Differential Diagnosis: Sprained vs. Broken Wrist

[montanarose]

OK, all you folks out there who "aren't a doctor but play one on skatingforums.com" . . .

This afternoon I fell while doing CW back crossovers. I still don't know
exactly how; it wasn't the dreaded "click of death" but all of a sudden I
was off my edge and on my butt. Well, actually, I would probably have been
better off had I been on my butt ;-) but instead I landed on my hip, left
arm outstretched and hitting the ice wrist first.

I skated another 20 minutes or so while the pain got progressively worse,
then finally got off and started icing it. I stopped on the way home to buy
an Ace bandage and have since alternated between the two while keeping my
forearm elevated as much as possible.

I am in rather excruciating pain (just took two naproxen so hopefully that
will help SOON) and my left arm is essentially useless. Although nothing is
obviously deformed, I do have some swelling.

I am assuming that what I have is "just" a terrifically bad sprain, but I am
wondering: how would I know if it was a broken bone, short of having an
x-ray which i will probably do tomorrow if it's not any better?

When I called my coach to inform her that I might miss my lesson tomorrw,
she said "you know, you can still skate with a broken wrist." Well, probably
so, but at this point I can't imagine pulling on my tights, lacing up my
skates or even, for that matter, fastening my bra ;-).

Thanks for any info,
Ellen (not bad for one-handed typing, eh?)

[TashaKat]

Get an x-ray!

When I broke my wrist (doing a BO3) the ONLY thing that 'told' me that something was wrong was a deep ache in my wrist (can't describe it but when people say that their 'bones' ache that's the nearest thing that I can use to describe it ... it wasn't a pain, it was a pulling ache) AND I grabbed my wrist (as though holding it together) and wouldn't let go! I don't know why I did this, my body obviously knew more than my mind 8-)

I could move my wrist up and down, it wasn't swollen and it wasn't bruised, it also wasn't and still isn't deformed (the rink kids were very disappointed that it wasn't obvious!).

I went along to casualty thinking that they would think that I was wasting their time. It wasn't until they threw heavy duty painkillers down my neck that I thought that perhaps something was REALLY wrong!

I didn't actually skate with my cast on. The doctor said to me that it was a 'good' break in that it had hardly displaced but that I stood the risk of displacing it 'properly' if I feel on it again. That made my mind up, I'd been 'lucky' and didn't want to tempt fate especially as the weight of the cast would inevitably throw my balance anyway. I do know people who have skated with breaks but I couldn't afford to cause more damage as I don't get paid if I don't work.

Oh, and I spent 6 weeks inputting data onto the hospital database one-handed so I can relate to the one handed typing! I have more problems with my non-bad hand (RSI!) than I do with the band hand :roll:

Good luck, I hope that it's ok.

[jazzpants]

Hi, Ellen!

I'm so sorry this happened to you!!! :cry:

I'm not a doctor and I don't play on on skatingforum (or RSSIR for that matter...) which is why my advice to you is not gonna be surprising: Get thee to a doctor PRONTO and insist on an x-ray to rule out that possibility! You never know these things unless you get an X-ray. And either route, you'll need a doctor get you thru the pain. So GO THERE ASAP!!!

Get well soon!!! (Sending healing vibes so you'd be back on the ice real soon.)

[TashaKat]

OK, all you folks out there who "aren't a doctor but play one on skatingforums.com" . . .

No, I don't 'play' one either. I am a Clinical Cardiac Physiologist so know a lot about cardiology as that is my speciality.

That really wasn't a very nice comment come to think of it!

[Thin-Ice]

I have no medical background, other than first aid.. but if it is still hurting, you need to get to a doctor and get an x-ray. I've seen several broken wrists in my ** years skating and every single skater has said "Oh I'll just wait to see how it feels in a day or two" and in almost every case, they were told when they finally went, "This would have healed more quickly and better if you had come here right away". :roll:

And anyway, some breaks heal faster than sprains.. so, you know you are injured: go get it checked out so you know what you really need to do for your individual case to heal the best it can.

Good luck!

[NickiT]

Awww...poor you. I'd definitely say it's worth getting it checked out at a hospital. The only way to tell if it's broken or not is with an x-ray.

Good luck and keep us informed.

Nicki

[sk8pics]

Please hurry up and get to a doctor to get this checked out. There is a bone in the wrist (whose name escapes me right now) that, if broken, may never heal properly if it is not treated properly right from the beginning. The blood supply to that bone can get screwed up and so the bone tissue can die. I know someone this happened to, and my cousin, who is an ER M.D., told me this as well.

So don't delay any more!

Pat

[rf3ray]

Yeah I Agree with everyone else, get it X-Rayed as soon as possible, I broke my wrist and I know the feeling that you are describing. Its best to get it checked out ASAP, btw I have 2 weeks left till my cast comes off, so you can skate if you did want too. But I noticed, if I didnt skate that often, I didnt really trust my skating, so the last coupla weeks I try to do 5 times a week skating :-)

:D :D :D

[Casey]

Please hurry up and get to a doctor to get this checked out. There is a bone in the wrist (whose name escapes me right now) that, if broken, may never heal properly if it is not treated properly right from the beginning. The blood supply to that bone can get screwed up and so the bone tissue can die. I know someone this happened to, and my cousin, who is an ER M.D., told me this as well.
Eeeek, that's scary stuff. I feel pretty stupid now though, because I landed on my wrist 2 months ago, and it still hurts if I bend it. It's not really painful or bothersome, so hopefully it's fine....but now I worry - I wanted to get an X-ray when it happened, but I don't have health insurance, and I'm sure they're quite expensive without.

In case this ever happens again, or for any others here who end up in a similar situation - how much do X-rays cost?


Good luck in your recovery, Ellen! I hope it's not too serious and that your recovery is speedy!

[Moto Guzzi]

I'm not a doctor but agree that you should get it x-rayed. Even if it's sprained instead of broken, the doctor can wrap it and make you more comfortable.

The very first time I fell when learning to skate, I fell exactly the way you described. I thought I had sprained my wrist because I could still move my fingers, and there wasn't much swelling or bruising. It kept getting worse as the hours went by, and I couldn't use my hand at all. When I went to work the next day, a coworker noticed how I was holding my wrist and told me it was broken and to get it x-rayed. Sure enough, the radius (the large bone) was fractured. It was in a cast for about six weeks.

A year and a half later, I broke the other wrist when I hit a rut while spinning and landed on my wrist. This time I knew right away that it was broken. I couldn't decide whether I was going to pass out or throw up and, fortunately, ended up doing neither. I was able to skate with my wrist in a cast but had to have the cast on longer the second time because another skater on our club session refused to wear her glasses even though she couldn't see without them and ran into me and knocked me down. Of course, I landed on my wrist and refractured it.

Good luck. I hope your wrist feels better soon.

[montanarose]

Thanks to all of you who responded to my inquiry. I'll be off to see a doctor tomorrow and get an x-ray; and will post here again to share what I learn. I've already read enough this morning perusing the internet to scare myself silly -- scaphoid fractures, navicular fractures, Colles fractures -- oh my! 8O

And TashaKat: I meant the comment about "not being a doctor but playing one" as tongue-in-cheek. For one thing, I do it quite often myself. :lol: Also, as evidenced by all the helpful replies above -- including yours -- I think that, unfortunately, we adult skaters learn an awful lot about our bodies and the myriad of ways we can injure ourselves. The good news is that people here are so willing to share their own experiences and advice to help each other. :bow: This is one case where "playing doctor" can be a very good thing!

(It also just occurred to me that this may be an issue of language usage . . . I can't remember whether or not you're from Canada or the UK, but this is a common American colloquialism, as in, "I'm not a lawyer but I play one on the radio.")

Cheers,
Ellen

[dbny]

Thanks to all of you who responded to my inquiry. I'll be off to see a doctor tomorrow and get an x-ray; and will post here again to share what I learn. I've already read enough this morning perusing the internet to scare myself silly -- scaphoid fractures, navicular fractures, Colles fractures -- oh my! 8O

Sorry to hear about your injury. Also not a doctor here, but play one all the time at home. Having had a Colles fracture, I can say that it doesn't sound anything like that. Having also had a cracked head of the ulna, I can say that the pain you are experiencing sounds like a broken bone to me. Glad to hear you will be off to the doctor tomorrow. Let us know the diagnosis!

[skaternum]

I feel pretty stupid now though, because I landed on my wrist 2 months ago, and it still hurts if I bend it. It's not really painful or bothersome, so hopefully it's fine....but now I worry - I wanted to get an X-ray when it happened, but I don't have health insurance, and I'm sure they're quite expensive without.Casey, you need to be particularly smart about stuff like this if you take up pairs skating. How would you feel if you were in the middle of hefting your partner over your head and the break you ignored snapped because it never healed properly and was a weak spot? 8O Trust me, there'll be lots of pressure on your bent arm in pairs!

[Skaternum's Nag of the Day] Grownups don't ignore pain. We get it checked out when it's appropriate. [/Skaternum's Nag of the Day]

[jazzpants]

Eeeek, that's scary stuff. I feel pretty stupid now though, because I landed on my wrist 2 months ago, and it still hurts if I bend it. It's not really painful or bothersome, so hopefully it's fine....but now I worry - I wanted to get an X-ray when it happened, but I don't have health insurance, and I'm sure they're quite expensive without.

In case this ever happens again, or for any others here who end up in a similar situation - how much do X-rays cost?Much more expensive than what you would pay for health insurance!!! :twisted:

Dude, if I were you, I'd get healthy insurance. What are you gonna do if you get one of those concussions while skating? (And believe me, in the many years I've seen skaters take a fall on the head, the majority of those who took a fall are male and tall!!!) I don't know about Seattle but here in CA Blue Cross PPO starts at around $150/month. Besides, I believe you can declare it as a business expense, since you are now self-employed and all!!! ;) (But check with a tax consultant first!) :)

[Casey]

Much more expensive than what you would pay for health insurance!!! :twisted:
Which is how much, precisely?

How would you feel if you were in the middle of hefting your partner over your head and the break you ignored snapped because it never healed properly and was a weak spot?
That's why I'm not skating pairs yet! I'd have to take a break from it if so. I can skate freestyle easily enough because I don't use my wrist. :P

[jazzpants]

Which is how much, precisely?

That's why I'm not skating pairs yet! I'd have to take a break from it if so. I can skate freestyle easily enough because I don't use my wrist. :PNot in you fall on your wrist again!!! :P

Depends on the health plan. The price varies widely!!! You could get a quote from this website: http://www.ehealthinsurance.com (http://www.ehealthinsurance.com/)

If you go to a doctor uninsuranced now, it will cost you at least $80-100 just to make a visit... and then there costs for the xray and cast...easily goes up to a few hundred dollars. But I'd rather you would have that "extra" cushion of having health insurance, so you don't have to worry about taking more spills like the one I saw in here: http://sk8rland.com/CaseyShobe003.3gp :P :lol: :twisted:

[bostonblizz]

http://www.oneshopinsurance.com they'll find you reliable and affordable quotes from known companies.

[crayonskater]

Casey, when I had an x-ray for a wrist that turned out to be just sprained about 14 years ago, it cost $375 dollars just for the visit and x-ray. That was at a hospital; check around in your area for walk-in clinics as they're usually cheaper.

If you can afford insurance (and you seem to be able to afford skating, so I'm guessing you've got disposable income..), find a plan. It will probably run you about $1700 a year for an HMO-style plan. It's easier to get insurance while you're young and low-risk, and even if you're in good health, accidents like broken arms, car crashes don't afflcit only the aged.

Depending on how you've structured your self-employment, you may be able to deduct it as a business excess.

To the original question, better to get it looked at than not. I wouldn't skate with a broken wrist, but I'm not training for the Olympics and I can go to the gym instead; perhaps if I were a competitive skater I'd feel differently, but risking a rebreak for a sport that I do soley for fun... not so much.

[liza]

http://www.oneshopinsurance.com they'll find you reliable and affordable quotes from known companies.

yeah, i checked on it. funny, i get to know what other companies are offering on the cost. :P

[flying~camel]

I sprained my ankle last week doing off-ice jumps and am SO GLAD I decided to go to the ER.

They took X-Rays and confirmed that it wasn't broken, plus they told me how to take care of it so it heals properly in a shorter amount of time.

[NickiT]

I sprained my ankle last week doing off-ice jumps and am SO GLAD I decided to go to the ER.

They took X-Rays and confirmed that it wasn't broken, plus they told me how to take care of it so it heals properly in a shorter amount of time.

I hope you heal quickly. I agree, it's always worth getting injuries checked out. When I sprained my ankle (ironically I did it on my warm-up before I even got on the ice!) I had physio on it and although it was very black and swollen, all the ultrasound etc really helped it to heal. I was back on in the ice in two weeks. I'm sure had I not got treatment, I'd have been off for at least a month.

Nicki

[TaBalie]

This exact same thing happened to me last week. Finally I went to the ER, and I was worried it was going to be nothing, but it turns out I broke a bone in my wrist and arm.

A sprain can be more painful than a break. In either case, you need to get it examined ASAP. I haven't skated since my break since I can't use my hand/wrist to lace skates etc etc.

[Skate@Delaware]

A young lady at our rink sprained her wrist-she resorted to having other people lace her skates for her. She hated to ask, but we didn't mind (although she liked them really tight!). She skated with a soft brace for about 3 weeks. After that, she still needed to have her skates tied for a few weeks more. She also worked there part-time, so they shifted her from ice-guarding to the counter (she really hated that).

Ya do what ya gotta do!

[emma]

I had the exact same fall working on gold moves. Fell very hard on my left hip and hit my wrist harder then i ever have,thought for sure i broke my wrist. My husband, who is a doctor, thinks i have a navicular fracture, which is a little bone in the wrist at the base of your thumb. It still hurts 6 weeks later but i did not see a doctor because i knew i would be in a cast even if the xray was negative. Something about wrist fractures not always showing up on xrays right away my husband said. It is painful to lift any heavy ojects and hurts when i fall on it but at this point seems to be healing on its own. I probably should have had an xray but its a little late now. I would not say i made the right choice but i am not in the amount of pain you seem to be in. Go get an xray,pronto.

[NickiT]

I had the exact same fall working on gold moves. Fell very hard on my left hip and hit my wrist harder then i ever have,thought for sure i broke my wrist. My husband, who is a doctor, thinks i have a navicular fracture, which is a little bone in the wrist at the base of your thumb. It still hurts 6 weeks later but i did not see a doctor because i knew i would be in a cast even if the xray was negative. Something about wrist fractures not always showing up on xrays right away my husband said. It is painful to lift any heavy ojects and hurts when i fall on it but at this point seems to be healing on its own. I probably should have had an xray but its a little late now. I would not say i made the right choice but i am not in the amount of pain you seem to be in. Go get an xray,pronto.

Certainly sounds like you had a scaphoid fracture. I suffered this back in September after falling on my wrist. At first I thought it was a bad sprain but there was this deep throbbing that I don't normally have with a sprain so four days after the accident I went for x-rays. I was told that I had in fact broken my scaphoid, put in plaster and given an appointment for the fracture clinic two days later. However when I saw the orthopaedic doctor at the clinic he was doubtful there was a fracture and said that they don't show up for two weeks usually anyway. So back I went two weeks later for yet more x-rays and this time the doctor could see the fracture so I was in a cast for over six weeks in all. Of course we did discuss the "what if's" - ie what if I hadn't treated it as a fracture and ignored it and carried on, and I was told that if I was lucky I'd be left with no problems and it would heal well, but normally because this is a very slow healing bone due to poor blood supply, the chances were that an ignored scaphoid fracture can lead to all sorts of problems with pain for years afterwards. Thankfully my wrist is feeling good now and I finally gave up wearing the splint for skating last week, but I do feel discomfort when I grip things and when I unscrew jars etc. My point is, I'd never leave any sort of injury without getting it checked if I had even the slightest doubt that it may be broken. Yep, six weeks in a cast is a pain in the butt, but better this than a lifetime of pain and problems!

Nicki

[sk8pics]

Of course we did discuss the "what if's" - ie what if I hadn't treated it as a fracture and ignored it and carried on, and I was told that if I was lucky I'd be left with no problems and it would heal well, but normally because this is a very slow healing bone due to poor blood supply, the chances were that an ignored scaphoid fracture can lead to all sorts of problems with pain for years afterwards.

Yep, that scaphoid bone can be a real pain! A family member of mine who is a physician told me once that if a scaphoid fracture is not treated properly right from the time of the injury it is likely to give you many problems for years after. For example, the bone can die because the blood supply is cut off as a result of the break. So do get it checked out if you have a bad fall on your wrist!

[russiet]

...My husband, who is a doctor, thinks i have a navicular fracture, which is a little bone in the wrist at the base of your thumb. It still hurts 6 weeks later but i did not see a doctor because i knew i would be in a cast even if the xray was negative. Something about wrist fractures not always showing up on xrays right away my husband said. It is painful to lift any heavy ojects and hurts when i fall on it but at this point seems to be healing on its own. I probably should have had an xray but its a little late now. I would not say i made the right choice but i am not in the amount of pain you seem to be in. Go get an xray,pronto.

Many years ago, when I was about 16 years old, I fell on an icey ski slope and banged my wrist really hard. It hurt , but it wasn't excrutiating. I just let it "heal". I thought it was a sprain.

Off and on over the years the wrist would occasionally bother me.

When I got to about 40 years old the wrist had less movement and would ache from activity, sometimes quite badly. At thar point I went to a specialist who determined that I had fractured the navicular bone in my wrist and it also HAD NEVER HEALED. Two bones for the price of one.

This caused a wierd geometry inside the wrist and caused uneven wear....yup, arthritis. If I try to catch myself with that hand while falling, the wrist aches for days.

Now, I was told that If I had done something about it sooner, this could have been avoided. I was also told that a dis-union of a wrist bone is not uncommon.

First, I should have had it looked at by a docter. That was my biggest mistake. There is a low blood supply to the bones of the wrist, so they don't heal as well as other places. Imobilizing the wrist right away would have given it a better chance. If that didn't work, the next step would have been to pin the bone back together.

By the time I reached 40, the uneven wear was to such an extent that not much could be done. I'm 50 now and I really regret my neglect. I've got a lot of life left and a bum wrist to go with it.

If your wrist (or any other part of your body) is giving you pain, go to a doctor. Get a referral to a specialist if you need to. You may spend what seems like a great deal of money, but with my hindsight I'm telling you that its cheap for what you may loose over the remaining years of you life.

There, that's my sage, aging-athelete opinion.

Jon

[Casey]

I had the exact same fall working on gold moves. Fell very hard on my left hip and hit my wrist harder then i ever have,thought for sure i broke my wrist. My husband, who is a doctor, thinks i have a navicular fracture, which is a little bone in the wrist at the base of your thumb. It still hurts 6 weeks later but i did not see a doctor because i knew i would be in a cast even if the xray was negative. Something about wrist fractures not always showing up on xrays right away my husband said. It is painful to lift any heavy ojects and hurts when i fall on it but at this point seems to be healing on its own. I probably should have had an xray but its a little late now. I would not say i made the right choice but i am not in the amount of pain you seem to be in. Go get an xray,pronto.
Hi Emma,

Would you mind telling me a bit more about the Navicular? My wrist injury which hurt me for several months seems fully healed at this point, however my left thumb started hurting at the base joint a couple months ago, and it hasn't eased up at all. It doesn't usually bother me too much, but it's a constant annoyance, so I try to avoid using it. Sometimes it's releiving to press the bottom portion of the thumb inward towards the palm. Does this sound like what you're talking about?

It's been a couple months, and no way can I afford an X-ray or health insurance...I'm really hoping this is something that can heal up on it's own. Funny thing is, that unlike the wrist injury, I have no idea how it happened. I just woke up one day and it hurt.

[emma]

Hi Emma,

Would you mind telling me a bit more about the Navicular? My wrist injury which hurt me for several months seems fully healed at this point, however my left thumb started hurting at the base joint a couple months ago, and it hasn't eased up at all. It doesn't usually bother me too much, but it's a constant annoyance, so I try to avoid using it. Sometimes it's releiving to press the bottom portion of the thumb inward towards the palm. Does this sound like what you're talking about?

It's been a couple months, and no way can I afford an X-ray or health insurance...I'm really hoping this is something that can heal up on it's own. Funny thing is, that unlike the wrist injury, I have no idea how it happened. I just woke up one day and it hurt.
Hi Casey, ,The navicular bone is i believe also called the scaphoid bone and is easily broken by a hard a direct hit to your wrist in a palm down position. I hit mine falling at full speed doing power crossovers. In hind sight i should have had an xray and actually will do that next week. My husband told me lack of blood supply and repeated falls onto the wrist can lead to lots of problems including surgery on the wrist for bone grafts etc. Sounds as if a cast is much less of a deal and lots less expensive than surgery. I will let you know the out come. i dont think an xray and cast is that expensive but i do have health insurance so most will be taken care of.

[kia]

THe scaphoid bode is at the base of the thumb. If you press where there is a little dent and it hurts you probably have broken the scaphoid. That is the bode that most often dies from damage to its blood supply in wrist injury.

[emma]

THe scaphoid bode is at the base of the thumb. If you press where there is a little dent and it hurts you probably have broken the scaphoid. That is the bode that most often dies from damage to its blood supply in wrist injury.
that little dent is known as the anatomical snuff box. When your scaphoid or navicular bone is fractured it should hurt when pressed on but it doesnt always, as in my case the pain is not in the anatomical snuff box but on the palm side at the base of my thumb. Fractures are funny things they dont always follow the rules.

[NickiT]

that little dent is known as the anatomical snuff box. When your scaphoid or navicular bone is fractured it should hurt when pressed on but it doesnt always, as in my case the pain is not in the anatomical snuff box but on the palm side at the base of my thumb. Fractures are funny things they dont always follow the rules.

Yep, when the doctor pressed on that point when I broke mine I nearly hit the ceiling! Honestly it was very tender and it made me shoot up out the chair!

Nicki