By Dr. Harry G. Sese, DC, BS, RMT,? Golf Injury & Performance Specialist
Welcome to our newest section ?Ask ?The Golfing Doc??. With a diverse medical background and experience in training and conditioning, Dr. Sese is your ultimate resource for golf injury prevention, rehabilitation, maximizing performance and improving your golf game. Dr. Sese, also known as the ?The Golfing Doc? will answer your questions about golf injuries, golf fitness, nutrition and other health issues commonly experienced by golfers.
?Dear The Golfing Doc. I was wondering if you could help me with my wrist problem. I?m a fair-weather golfer but I wanted to practice over the winter. I?ve only practicing at the driving range, but I?m starting to notice my left wrist is getting sore. It?s now at a point where after hitting a few balls, I have to stop because of the pain. I?m not sure if this makes a difference but I?m a right-handed golfer, a 9-handicap, and try to go to the range about three times a week. Please help! Thank you. Rob D., Redmond, Wash.?
Thank you for your email Rob. This is a very good question. As we are now in the winter season, I actually see and treat a higher number of wrist injuries. It does not matter if my patient is a fair-weather, single digit handicap golfer as yourself, or a touring professional who is home in the Pacific Northwest for the off-season. Wrist injuries are more prominent this time of year.
So why is the wrist prone to injury?
The wrist is made up of a complex combination of bones, joints, ligaments, tendons and other vital structures. If you wrap two fingers around your wrist, underneath your fingers will be two rows of bones known as carpals. There are eight carpal bones which contact each other to forms individual joints. Ligaments connect these bones to stabilize the joints. Tendons from your forearm then cross over each side of the wrist to provide some extra stability. Your vital blood vessels and nerves are then intertwined in this mix.
Within the intricate anatomy of the wrist is a very important structure known as the triangular fibrocartilage complex, also known as the TFCC. The TFCC is a vital structure for any golfer. It is found on pinky-side of wrist and connects your ulna to two of the carpal bones on that side. The TFCC improves range of motion at the wrist by allowing it to move in six different directions: bending, straightening, twisting and side-to-side motion. All of these motions are crucial to the golf swing so imagine what it would happen if you injured your TFCC.
The TFCC is commonly injured when someone falls to the ground with an outstretched hand. However, this injury is also prominent in golfers due to the repetitive pronation (palm faces down), gripping with rotation, and then force from the impact of hitting the ball and the ground. ?This repetitive combination of stresses may lead to tissue degeneration over time. In the summer months, the majority of golfers practice off soft grass ranges and play under good conditions. During the winter months, golfers have to hit off cold, hard, and soggy range mats or better yet, hit off some turf in the basement. Unfortunately, hitting off these mats can case too much impact and stress to the wrist. To give you an example, I once sent three college players for wrist surgery one year due to injuries sustained from having to hit off mats in the gym during the winter months.
The most common symptoms of a TFCC injury include general wrist pain, wrist pain that cannot be pinpointed, and pain with rotation of the forearm such as when shaking hands or hitting a golf ball. Other common symptoms include clicking, catching, snapping, weakness and swelling.
Minor wrist and hand injuries can heal with conservative care, but sometimes, especially if it is the TFCC that is injured, surgery may be required. For any of my professional golfers, surgery is usually the only option as any injury to the TFCC may be a career-ending injury. If you are experiencing wrist pain, especially related to when you are golfing, my best recommendation is to seek professional care from your medical provider.
Wrap two fingers around the crease of your wrist to locate the carpal bones.
The TFCC is located between the ulnar or ?pinky? side of the wrist.
Dr.Sese is the Clinical Director at the Washington Golf Performance Institute in Bellevue, WA. He also travels the country as an instructor for the Titleist Performance Institute and works with players on the PGA, LPGA, and other professional Tours. Please send your question to drharrysese@gmail.com, visit his website at www.thegolfingdoc.com or follow him on Twitter @thegolfingdoc.
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Source: http://golftodaynw.com/2012/12/31/what-is-ailing-you-the-golfing-doc-wants-to-help/
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