The wrist is made up of the ends of the forearm bones (ulna and radius) and eight small bones called carpals. The radius, which is located on the thumb side, forms a joint directly with the wrist bones, but the ulna, which is on the pinky side, does not. Instead, a hammock-like structure made up of cartilage and ligaments called the triangular fibrocartilage complex (TFCC), joins the end of the forearm to the small wrist bones on the pinky side. The cartilage of the complex is in the shape of a triangular disc.
The TFCC stabilizes the bones in the wrist, acts as a shock absorber and enables smooth movements. However, the cartilage and ligaments of the complex are prone to degeneration and wear-and-tear injuries. This can lead to pain, weakness and instability.
The TFCC can be strained or torn from over-swinging or from grounding the golf club forcefully, causing pain. The wrists are locked when you hold a club, but once the club swings, the wrist movement may cause pain in the TFCC region. Also, a sudden injury to the pinky side of the wrist may sprain or tear the TFCC.
Treatment usually depends on the extent of the injury. Conservative treatment consists of rest, immobilizing the wrist with a splint, applying ice, and taking non-steroidal anti-inflammatory medicines. Most golf-induced wrist injuries due to overuse are successfully treated without surgery, but the golfer may need to give up the game for an extended period of time. If initial treatments fail, cortisone injections may provide relief.
If a sudden injury causes a wrist sprain or a tear of the TFCC, the wrist should be immobilized for four to six weeks. After that, depending on the injury, golfers can slowly return to play. If a golfer has persistent pain and instability, wearing a wrist brace may help. In severe cases, surgery is usually needed to reconstruct the TFCC.
Following TFCC reconstruction, the wrist and forearm are immobilized for four to six weeks. By six weeks, the golfer is usually able to initiate palm up and down motions and wrist bending and extending. The main goals of physical therapy are to achieve full forearm and wrist range of motion and to return to the golf game pain-free.