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Imran has been weight lifting with lots of load for long hours so the Guru recommends MRI or Ultrasound

Jul 24th, 2015

Hi

I have been working out for 4 years on upperbody and loved bench pressing, over the course of a few months i increased my bench press in weight and was an avid follower of working out til failure, in may of this year. i began noticing a small pain in my right wrist which i only felt when waking up – some stiffness, this would go after a few minutes so continued working out, it gradually became a little more prominent, so instead of resting it like normal people i thought i could work through the pain.

on 3rd june i went gym had an extremely heavy workout about 2 hours long with loads of bench press at 120kg til failure repeatidly, that night i went to sleep and woke up with a pain which can only be described as horrific in my wrist along the thumb bond i believe its the metacarpel bone down to the radius bone, most of the pain is in the radius section but all at the end where i assume it meets the metacarple bone, i went and got an xray which showed all bones were fine no chipping or fracture and apprantely lingaments were fine also (i didnt know you could see ligaments in xrays)

im soo depressed i have left it rest for 8 weeks and it has gradually got better but my god it has taken so long and progression is soo slow, im thinking a few things (please help me out regarding this ) it could be tenosynovitis it could be an inflamation infection what do you recommend ???

do you think an MRI is wise at this point???

please help any response would be highly valued

Thanks I.M

Jul 24th, 2015

The Guru Responded:

Hi Imran

 

Sounds pretty hard core – lots of load and lots of hours spent in the gym, leading to a pretty unhappy wrist.

 

I think you’re right about X-rays and ligaments – X-ray is great for assessing the bone surface and not really much cop for ligaments, unless there is frank instability, which I don’t think you’ve got.

 

I think this sounds like an overload issue, and I think probably an MRI or even an ultrasound should be the next next step forward.

 

I’d like to see if you’ve got a ganglion in your wrist, which is inflamed. This can be done by palpation (it’s sore when it’s poked!), US or MRI.

 

The US could also look for any tendon issues – you may have a DeQuervains tenosynovitis, which is focused more at the wrist just above the thumb.

 

MRI would see them all, and even look at the sub bone complex to make sure you don’t have a stress reaction.

 

Anyway, I think getting further investigation is warrantied as you’ve had 8 weeks rest and are not really progressing as expected.

 

Good luck

 

The Guru

 

Imran thanks the Guru:

hi firstly thank you so much for your response it is so refreshing to hear an expert at least give some time to correctly diagnose, i doubt it is a ganglion only because i recently watched this video on youtube which was like a eurika moment

the motion of the thumb it what im having trouble with so im absolutely certain its de Quervain syndrome

can you advise anything on this

Thanks

Imran.M

 

The Guru replied:

Good stuff!

 

If you’ve got a positive Finkelsteins test then your options are either resting in a thumb spica splint for a few weeks or getting the sheath around the tendon injected under US guidance and then rested in a splint.

 

Very much your call.

 

The Guru

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