Understanding TFCC Injuries in Climbers: What It Is, Why It Hurts, and How to Recover

🧠 What Is the TFCC?

TFCC stands for Triangular Fibrocartilage Complex—which is group of ligaments and cartilage that stabilizes the ulnar or pinky side of your wrist. It acts as a shock absorber and stabilizer between your ulna (long bone on your pinky side) and carpal bones (small bones in your wrist). 

🧗‍♂️ Why Are TFCC Injuries Common in Climbers

Injuries to the wrist complex and the TFCC (triangular fibrocartilage complex) are relatively common in climbers due to the high demands placed on the wrists and the variety of grip positions used during climbing. These positions can create compression or traction forces through the wrist, particularly at the TFCC, leading to irritation or injury over time. Some provocative or irritable positions are included below: 

• Deep underclings 

• Mantles (push-ups also may bother you)

• Crimping especially with wrist deviation or on steeper climbs

• Pinches

• Gastons and Sidepulls or any holds that has the wrist in a deviated position

🚨 Signs and Symptoms

There are various signs and symptoms that the TFCC may be irritated. 

• Pain on the ulnar (pinky) side of your wrist

• Discomfort with twisting motions (such as opening a jar or turning a doorknob)

• Pain with weight-bearing on the hand or certain climbing moves/positions

• Reduced grip strength or pain when utilizing grip strength

• Pain when loading the wrist, especially in deviated positions

🛠️ Treatment

Every TFCC injury is a little different and should be treated based on your specific signs and symptoms. That said, the following strategies are generally a good starting point to help reduce irritability and begin building strength and stability around the wrist and TFCC region. These strategies are designed to gradually restore control and resilience without overloading the joint too early in the recovery process. 

• Distraction

  • Gently unloading the wrist joint can help reduce compression through the TFCC and wrist complex, which is often a key source of irritation. This technique can be effective for easing symptoms and improving range of motion, especially in the early stages of recovery.

Wrist distraction with band

• Wrist Isometric Loading

  • Strengthening the muscles surrounding the wrist complex can help reduce strain on the TFCC. Generally the TFCC hurts more initially when loading with movement so starting with isometric exercises are a great place to start. 

    
    

• Shoulder and Scapular Strengthening

  • Strengthening up the chain including the shoulder and scapular complex can help reduce load on the wrist

    
    

• Soft Tissue Mobilization

  • Climbers tend to have tight forearm flexors and/or extensors causing restriction in wrist range of motion. Releasing forearm flexors and extensors can help reduce irritation in the wrist complex. 

    
    

In some cases, temporary de-loading (e.g., backing off on provocative climbing positions and then gradually loading the wrist complex with graded exposure.

Everyone is different and if pain continues it is best to see a Physical Therapist to get your specific rehab needs met!

Climber using wrist widget while strengthening fingers

All of the above options are meant to provide encouragement to help you better understand and address TFCC pain/injuries. I encourage you to consult with us at The Climb Clinic or meet with a physical therapist in your area skilled in the diagnosis and treatment of foot conditions to help guide you through this process!