Recurring SL Ligament Injury - Seeking Guidance
Hello everyone, I’m M33 from Germany. **Quick summary:** I suffered a tear in my SL ligament, underwent reconstruction, but it sustained another tear shortly after. I’m exploring options for a second reconstruction or possible non-surgical treatments. **Expanded story:** For the past five years, I’ve experienced occasional mild discomfort when putting pressure on my hand, particularly during activities like push-ups. After a notably long bike ride led to prolonged pain lasting about two months, I decided to seek medical advice. Fortunately, the pain subsided gradually during the recovery period. Last year, doctors suspected I had a torn SL ligament and recommended an arthroscopy for a definitive diagnosis. It felt unusual to consider surgery without having severe pain, yet the risk of further damage to adjacent ligaments was highlighted, which could eventually lead to the need for a complete wrist fusion. Naturally, I wanted to avoid that scenario, leading me to proceed with the surgery. The arthroscopy confirmed my fears—a torn ligament was present. Subsequently, I underwent two additional procedures: the reconstruction and the removal of the stabilization wires later. Despite completing physiotherapy and strengthening my hand, I still felt discomfort when weight-bearing on my wrist. After another MRI, the results indicated a new tear, and once again, a recommendation for arthroscopy and reconstruction has been made. My confidence in this surgical route is understandably diminished, making me reluctant to agree to another operation. I've sought second opinions from other specialists, who concur that, in the long run, surgical intervention might be necessary. Two osteopaths have echoed this sentiment but also suggested that a conservative treatment approach could potentially be beneficial. They mentioned that this would involve regular fascia release and muscle strengthening, though I find that to be quite uncertain. Now, I’m at a crossroads: my faith in surgical intervention has waned, yet I remain doubtful about the efficacy of conservative methods. If these non-surgical options fall short, I could be facing significant complications soon. Adding to my personal conflict, I am an avid volleyball player. While I only play for fun and not in competitions, it's a big part of my social life, and I would be reluctant to give it up. At the same time, I am aware that volleyball can place considerable strain on the wrist, albeit I don't experience pain during play. I’m reaching out for insights from both medical professionals and those with similar experiences. **To medical experts:** * Do you believe reconstruction remains the optimal long-term solution? * Could conservative approaches succeed? Specifically, does there seem to be a chance that surrounding tissues might remain unharmed for the next few decades (I’m currently 33, so aiming for about 30 more years)? * Are there alternative treatments you could recommend? I realize my situation might be assessed with limited data, but any feedback would be greatly valued. **To those with personal experience:** * Did you opt for surgical reconstruction or conservative treatment? * Would you make the same choice again knowing what you know now? * How has your wrist functioned in day-to-day life? * How does it hold up during sports activities, especially those that heavily involve wrist movement (e.g., volleyball)? * When did your tear occur? Any insights would be immensely helpful!
Answers (1)
8/22/2025, 1:13:06 PM
OpenHealth AI
Main Points: You're facing a tough decision regarding your recurrent SL ligament tear. You have options between further surgical reconstruction or conservative treatment, but you're unsure which direction to take, especially considering your commitment to recreational volleyball and concerns about long-term wrist function.
Explanation: The SL (scapholunate) ligament is crucial for wrist stability, and tears can lead to long-term complications if not addressed appropriately. You've already undergone surgery, and now there's a new tear, which understandably makes you hesitant about another operation. While surgery can provide a definitive solution, conservative treatments may also help manage your symptoms, improve function, and maintain your activity level, especially in sports.
Next Steps:
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Explore Non-Surgical Options: Consider starting a structured rehabilitation program focusing on:
- Strengthening Exercises: Work with a physiotherapist to develop a tailored exercise plan that includes wrist strengthening and flexibility training. This can help support the surrounding muscles and potentially alleviate pressure on the ligament.
- Fascia Release Techniques: What your osteopath mentioned may involve techniques to relieve tension and improve mobility in the wrist. These can complement strengthening exercises.
- Activity Modification: Since you enjoy volleyball, you could adapt how you play, focusing on technique to mitigate strain on your wrist.
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Regular Monitoring: Since you're concerned about future complications, keep a symptom diary to track any discomfort or limitations during activities. This will help identify triggers and monitor progression over time.
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Engage in Shared Decision-Making: Speak openly with your healthcare providers about your fears and goals. They may suggest a trial of conservative management before deciding on another surgical intervention. Setting a timeline for reassessment can help you feel more comfortable.
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Informal Peer Support: Seek connections with others who have dealt with similar injuries, preferably in sports communities. Hearing firsthand experiences can provide additional insights and reassurance.
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Consider a Third Opinion: If you're still uncertain, consulting another orthopedic specialist might provide further clarity on the potential outcomes of surgery versus conservative management.
Your health and quality of life are paramount, and whatever choices you make, ensure that they align with your personal and activity-related goals. It's important to remain hopeful and proactive in managing your wrist condition. Please feel free to ask if you need further information on exercises or specific treatment modalities.
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