From surgery to surfing

This patient is an active young professional who enjoys outdoor activities such as hiking and surfing. Due to the nature of her injury, MRI results revealed a tear of the triangular fibrocartilage complex (TFC). Given her goal to return to surfing—which involves forearm pronation and weight-bearing for push-off, both of which are painful with a TFC injury—she and her excellent surgeon discussed the potential benefits of surgery.

She underwent a wrist arthroscopy and was referred to occupational therapy (OT) post-operatively for a custom ulnar gutter orthosis and rehabilitation. At the time of her initial evaluation, she presented with decreased active range of motion (AROM), increased wrist stiffness, swelling, tenderness along the ulnar aspect of her wrist, mild hypersensitivity at Guyon's canal (affecting the ulnar nerve), and pain. Her initial therapy focused on improving range of motion, reducing swelling, managing her scar tissue, and alleviating pain.

She responded well to desensitization techniques and the use of a Coban wrap for support and edema management. The patient was compliant with therapy, attending sessions twice a week, and made steady progress. As she continued to improve, she transitioned from the ulnar gutter splint to a wrist widget for increased activity support. She was ultimately discharged from OT pain-free, with a home exercise program (HEP) to continue focusing on strengthening and weight-bearing exercises.

Nearly a year after surgery, I was thrilled to hear from her. Having relocated to the West Coast, she reported that she was now enjoying daily surfing without pain. Surfing is a dynamic activity that requires full weight-bearing and wrist loading in pronation. In her own words: "From surgery to surfing—that’s a success story if I know one!"