Wrist Pain: Physiotherapy Treatment of Wrist Instabilities 

Wrist pain can quickly disrupt your everyday routine—from lifting groceries to typing on a keyboard. One of the most common and overlooked culprits is a wrist instability and TFCC tear. This condition can limit your motion, cause persistent pain, and weaken your grip. Understanding the causes, symptoms, and available treatments can help you take control of your recovery.

What Is the TFCC?

The Triangular Fibrocartilage Complex (TFCC) is a group of ligaments and cartilage located on the ulnar (pinky) side of the wrist. It stabilizes the distal radioulnar joint and supports your wrist during twisting and weight-bearing movements¹. When injured, the TFCC can no longer support the joint effectively, resulting in wrist pain from wrist instabilities. 

Common Causes of Wrist Instability

There are several ways a wrist instability and TFCC tear can occur:

  • Trauma: A fall onto an outstretched hand or a forceful wrist twist can tear the TFCC².

  • Repetitive Use: Sports and jobs requiring constant wrist motion—like climbing, pickle ball, tennis, weightlifting, or carpentry—can lead to gradual TFCC damage³.

  • Degeneration: As you age, the cartilage in the TFCC naturally wears down, increasing your risk of tearing⁴.

  • Ulnar Variance: If your ulna is slightly longer than your radius, it increases pressure on the TFCC and raises the risk of injury⁵.

Signs and Symptoms

Watch for these signs of a wrist instability and TFCC tear:

  • Wrist pain on the pinky-side of the wrist

  • Clicking or popping when rotating your wrist

  • Weak grip strength

  • Swelling or tenderness near the ulnar side

  • A feeling like the wrist might “give way”

These symptoms usually get worse with twisting motions or weight-bearing tasks⁶.

How a Physiotherapist Can Help with Wrist Pain

Physiotherapy offers a powerful, non-invasive way to manage and recover from a wrist instability and TFCC tear. Here’s how physiotherapists help:

1. Precise Assessment

A physiotherapist uses specific tests, including the TFCC load test and piano key test, to pinpoint the exact cause of wrist instability⁷.

2. Wrist Pain and Swelling Control

Techniques like manual therapy, kinesiotaping, bracing, ice, and ultrasound help reduce pain and swelling⁸.

3. Strength and Stability Restoration

Targeted exercises strengthen the muscles around your wrist and forearm. Proprioception and coordination drills help retrain your wrist for stability⁹.

4. Safe Return to Activity

Physiotherapists build a step-by-step rehabilitation program to help you return to your sport, work, or everyday tasks safely¹⁰.

5. Long-Term Injury Prevention

They also educate you on wrist ergonomics, protective gear, and movement patterns to avoid reinjury¹¹.

Wrist Pain? Take Action Early

Ignoring a wrist instability and TFCC tear can lead to long-term joint damage or even arthritis. Early diagnosis and rehab offer the best chance for full recovery—often without surgery.

Physiotherapy not only treats the symptoms but addresses the root of the problem. With a custom rehab plan and expert guidance, you can restore wrist function and prevent future issues.

Final Thoughts

Your wrists play a role in nearly everything you do. A wrist instability and TFCC tear can greatly impact your life, but physiotherapy provides a clear, proven path to healing.

If you’re dealing with wrist pain, weakness, or instability, don’t wait. Book an assessment with a physiotherapist and take the first step toward recovery—confident, strong, and pain-free.

References

  1. Palmer AK, Werner FW. The triangular fibrocartilage complex of the wrist—anatomy and function. J Hand Surg Am. 1981;6(2):153–162.

  2. Atzei A, Luchetti R. Foveal TFCC tear classification and treatment. Hand Clin. 2011;27(3):263–272.

  3. Garcia-Elias M. The TFCC: Biomechanics and Injury. J Hand Surg Eur Vol. 2006;31(3):261–266.

  4. Nakamura T, Yabe Y, Horiuchi Y. Functional anatomy of the triangular fibrocartilage complex. J Hand Surg Br.1996;21(5):581–586.

  5. Nakamura R, Makita A. Ulnar variance and TFCC injuries. Orthop Clin North Am. 1993;24(2):255–259.

  6. Manske RC, Reiman MP. Physical examination tests for the wrist and hand. J Athl Train. 2010;45(5):499–507.

  7. American Physical Therapy Association. Practice Guidelines for Wrist Injury Management. APTA; 2023.

  8. Bialocerkowski AE, Grimmer KA. Evidence on the physiotherapy management of TFCC injuries. Aust J Physiother. 2001;47(4):217–229.

  9. Ellenbecker TS. Rehabilitation of the wrist and hand. Orthop Clin North Am. 2002;33(4):681–692.

  10. Brotzman SB, Wilk KE. Clinical Orthopaedic Rehabilitation. 4th ed. Elsevier; 2011.

  11. NICE (National Institute for Health and Care Excellence). Clinical knowledge summaries: soft tissue injuries of the wrist. 2023.