April 1, 2019
Former U.S. Open champion Brooks Koepka knows the pain of giving up golf because of a wrist condition.
A year after capturing the Open title, Koepka was sidelined for four months in 2018 due to a partially torn tendon in his left wrist. The injury, the cause of which Koepka can’t pinpoint, left him in a cast for two months before he was able to return to the PGA Tour.
“It was torn a lot worse than they originally thought,” Koepka told reporters after not touching his clubs for 91 days. “The ligaments that hold the tendon in place were gone. Every time I went to the doctor, it seemed like it got worse and worse.”
Although torn tendons like Koepka’s can occur in amateurs, wrist tendinitis is more common, according to Dr. John Fernandez, an orthopedic surgeon and hand, wrist and elbow specialist with Midwest Orthopaedics at Rush. Dr. Fernandez estimates he treats between three and six cases of wrist tendinitis each week during the golf season.
Wrist tendinitis, which is sometimes referred to as tenosynovitis, is characterized by irritation and inflammation of the tendons around the wrist joint. Such inflammation and discomfort can be attributed to several factors, Dr. Fernandez said.
Tendon inflammation can be caused by overuse, especially of the exterior carpi ulnaris (ECU) tendon. The ECU tendon can become dislocated or torn, as can the triangular fibrocartilage (TFCC) tendon, when a golfer “grounds” his or her club during play. Wrist pain can also occur in those with arthritis at the base of the thumb when they compensate by using an improper grip on the club.
While golfers experiencing wrist injuries keep Dr. Fernandez busy, wrist tendinitis is also common among tennis players and those who work manual labor jobs. In both cases, the wrists are depended upon regularly, and sometimes for heavy lifting.
Extreme cases can involve a variety of treatment options. Koepka, for instance, had bone marrow taken from his hip and injected into his left wrist. A month later, he also received injections of platelet-rich plasma to strengthen the area where the tendon in his wrist had deteriorated.
In less severe cases, Dr. Fernandez says that a combination of rest, immobilizing the wrist in a splint, compression (keeping the wrist wrapped) and ice will help discomfort and swelling subside. Surgery may be necessary in rare cases, but, according to Dr. Fernandez, most players can receive cortisone shots to help deal with any pain associated with the injury.
The biggest challenge Dr. Fernandez runs into, however, is when golfers aren’t willing to take time off.
“The problem is that golfers are addicted and won’t give up the game,” Dr. Fernandez said. “So they suffer.”
If golfers notice inflammation early on, he says it is OK to continue playing. However, if the pain increases, it may become necessary to dial back on activity and/or play, Dr. Fernandez said.
“If an injury or increased pain does occur, get it checked early as many injuries heal if properly treated. If not, many can require surgery.”
Ultimately though, common sense should be the overriding guide. “Listen to your body,” Dr. Fernandez said.
To make an appointment with Dr. John Fernandez to discuss your hand and wrist issues, call 877-MD-BONES or visit www.rushortho.com.