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Old 04-02-2014, 02:40 AM   #1
Carmen Malcolm
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Cortizone for wrist - advice please

I posted about this a couple of weeks back. I have tendonitis in my wrist from heavy kettle bell swings. Got the injury mid-February. I had three weeks of active rest (where I lifted, pushed, pulled absolutely nothing). Didn't use my right hand at all. Only did lower body workouts. During week four, even though I wasn't fully recovered, I start using my hand again - lifting very very light - but I found that the tendonitis was flaring up again. This is week five and I've gone back to resting the hand again. I have also been going to a physio once a week where she massages the area, straps it and gives me some ultra-sound therapy.

I have an appointment with a sports physician tomorrow. Even though my hand is feeling better, I just want to know how bad the tendonitis is, whether I can speed the rehab along, how to avoid re-injury and so on.

Question - if he suggests that I get a cortizone shot - should I have one? Has anyone had any experience regarding the pros and cons of cortizone injections?
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Old 04-02-2014, 07:04 AM   #2
Richard Deyan
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Re: Cortizone for wrist - advice please

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Originally Posted by Carmen Malcolm View Post
I posted about this a couple of weeks back. I have tendonitis in my wrist from heavy kettle bell swings. Got the injury mid-February. I had three weeks of active rest (where I lifted, pushed, pulled absolutely nothing). Didn't use my right hand at all. Only did lower body workouts. During week four, even though I wasn't fully recovered, I start using my hand again - lifting very very light - but I found that the tendonitis was flaring up again. This is week five and I've gone back to resting the hand again. I have also been going to a physio once a week where she massages the area, straps it and gives me some ultra-sound therapy.

I have an appointment with a sports physician tomorrow. Even though my hand is feeling better, I just want to know how bad the tendonitis is, whether I can speed the rehab along, how to avoid re-injury and so on.

Question - if he suggests that I get a cortizone shot - should I have one? Has anyone had any experience regarding the pros and cons of cortizone injections?
Did the wrist still hurt when you didn't use it for four weeks? In the future, I would not completely take a break from using an injured limb or area like that. Encouraging movement of the area (it doesn't have to be heavy or intense) will increase blood flow to the area and facilitate faster recovery. It's almost impossible to say how bad your injury is. In this case it's technically worse than tendonitis, it's more like tendonosis since it's been so long and still hurts. Cortizone shots are incredibly anti-inflammatory but people make the mistake of using it as their cure-all or medication, instead of prevention. I would definitely seek an x-ray etc. to ensure nothing is fractured or torn. If that's not the case I would chase the tissues upstream at the forearm and above and work on the mobility of the wrist and also have a coach examine your mechanics that may cause the wrist pain.
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Old 04-03-2014, 12:42 AM   #3
Carmen Malcolm
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Re: Cortizone for wrist - advice please

Thanks Richard for your reply.

The initial injury was acute - heavy KBS during a WOD. That same night my wrist ached - kept me up all night. The next morning I took an anti-inflammatory. For the next week or so I just trained through it. It wasn't sore during the workout but afterwards, once I had cooled down (and the next morning) it was stiff and very sore. After a week I realised something was very wrong and that's when I started resting it (on the physio's advice). I'm convinced that it's not fractured and nothing is torn. I think you are also correct in that this is a case of tendonosis because I initially kept on training and probably stressed the tendons even more. During the four weeks, I'd say that for two out of those four weeks, my wrist was really painful. Sharp shooting pains if I moved it. I did wear a brace initially and took NSAIDs about a week. My wrist did respond to this.

It no longer aches all the time - only during certain movements like KBS (even very light ones). I haven't tried to push anything overhead (like thrusters). I can do certain movements like kipping pull-ups with no problems. I can also lift (deadlifts for instance where my wrist stays straight) but I can't press - burpees and push-ups for example are painful.

There is a definate improvement and I'm wondering whether I should just stick it out for another week or two as opposed to masking the residual pain with cortisone?

The physio has been treating my forearm too (which she said was also stiff). She's given me some stretches to do as well for my wrist. According to her the inflammation is down but scar tissue has formed which I'm trying to massage out.
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Old 04-03-2014, 04:56 AM   #4
Steven Wingo
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Re: Cortizone for wrist - advice please

About 8 years ago, long before I became involved in CrossFit, I had a cortisone injection in my wrist due to a weightlifting. I'm embarrassed to say it was probably from doing dumbbell curls. I never had an acute injury, however, different from your experience. It just started hurting and got worse over time. I had deposed a very qualified hand and elbow surgeon around that time for one of my cases and therefore set an appointment with him. He gave me a cortisone injection in the wrist the day I saw him, was confident it would help dramatically, and he was right--I've never had a problem again even with 2+ years of CrossFit.

One thing that strikes me as being different about your situation is you had an acute incident one day. That leads me to believe you've got something more significant going on with your wrist. I know you don't think you tore anything, but with an acute incident--and the lack of healing--I think you need to consider that as a realistic possibility. My guess is the doc might want an MRI at this point depending on the results of the physical exam of your arm, hand, and wrist.
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Old 04-05-2014, 05:47 AM   #5
Carmen Malcolm
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Re: Cortizone for wrist - advice please

Steven and Richard

Thought I would let you know what transpired with the Doc. You were both pretty much spot on.

So, the diagnosis (according to the Doc) is tendonitis that has progressed to tendinosis. My physio doesn't believe there is any degeneration of the tendon - so she differs in her opinion from the Doc. Anyway, Doc says that I should not have rested the wrist for so long - I've now lost some strength and need to build that up again. Ironically, since I've started using it again I've been doing too much. I'm loading the wrist too quickly instead of getting back into lifting slowly. The result is that I'm doing too much too soon and my wrist is not healing. One step forward, two steps back. I can't help it though - when I'm training with everyone else at my box I just get so caught up in it all!

Doc says that if I strengthen the wrist slowly I should see progress over the next two or three weeks. If not, then he'll want to order a sonar and/or MRI to see if there is something else going on. Doesn't believe the tendons have torn though.

As a matter of interest, he says he is not a fan of cortisone for tendinitis / tendinosis - causes weakness in the tendons and may even lead to the tendon rupturing. So I didn't get a shot after all.

Any ideas what I can do to strengthen the wrist without aggravating the injury? I'll still go to crossfit but will scale the wods and only do lower body. I'll just have to be disciplined about it.

Thanks

Last edited by Carmen Malcolm : 04-05-2014 at 05:49 AM. Reason: Error in spelling
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