Training with an Obscure Wrist Injury

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[Larry John]

Folks, I could use some help.

It appears that while training last week I may have partially or completely torn the ulnar collateral ligament in my left wrist (I had an MRI on Monday, but won't know the results 'til next week).

This happened when my (bigger, stronger and more experienced) partner applied kotegaeshi, then extended my arm 'til it was almost straight and smoothly drove his hip forward. There was an audible pop!, I yelped (martially, of course), and completed the obligatory breakfall unenventfully. We examined my wrist, saw no obvious swelling or bruising, and I experienced little or no pain, so I continued training using techniques that did not subject me to wrist locks (lots of koshi, YEAH!).

The joint's stable and strong in all degrees of motion, but I can't supinate the wrist without pain.

Here's where I need the help. I can't find anything about this injury on the web, so I don't know where to steer my doc in terms of treatment, physical therapy, braces, etc.. And I figure it's gonna be hit or miss about getting a referral to a bone doc who has sufficient experience in dealing with Aikido techniques and nut cases like me who want to continue doing them until they plant me in a box. Or an urn. Or scatter me in some undisclosed location (is that you, Mr. Hoffa?)

I can't believe I'm the only person in the history of the art to have had something like this happen, so does anyone out there have a clue on how to handle this?

Thanks in advance for your help!

[Ted Marr]

There's a "bone doc" that trains at my dojo. Sadly, that's in Rhode Island, so you probably can't come up here for treatment. Still, I'll mention your case to him next time I see him, and so there's a slim chance of getting some actual helpful advice *grin*

[Larry John]

There's a "bone doc" that trains at my dojo. Sadly, that's in Rhode Island, so you probably can't come up here for treatment. Still, I'll mention your case to him next time I see him, and so there's a slim chance of getting some actual helpful advice *grin*
Thanks, Ted! Getting the straight word from someone who understands what we do would be great.

[Jack Simpson]

Larry,

Sorry to hear about your injury. I have two suggestions. One, there is an excellent orthopedic-sports medicine dude in the No.Va/DC area, his name is Stephen Haas. He is/was the orthopedic doc for the Washington Wizards. I say this as his mind set is to return an "athlete" back to "competition level". This is far diffent from a normal orthopedic dude (or dudette) who's likely to think you crazy for doing aikido in the first place. Dr. Haas has his initials on the inside of several knees at my old dojo and I've seen him as well.

On a more academic front, there have been several papers published on the medical reasons for pain caused by aikido techniques (see the links below). Most academics love to hear that people read their papers and you may just email one of the authors to see if kotegaeshi has been studied. It might give a local doc more useable information.

Best of luck and stay safe,

Jack :ai:

nikyo paper (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7870549&dopt=Abstract)

nikyo 2 paper (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8284142&dopt=Abstract)

[Larry John]

Jack,

Thanks! Will see if I can track down Dr. Haas. When my knees started tweaking two years ago (I was consistently pivoting on a weighted leg), I worked with a former team doc from the Steelers. He was spot on on the diagnosis (inflamed cartilage), but didn't understand the damage mechanism 'cause he didn't know anything about Aikido. My sensei (Jim Sorrentino) and his mentor Bob Galleone-sensei helped me figure out how to move without hurting myself (I always pivot on my heel, now). I thought this new injury might be even more obscure so he might now be that helpful.

I had read one of the nikkyo papers during my web search (pretty interesting, actually), but noticed that it was written 10 years ago and I wasn't sure where to start trying to find the authors.

Thanks Again!

[philipsmith]

Sounds like a collateral ligament has popped. However there is a possibility of a distal radial fracture.

I suggest that you consult an orthopeadic guy (who deals with sports injuries) or a physical therapist.

Philip Smith Physiotherapist

[Larry John]

Phillip,

Yeah, that's what I thought, although a fracture seemed unlikely because there was no swelling. Interestingly, the ulnar process does appear to be slightly more prominent than I'd remembered it (and more than the one on my right hand), but that may just be because I'm more conscious of it now.

I noticed in training last night that this injury has really affected my self-confidence--I'm a lot more hesitant than I've been in years and it's affecting my ability to do unrelated techniques. Just one more step along the tortured path to developing "no mind."

I think I've found the number for the doc that Jack suggested--will be calling him today to see if he knows anything about this type of injury.

Thanks for your help!

[Ted Marr]

Is there some way to get access to the fulltext of the nikyo article online if you don't have access to an academic library at the moment?

[Jack Simpson]

Larry,

Glad you've hook onto Haas. He's very good. As far as contacting authors for more info (or for Ted, a copy of the paper), check out the link to Gregory D. Olson at Montana State, author of one of the nikyo papers. I'm sure he'd be happy to supply reprints. And, Larry, say hi to Jim for me. I've trained with him off and on over the years and always had a fine time.

Best Regards,

Jack :ai:

Gregory Olson, Montana State Univ (http://www.montana.edu/wwwhhd/faculty/intros/intro-golson.htm).

[Larry John]

Jack,

Thanks fow following up! Will write him this afternoon.

[Janet Rosen]

Hi. Just to clarify: the classic pain of nikkyo has to do with nerves on the periosteum (thin membrane over bone) touching each other momentarily, which is why it is a transitory pain that has nothing to do with actual damage.

When you hear pops and have ongoing pain, something has torn, generally a tendon or ligament.

Basic rule of thumb on these: minimum 8 wks to heal, and every little re-trauma during that time not only resets the clock, it makes it worse. Elevate, ice, and if its possible to devise a splint that supports it to prevent you turning in the direction that hurts, it would be a good thing (I doubt general compression to the area will do a darn thing, but I'm not a doctor, I'm a recovering nurse who can't and won't diagnose individual problems).

Sounds like you are on track with an mri done and a good doctor in your area--best of luck.

[Larry John]

Thanks, Janet!

I'm not sure what sort of splint would be useful, because I'm not sure in which dierctions the joint needs to be immobilized, and I'd rather not lose strength and flexibility in areas that son;t need to be splinted.

Can you point me to any resources that might give me a good idea about that?

Thanks!