Are You Dealing with a Snapping Wrist? Read About My ECU Subluxation Treatment
In the summer of 2009, I injured myself while lifting weights. Really, what happened was I was performing power cleans until I heard a “pop” in my wrist. I later found out this “pop” was ECU tendon subluxation.
With ECU tendon subluxation, what happens is that the distal tendon of the extensor carpi ulnaris dislocates out of the tunnel on the ulna bone when performing certain movements, then re-enters the tunnel it was supposed to be held in. Basically, a tendon pops in-and-out of your wrist bone. To illustrate, here’s a video of a subluxation occurring.
As you can see in the video, there is a long “bulge” in the person’s wrist. This is the tendon of the extensor carpi ulnaris, and it’s dislocating itself. The problem with this injury isn’t necessarily impairment of the function of this wrist-extending muscle – one can actually function quite well if the sensation of snapping isn’t bothersome. The eventual inflammation of the tendon is what becomes problematic for people. This is because the recurrent snapping causes microtrauma to the tendon that never gets to heal.
Over time, it makes sense that the tendon can become damaged, eventually affecting the function of the extensor carpi ulnaris. Until then, it’s just a weird “snapping” sensation and some pain.
I don’t know about you, but I wasn’t willing to deal with the pain and snapping. It was a constant reminder that my wrists were screwed up. So, I sought to fix my injury. Here’s some of what I did for my ECU subluxation treatment. Note: this is NOT medical advice, just a retelling of my experiences.
Stabilize the ECU Tendon
I knew that repeatedly having my tendon slip out of place would prevent the nearby ligament from healing. Each time it pops out of place, the ligament is either stretched (if it is not torn) or the two ruptured ends are re-separated. Effectively, each subluxation re-injures this ligament. This kind of recurrent “trauma” renders any ECU subluxation treatment useless and ineffective.
The first thing I did to fix my subluxating ECU tendon was to prevent further snapping. This meant ceasing any activity or movement that did cause or may have caused any snapping. This also meant substantially less time in the gym.
I also had to immobilize my wrist for some time. I first started using basic wrist splints. After a while, I found WristWidgets. This product is a sort of wrist-wrap that applies pressure above and below the head of the ulna bone. This helped keep the ECU tendon from snapping by holding it “in place”, while giving mmy wrists more range-of-motion. These lasted me a few months until the velcro straps wore out.
Honestly, I think they’re a bit costly considering they’re just velcro wrist straps, but the WristWidgets definitely helped prevent further subluxation. I consider them to have been an important part of my ECU sublxuation treatment. If you’re interested in the product, Amazon has WristWidgets for sale.
In retrospect, the splints weakened the hell out of my wrist and grip strength. I wonder if the WristWidgets would have been better right off the bat. Oh well, we’ll never know.
Another tool that helped me prevent snapping of the ECU tendon was teaching myself to keep my wrist neutral at all times. I basically had to drill it in my head to not use excessive flexion, extension, ulnar deviation, and radial deviation, as extreme ranges-of-motion would increase the likelihood of snapping. This was essential in terms of my ECU sublxuation treatment, specifically with stabilization of the tendon.
Use Prolotherapy To Strengthen The Connective Tissue
In 2011, I found a medical doctor who offered me prolotherapy. In addition to having the ECU tendon subluxation, I also had lax wrist ligaments from excessive stretching.
In short, prolotherapy is a modality used by medical doctors to quicken (or start-up) the healing of connective tissue. An irritating solution is injected into the damaged areas, which causes an inflammation. Subsequently, tissue remodeling occurs. Here’s what a session of prolotherapy looks like…
I was unresponsive to the treatments at first, which was discouraging. However, months went by after receiving the treatments and my wrists felt more stable and resilient. Healing is a slow process, and you do what you can to facilitate it. In retrospect, I’m confident that prolotherapy sped-up my ECU subluxation treatment.
Gradually Reintroduce Movements and Exercises
As I mentioned before, I removed a bunch of movement as to prevent recurrent snapping in my wrist. This was done with the intention of being able to do everything again. Meaning, I wanted to lift heavy again.
When I began moving again, I found a lot of exercises to be uncomfortable and even painful. I did figure out, though, what was easiest to start with.
Static holds and exercises similar to them were the easiest in the beginning. Simply holding onto a gallon of milk or a bag of groceries was plenty difficult. This progressed to pulling-motions using a neutral grip, such as rows and pull-downs. I was stuck with these exercises for a while. It actually took me more than a year to get past this stage.
My wrists adapted and I eventually moved on to other things. This is the following order that I reintroduced wrist movements:
- Neutral gripping (e.g., static holds and dumbbell rows)
- Wrist flexion (e.g., wrist curls)
- Wrist extension (e.g., opposite of wrist curls)
- Radial deviation (e.g., tilting wrist towards the side of the thumb)
- Ulnar deviation and rotation in both directions.
I found ulnar deviation and rotation to be the most problematic when it came to recurrent subluxation of the ECU tendon. Thus, those movements were introduced last. I was already lifting heavy by the time they were re-introduced.
Avoidance of Extreme Ranges of Motion
Even today, I still do not push my wrist into extreme ulnar deviation. I’m not actually using my ECU tendon treatment “protocol” anymore, but I feel that avoiding extreme joint positions is still prudent.
I can count the number of times my ECU subluxates for the entire year on one hand. It is only when I accidentally venture into these extreme ranges-of-motion that I’ll ever feel a snap in my wrist. This doesn’t hinder me at all in my training. For a while, the only exercise I could not perform was the power clean. However, I’m able to do tit now.
In the End, My ECU Subluxation Treatment Worked
It was a long journey, but I was able to recover from my wrist injuries. If it weren’t for the strict adherence to my ECU subluxation treatment, I’m not too sure I would have improved at all. With a little guidance from a doctor plus some self-help, I did what I could have to fix my injury, and it worked.