TFCC Tear (Triangular Fibrocartilage Complex)
What is a TFCC Tear?
The triangular fibrocartilage complex (TFCC) is a structure on the ulnar (pinky) side of the wrist that stabilizes the joint and helps absorb force. A tear of the cartilage can result from trauma, repetitive stress, or degeneration.
Common Symptoms
Pain on the ulnar side of the wrist
Clicking or catching with movement
Pain with gripping or rotating the wrist (e.g., turning a doorknob or opening a jar)
Weakness in the hand or wrist
Physical Therapist Diagnosis
A PT performs special tests such as the TFCC load test (pain with wrist deviation and rotation). Palpation, grip testing, and motion assessment help guide diagnosis. Imaging may be needed for confirmation.
Why it Happens
TFCC injuries often occur after falls, forceful twisting, or repetitive wrist loading (common in racquet sports, gymnastics, and weightlifting). Degenerative tears can also develop over time.
Why it Doesn’t Always Heal on Its Own
Cartilage has poor blood supply, so healing may be incomplete without intervention. Left untreated, pain and instability may persist.
Ideal Physical Therapy Treatment
Treatment focuses on restoring stability and function while reducing pain.
Key strategies include:
Activity modification and protection in early stages
Manual therapy to restore wrist and forearm mobility
Dry needling to promote healing and for secondary muscle tension in forearm muscles
Progressive strengthening of grip, wrist, and forearm muscles
Proprioceptive and stability training for wrist control
Gradual return-to-sport progression
Expected Outcomes
Mild TFCC tears often respond well to therapy, though severe cases may need surgical consultation. Rehab helps reduce pain, improve stability, and restore sport performance.
Key Takeaway
A TFCC tear can be frustrating, but with proper rehab many athletes return to full function without surgery.