely other soft tissue injuries.

The doctor said to avoid using the wrist as much as possible and it should heal in 3-4 weeks. 4 weeks later there was not much improvement so I went back to the doctor. This time he didn't say much but suggested that I might be causing the delayed healing by trying to do too much with my hand and prescribed a wrist splint and another 4 week trial.

This 4 weeks is almost up and it has been nearly 3 months since the injury and there is still very little noticeable improvement. The palm bruise has healed and the wrist is pretty much pain free until I move it the wrong way unloaded or or mechanically load it too much in the wrong way.

The pain is a sharp burning sensation on the back of the wrist localized to the area around the head of the ulna and sometimes in the area between the ulna and the radius. Twisting the wrist seems to make the pain worse but the pain can occur just extending the hand and arm without twisting.

1. Does this sound like tendinitis? Can a FOOSH lead to tendinitis? Is there any way to come to a conclusive diagnosis of this problem.

2. Should it be taking this long to heal? 3 months seems kind of long.

3. Is it likely that there is another underlying and yet undiagnosed cause of of this problem like torn cartilage or meniscus?

4. Is there anything else I should or should NOT be doing to improve the healing process?

This is really starting to get old only having 1 1/2 hands!


Thanks,

Steve

Hello Steve. Thanks for adding all that detail into your question.

For anybody else reading this, FOOSH stands for Fall On Out Stretched Hand.

I'm glad your Doctor took X-rays. That's all I'm going to say about that, except that I'm not surprised the wrist splints and 4 more weeks didn't help.

So.....let's see. First, short answers to your questions, then I have some questions to continue to get a more clear idea of what is going on.


Steve asked #1. Does this sound like tendinitis? Can a FOOSH lead to tendinitis? Is there any way to come to a conclusive diagnosis of this problem.

Joshua says: No, it does not sound like tendonitis per se (though it definitely sounds like much of the problem of a Tendonitis dynamic is present in the wrist area).

Yes, a FOOSH can lead to tendonitis, depending on the damage.

Steve asked #2. Should it be taking this long to heal? 3 months seems kind of long.

Joshua says 3 months does sound really long to not get better or worse.

It is also a good clue.

Steve asked #3. Is it likely that there is another underlying and yet undiagnosed cause of of this problem like torn cartilage or meniscus?

Joshua says: Yes, but I wouldn't worry about that yet. Even if that's the case, I doubt it's the main source of pain, though definitely related and a significant factor.

My point is, up to a certain level of damage, 'injury' isn't really the problem.

The way the body responds to the injury is MORE of a problem than the injury itself. I'm thinking you're in that category.

I'm thinking that the impact either created some torn ligament/tendon/cartiledge or even just a connective tissue tear on the front of the wrist,

or....

As it sounds like most of the pain is on the back of the wrist, I'm guessing you fell forward, the wrist bent/compressed back and created a deep bruising, by which I mean bone, and or the connective tissue wrapping the bone, and/or ligament/tendon/cartilage got bruised.

That kind of bruise can take a long time to heal without the right ways of helping it heal (and even then).

At this point, my suspicion is that you're more in this last category.

Steve asked #4. Is there anything else I should or should NOT be doing to improve the healing process?

Joshua says: Absolutely.

But first, help me get a more clear picture of going on.

1. You still have a bruised feeling on the front of the wrist/palm, yes? Please describe that in more detail.

2. When you extend your wrist back loaded or not, is the pain in just a single spot? Is it spread out across the entire line of the wrist joint, or just a small spot? Is the pain always the same? Does it hurt when you aren't doing anything or only when you extend your wrist.

3. When you say bike, is that bicycle, or motorcycle? Mostly my question is, how fast were you going, how far down did you fall. Did you roll, or just do an impactful push up, basically.

4. Did you land on both hands?

5. Were you wearing gloves when you FOOSHed?

6. Do you have pain anywhere else in the forearm, elbow, shoulder?


7. Read this article for doctors from Family Physician Reports, and see if any of the FOOSH damage categories apply to you. It is possible you have a tiny fracture somewhere in there, and I'd say you definitely have some deep bruising.

The article is called Befuddled by a FOOSH? and is about diagnosing different fracture patters for different angles of FOOSH falls.

I think you'll find it interesting and possibly helpful.

Answer the above questions, and then let's get started getting you out of pain.

1 and 1/2 hands gets old. I'm happy to work with you to get you back to a full 2.




Joshua Tucker, B.A., C.M.T.
The Tendonitis Expert
www.TendonitisExpert.com