TFCC Tear & Wrist Injury Treatment Singapore | Hand Therapy

Written by Mavis Tham, Shamaine Soh and Yuna Zhuang, Principal Hand Occupational Therapists at Phoenix Rehab.Clinically reviewed by Nigel Chua, Founder and Clinical Director, Registered Occupational Therapist, AHPC A1300362Z.Last reviewed 2 October 2026.

TFCC Tear and Wrist Injury: Hand Therapy Treatment in Singapore

A TFCC tear is an injury to the triangular fibrocartilage complex, the cushion of cartilage and ligaments on the little-finger side of your wrist. It causes pain on that side of the wrist when you twist, grip or push up from a chair, and sometimes a click.

Many TFCC injuries settle without surgery. TFCC tear treatment starts with a splint that rests the wrist, changes to the movements that load it, and a hand therapy program that rebuilds the muscles protecting the joint.

The location of the tear shapes how it heals. The outer rim of the TFCC has a blood supply and can heal. The central disc has little blood supply and seldom heals back, yet many people still become pain-free once the wrist is strong and the tear stops being irritated.

A hand surgeon repairs or trims the tears that stay painful or leave the forearm bones unstable. At Phoenix Rehab Group, our hand therapists examine the little-finger side of your wrist, refer you to a doctor for imaging when needed, and make a custom splint in the same appointment.

You do not need a doctor’s referral. If ulnar-sided wrist pain has lasted more than two weeks, or your wrist clicks when you twist it, schedule a hand therapy assessment.

TFCC TEARS AND SPRAINS — “Wrist Sprain Little Finger Side” at a glance

WHAT IS THIS TRIANGULAR FIBROCARTILAGE COMPLEX (TFCC)?

Our triangular fibrocartilage complex (or TFCC / TFC, for short), refers to a very complex cartilage structure that’s located at the wrist area that’s close to your little finger.

The TFCC is made of a mix of

• tendons
• ligaments
• cartilage

that’s connected to the extensor carpi ulnaris (ECU).

When we grip something or whenever we rotate our wrist and forearm, our TFCC helps stabilize the wrist and forearm bones.

On top of that, our TFCC also behaves as a “shock absorber” between the ulnar bone (the forearm bone that’s closer to the little finger side) and the small carpal bones of the wrist called the triquetrum and lunate.

Unfortunately, some individuals are more at risk / higher tendency to get TFCC injuries due to a problem from birth called ulnar variance, where the ulna is longer than the radius.

The triangular fibrocartilage complex, or TFCC, sits between the end of the ulna (the forearm bone on the little-finger side) and the small bones of the wrist. It has two jobs. The triangular disc at its centre cushions the load that passes through the little-finger side of the wrist when you grip or lean on your hand. The ligaments around the disc hold the two forearm bones together at the wrist, at the distal radioulnar joint (DRUJ), so your forearm can turn the palm up and down without the bones separating.

Several parts make up the complex: the central disc, the ligaments that join the radius and ulna, and the ligaments to the small wrist bones. It also forms the floor of the sheath for the extensor carpi ulnaris (ECU) tendon. An injury can affect one part or several.

TFCC sprain vs TFCC tear

A TFCC sprain is a stretch or small tear of the ligaments in the complex. A TFCC tear is a larger break in the disc or its attachments. People use the two terms for the same injury, and an MRI or a wrist arthroscopy grades it. Treatment starts the same way for both.

Surgeons describe these tears with the Palmer classification: type 1 for traumatic tears and type 2 for degenerative ones.

TFCC tear symptoms

• Pain on the little-finger side of the wrist. Clinicians call it ulnar-sided wrist pain.
• Pain when you twist. Turning a door handle or key, opening a bottle, wringing a towel or using a screwdriver.
• Pain when you push up. Pushing up from a chair, push-ups, planks and downward dog all load the TFCC.
• Pain with sideways bending. Tilting the wrist toward the little finger, as in a badminton smash, a golf swing or hammering.
• Clicking, popping or catching as you turn the forearm.
• A weak grip, or a wrist that gives way when you carry something palm-up.
• Swelling on the little-finger side of the wrist.
• A loose or prominent ulna head, the bony bump on the back of the wrist, if the forearm joint is unstable.

TFCC injuries tend to feel better with rest and flare as soon as you twist or bear weight again. That pattern is the reason they linger when people return to sport too soon.

WHAT CAUSES A TFCC TEAR // COMMON CAUSES OF WRIST TFCC INJURY

• A fall on an outstretched hand, landing with the palm down and the wrist bent back.
• A twisting injury. A drill that jams, a racquet or club that catches, or a heavy object that twists the wrist.
• Repeated rotation and sideways loading. Badminton, tennis, pickleball, golf, gymnastics, boxing, rowing and climbing. Striking a hard driving-range mat with a golf club sends a jolt up the little-finger side of the wrist.
• Weight-bearing training. Push-ups, bench press, handstands, front rack positions and yoga on flat palms.
• A wrist fracture, often with a break of the ulnar styloid, the tip of the ulna.
• Age-related wear. The disc thins with age, and a longer ulna raises the load on it.

In Singapore, we see TFCC injuries in badminton and golf players, gym-goers, yoga practitioners and climbers. We also see them in F&B workers who toss woks and carry heavy pots, cleaners who wring mops, and new parents lifting car seats.

The key causes that increase your risk of developing a triangular fibrocartilage complex (TFCC) in your wrist:

1. Sports: wrist injuries are very common in those who play tennis, badminton, basketball and baseball (or cricket). Research shows that 25% of all sports injuries are in the hand or wrist!
2. Age: our risks of injuring our wrist TFCC increases with age predominantly because as the wear and tear (degradation) of the wrist joint and TFCC, it makes it easier to injure it more seriously.
3. Chronic Inflammation: inflammatory diseases such as rheumatoid arthritis or gout as well as repetitive strain injuries (RSI) can cause wrist damage over time. Research showed that TFCC tears were observed in 39% of people with severe rheumatoid arthritis.

HOW DOES TFCC INJURY OCCUR?

Generally, there are two types or forms of triangular fibrocartilage complex tears:

1. Traumatic kind where a fall on an outstretched hand, very hard or strong arm rotation or a force or blow to the wrist. People who play games or sports that involve bats, racquets or place pressure on their wrist (such as weight lifters, dancers, yoga instructors) are often at risk
2. Degenerative kind where the TFCC cartilage wears down with use and time. If their jobs or interest include repeated wrist rotations and squeezing, that can weaken the TFCC such that even minor forces or rotations can tear the TFCC easily.

HOW TO TELL A TFCC WRIST INJURY FROM OTHER WRIST ULNAR-SIDED PAIN?

The #1 symptom of a TFCC injury, sprain or tear is ulnar sided wrist pain (which is pain at the wrist level below the little finger).

You may feel the pain constantly (like 24/7) ache, and sharp pains when force is applied through it. Some patient may feel pain in their entire wrist.

Other related pains of TFCC include:

• A clicking or popping sound when you move your wrist
• Swelling
• Instability
• Weakness
• Limited motion
• Tenderness

TESTS: DIAGNOSING YOUR WRIST PAIN (IS IT TFCC INJURY?)

Ulnar Fovea Sign

The ulnar fovea sign is the most specific and can be the most intense TFCC-specific test, and it’s performed with

1. the patient is across the therapist (or orthopedic doctor)
2. their elbow flexed 90 degrees upright on the table
3. ulnar aspect of wrist facing the therapist
4. we stabilize the wrist with our left hand
5. and with the other hand, we palpate and push into the soft region of the ulnar side of the wrist, above the ulnar styloid
6. if tender, then the test is positive and indicates a possible wrist TFCC injury at the styloid and/or foveal attachment sites

Piano key test

This test is to determine wrist stability, where we

1. support the wrist in pronation (palm down)
2. we stabilize the ulnar side of the forearm
3. then we apply gentle force to the ulnar head and release
4. IF the ulnar head pops back to its usual location, then the test is positive

An additional test is to

1. get the patient to sit at a desk
2. place their injured hand face up under the table, pressed against the bottom of the table underside
3. patient to attempt to raise the table by flexing the wrist
4. this action loads the dorsal part of the TFCC, and if this test is painful, that may be indicative of a peripheral dorsal TFCC tear

Ulnocarpal stress test

For this test,

1. we use our left hand to stabilize your injured hand
2. your elbow is flexed at 90 degrees with the hand facing upwards
3. we then hold your elbow in our left hand and your hand in our right hand
4. then we deviate your wrist in full ulnar deviation (means to bend your wrist towards your little finger) AND rotate your wrist at the same time

If there’s pain, it’s a positive sign.

Press test

The patient sits in a chair or bed and push themselves off with their palms facing down — this typically causes sharp, intense pain with patients with TFCC tear.

WRIST TFCC INJURY OR TEAR TREATMENT OPTIONS

• Splinting comes first. For most TFCC injuries, a splint rests the tissue for 4 to 6 weeks. A wrist splint suits many sprains. If the forearm joint is irritated or unstable, your therapist may use a splint that also stops the forearm turning, because rotation loads the TFCC. Your therapist can mold a custom splint for either purpose.
• Change the load. Avoid twisting under load, bearing weight on a bent-back wrist, and tilting the wrist toward the little finger. Carry bags with your palm facing your body, lift with two hands, and use thicker grips on tools.
• Hand therapy builds a stable wrist. Two muscles steady the little-finger side of the wrist: extensor carpi ulnaris (ECU) along the back and flexor carpi ulnaris (FCU) along the front. The pronator quadratus, a small muscle across the front of the forearm near the wrist, holds the forearm bones together. Your therapist trains these muscles first, then your grip, joint position sense and weight-bearing, in stages.
• Steroid injections. A doctor may inject a steroid into the wrist for short-term relief, most often for degenerative tears and ulnar impaction. Hand therapists do not give injections; we coordinate your splint and exercise plan with your doctor.
• Surgery. Surgeons trim central tears that stay painful (arthroscopic debridement), stitch peripheral and foveal tears back to the bone (repair), and shorten a long ulna to take load off the TFCC (ulnar shortening osteotomy). After a repair, expect 4 to 6 weeks in a cast or splint that limits forearm rotation, then 3 to 6 months of hand therapy. See post-surgery rehabilitation as it’s more intensive surgically. Likewise, the surgeon can also fix the ulnar variance too.

WRIST AND HAND THERAPY FOR TFCC WRIST PAIN AND INJURIES AT PHOENIX REHAB

Our hand therapy team is led by Nigel Chua, Principal Hand Therapist, who has treated hand and wrist conditions since 2005. Our hand therapists are AHPC-registered occupational therapists and physiotherapists with post-graduate training in hand therapy.

At your first appointment, you can expect:

1. The story of the injury. We ask about the fall or twist, your sport, your work and the movements that hurt.
2. A focused wrist examination. We run the fovea sign, press test and DRUJ tests, and measure your grip with a calibrated gauge.
3. A referral when needed. If a fracture, an unstable forearm joint or a large tear is likely, we refer you to a doctor for imaging and share our findings.
4. A custom splint. We make a wrist splint, or a splint that limits forearm rotation, in the same appointment.
5. A load plan for work, home and sport.
6. A starter exercise plan that keeps the fingers, elbow and shoulder moving while the wrist rests.

At follow-up appointments, we wean you off the splint, build strength and joint control, and plan your return to sport. Most people need 4 to 8 appointments over 6 to 12 weeks. After TFCC surgery, we follow your surgeon’s protocol.

Contact us for a TFCC assessment. WhatsApp us or schedule an assessment online.

TFCC TEAR & WRIST SPRAIN INJURY RECOVERY TIMELINES

You are on track if twisting hurts less week by week, pushing up from a chair stops hurting, and your grip gets stronger. Contact your therapist if the wrist starts to clunk, pain rises despite the splint, or tingling appears in the ring and little fingers.

TFCC WRIST BRACES, BANDS & TAPING

• Splints for the protection phase. A rigid wrist splint, or a splint that limits forearm rotation, rests the TFCC in the first 4 to 6 weeks.
• Ulnar-sided wrist bands for return to activity. A band that wraps the wrist above the wrist bones presses the two forearm bones together and supports the forearm joint during gripping and weight-bearing. Several ready-made designs exist, including the WristWidget, which a hand therapist designed. Wear the band for sport, gym and heavy tasks rather than all day.
• Standard wrist braces. A brace that holds the wrist straight helps in the early weeks. It does not stop the forearm turning, which matters for tears that involve the forearm joint.
• Taping. Kinesiology tape and rigid tape have limited evidence for TFCC injuries. Some athletes find tape helpful when they return to sport, and your therapist can show you a method.

TFCC SPRAINS / TEAR SELF EXERCISES

Start these once your hand therapist or doctor has checked the wrist and ruled out a fracture or an unstable forearm joint.

Stage 1: protect (splint phase)

• Finger tendon glides. Move through a straight hand, hook fist, full fist and flat fist. 10 rounds, 3 times a day.
• Elbow and shoulder movement. Bend and straighten the elbow and lift the arm overhead. 10 repeats, 3 times a day.
• Wrist bends out of the splint, if your therapist allows. Bend the wrist up and down within comfort, without turning the forearm. 10 repeats, 3 times a day.

Stage 2: activate (after the splint phase)

• Forearm turn holds. With your elbow at your side and your thumb pointing up, try to turn your palm down against your other hand without moving. This works the pronator quadratus. Hold 5 to 10 seconds, 5 times.
• Wrist lift holds. Rest your forearm on a table, palm down, and lift the back of your hand against your other hand without moving. This works the ECU. Hold 5 to 10 seconds, 5 times.
• Dart thrower’s motion. Move the wrist on a diagonal, from back and toward the thumb to forward and toward the little finger. 10 to 15 repeats, twice a day.
• Grip with therapy putty. 2 to 3 sets of 10.

Stage 3: strengthen and load

• Wrist curls and extensions with a light weight, lowering over 3 seconds. 3 sets of 12.
• Forearm rotation with a light hammer, within a pain-free range. 3 sets of 10.
• Weight-bearing progression. Lean on a table, then do a wall push-up, a knee push-up on fists or push-up handles, and a full push-up. Move on once the current step is pain-free for 3 sets of 10.
• Ball circles on a wall for joint control. 30 seconds, 3 times.
• Sport drills, such as shadow swings and light hitting.

Stop or scale back if pain on the little-finger side goes above 3 out of 10, a new click comes with pain, or pain is higher the next morning.

One habit to drop: stretching the wrist into twisting or sideways bending to “loosen” it. Those stretches load the TFCC and keep it irritated.

RETURNING TO BADMINTON, GOLF & GYM AFTER TFCC WRIST SPRAINS AND INJURIES

Return to full sport once twisting is pain-free, your grip is within about 10% of your other hand, and the press test and a push-up are pain-free.

• Badminton, tennis and pickleball. Start with drives and clears, and add smashes last. Check your grip size, because a thin grip makes you squeeze harder. Wear an ulnar-sided band for play at first.
• Golf. Start with half swings and short irons, and hit off grass or a good mat. Build range appointments in steps, because hard mat strikes jar the little-finger side of the wrist.
• Gym. Use push-up handles or fists, choose dumbbells and neutral grips for pressing, and bring back front rack positions last.
• Yoga. Use fists, blocks or a wedge under the heel of the hand, or forearm variations, until weight-bearing is pain-free.
• Climbing. Start with larger holds and static moves until your grip is close to the other side.

MISTAKES THAT SLOW TFCC WRIST INJURY RECOVERY

• Going back to flat-palm push-ups and yoga too soon. Weight-bearing on a bent-back wrist puts a heavy load on the TFCC.
• Stretching into twisting or sideways bending. It irritates the tear.
• Wearing a brace that lets the forearm turn when your tear involves the forearm joint.
• Ignoring a clunk or a loose ulna head. Instability needs a hand surgeon’s opinion.
• Carrying heavy bags palm-up. It loads the forearm joint. Carry with the palm facing your body.
• Waiting months without an assessment. Pain that persists after 6 weeks of good care deserves imaging and a surgeon’s view.

WHEN TO SEE A DOCTOR FOR YOUR WRIST SPRAIN, PAIN OR SUSPECTED TFCC TEAR?

See a doctor on the same day if:

• after a fall, the wrist looks deformed or swells fast
• the hollow at the base of the thumb is tender after a fall (possible scaphoid fracture)
• the ulna head clunks out of place, or the forearm bones feel loose
• your fingers are numb, pale or cold
• the wrist is hot, red and swollen, or you have a fever

Make an appointment with a doctor soon if:

• you have tingling in the ring and little fingers
• pain has not started to ease after 2 weeks
• the wrist clicks with weakness
• pain persists after 6 weeks of splinting and therapy

FREQUENTLY ASKED QUESTIONS ABOUT WRIST SPRAINS, PAINS AND TFCC TEARS

Will a TFCC tear heal on its own?

Many TFCC sprains and stable tears settle without surgery, with 4 to 6 weeks in a splint and a hand therapy program over 6 to 12 weeks. Tears in the outer rim have a blood supply and can heal. Central tears seldom heal back, yet many people still become pain-free once the wrist is strong. A hand surgeon reviews tears that stay painful after 3 to 6 months of good care, or that leave the forearm joint unstable.

How can you tell if you have a TFCC tear?

A TFCC tear causes pain on the little-finger side of the wrist when you twist, grip or push up from a chair, often with clicking and a weak grip. A clinician checks for tenderness in the soft spot beside the ulna (the fovea sign), pain when you push up from a chair (the press test), and a loose forearm joint. A doctor confirms the tear with an MRI or a wrist arthroscopy.

Is TFCC a serious injury?

Most TFCC injuries are not serious and settle with a splint and hand therapy. A TFCC tear becomes more serious if the forearm joint is unstable, if it comes with a wrist fracture, or if pain persists for months, and these need a hand surgeon’s opinion. Getting the diagnosis right early matters, because a scaphoid fracture or ligament tear can look like a TFCC injury.

What happens if you leave a TFCC tear untreated?

Many mild TFCC injuries settle with rest from the movements that hurt. Tears that keep getting loaded can leave lasting pain on the little-finger side, a weak grip, clicking, and in some cases an unstable forearm joint or arthritis over time. Pain that persists after 6 weeks, a clunk, or a loose ulna head needs an assessment and imaging.

What does a TFCC injury feel like?

A TFCC injury feels like pain on the little-finger side of the wrist. It sharpens when you twist, such as turning a door handle, opening a bottle or wringing a towel, and when you push up from a chair. Many people feel a click or pop as the forearm turns, a weak grip, or a wrist that gives way when carrying something palm-up. Tingling in the ring and little fingers points to a nerve problem instead.

How long does a TFCC injury take to heal?

A TFCC sprain often settles in 4 to 6 weeks. A stable tear treated without surgery takes 6 to 12 weeks, with a return to sport around 3 months. After arthroscopic trimming, light use returns in 2 to 4 weeks and sport in 8 to 12 weeks. After a TFCC repair, expect 4 to 6 weeks of protection and 4 to 6 months to full activity.

What is the difference between a TFCC sprain and a TFCC tear?

A TFCC sprain is a stretch or small tear of the ligaments in the complex, and a TFCC tear is a larger break in the disc or its attachments. People often use the two terms for the same injury. An MRI or a wrist arthroscopy grades the damage. Treatment starts the same way for both: a splint, changes to the movements that hurt, and a hand therapy program.

Should I wear a brace or band for a TFCC tear?

In the first 4 to 6 weeks, a rigid splint rests the TFCC better than a soft brace, and some tears need a splint that also stops the forearm turning. For the return to sport and heavy tasks, an ulnar-sided wrist band supports the forearm joint during gripping and weight-bearing. A hand therapist can choose and fit the right support for your tear.

Do I need surgery for a TFCC tear?

Most people with a TFCC injury do not need surgery. A hand surgeon considers an operation when pain persists after 3 to 6 months of good conservative care, when the forearm joint is unstable, or when a long ulna overloads the TFCC. Options include trimming a central tear, repairing a peripheral or foveal tear, and shortening the ulna. Hand therapy after surgery improves movement and strength.

Do I need a referral to see a hand therapist for a TFCC injury in Singapore?

No. You can see a hand therapist at Phoenix Rehab Group without a doctor’s referral. If your wrist needs an X-ray, MRI or a surgeon’s opinion, we refer you to a doctor and share our findings. Some insurers ask for a doctor’s referral before they reimburse therapy, so check your policy first.

CONTACT US FOR A WRIST TFCC ASSESSMENT

If the little-finger side of your wrist hurts when you twist, grip or push up, a hand therapist can find the cause, fit a splint and start your rehab in the first appointment.

• WhatsApp: Message us. Your message opens with “Hi, I’d like to schedule a hand therapy assessment for a TFCC injury.”
• Online: schedule an assessment
• Clinics: Orchard, Serangoon, Tampines, Tanjong Pagar at International Plaza and Jurong East at Vision Exchange, opening 20 October 2026.
• Referral: not required. Some insurers need one for claims, so check your policy.
• Insurance: we provide itemised invoices, and a clinical report if your insurer asks for one.

Numbness in the ring and little fingers, worse with the elbow bent, points at the ulnar nerve at the elbow rather than the wrist. See the Cubital Tunnel Recovery Program, which sets out the four stages and what moves you up.

A sore hollow at the base of the thumb after a fall is the classic missed scaphoid fracture. See the Scaphoid Fracture Recovery Program, which sets out the four stages and what moves you up.

  
 
 
 
  
 
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 Micah 
 
33 days ago
 
 
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Amazing experience with Phoenix Rehab, was assisted by Mavis. She’s very kind and professional and did thorough check on my wrist. I feel very comfortable during the process.

I went in for thermoplastic splint, and everything went smoothly. She was able to address my needs on my left wrist sprain.

They were prompt with appointment process and inquiry. Also the clinic is very close to Tanjong Pagar MRT. I highly recommend!
  
 
 
 
 
 
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Fist time doing ultrasound for my tennis elbow!! Let’s hope it gets better the next few weeks!! Thank Mavis Tham!!
  
 
 
 
 
 
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Great treatment from my therapist. My painful wrist felt a lot of relief after the session. I’m glad I can slowly get back to doing my usual activities without constant pain.
  
 
 
 
 
 
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Very helpful and friendly !
  
 
 
 
 
 
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The masseur is very professional and provides excellent service ，yati is very good!
  
 
 
 
 
 
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I wasn’t able to close my fingers due to an injury. Nurul at Phoenix Rehab has helped me tremendously with my recovery process. I have been able to resume my daily activities and exercises after only a few sessions. Nurul has been very professional and positive throughout the entire process. Thank you so much for your help!
  
 
 
 
 
 
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Huge shoutout to Yuna Zhang from Phoenix Rehab for helping in my recovery from golfer’s elbow 🙌

I walked in with persistent elbow pain that was affecting workouts and everyday tasks, and Yuna immediately made me feel confident I was in the right hands. She took the time to properly assess my condition, explain the root cause, and tailor a treatment plan to my specific needs instead of using a one-size-fits-all approach.

What I really appreciated was how personalised every session felt. The exercises she gave me were practical, easy to follow, and actually worked. Within a short time, the pain reduced significantly and my strength and mobility improved much faster than I expected.

On top of that, the pricing is very reasonable and affordable, which made committing to recovery much easier.

Professional, knowledgeable, and genuinely caring — highly recommend Yuna at Phoenix Rehab if you’re dealing with hand-related sports injuries 💪
  
 
 
 
 
 
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I enjoy coming to Phoenix rehab as they offer a wide variety of services. I had a finger accident and was working with a very experienced hand therapist. Place is clean and comfortable.  Staff were friendly and appointment was on time
  
 
 
 
 
 
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Have both physio n Tcm visits here, highly recommend!
  
 
 
 
 
 
 
 
 
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