Being a new mom you are constantly lifting your baby, from the crib, to feed, to change, back to feeding, back to changing…ALL DAY LONG. You're holding your baby to breastfeed and compromising your own position to make them comfortable. Baby falls asleep on you? Now you're stuck in an awkward position for a nice stretch of time.
This is a shock to your muscles and causes some of them to be overworked. De Quervain's Tenosynovitis is an inflammation of the muscles that move the thumb as they pass through a pulley system which is located in the wrist. This caused pain on the thumb side of the wrist. Constant use of these muscle can cause them to be stretched over a bone and become swollen, leading to further pain. Other changes that happen with pregnancy such as water retention, weight gain and hormonal changes can worsen symptoms as well. Think of how new moms pick up their baby- thumb side of your hand under your cuties armpits, which forces your wrists to be bent into ulnar deviation (pinky side of the hand going to the floor), doing this overstretches those muscles on the thumb side and further irritates everything- as you can see it's a pretty nasty cycle.
The finkelstein test is a way that doctors and therapists test for this diagnosis. To try this test, make a fist and tuck your thumb inside of the fist. Hold your elbow at your side, bent to 90 degrees with the thumb side of your hand up to the ceiling. Keeping hand and thumb in that fist, quickly bend your hand down towards the floor (like you are using a hummer) repeat this a few times quickly. If it causes pain De Quervain's might be your problem (just to be clear this test is not 100% definitive or accurate, as most tests aren't!). Check out our exercise guide for visuals on how to complete this or this video.
So, maybe you have DeQuervains? Rest is the best first step to help control the inflammation which would lead to further pains and problems. Try a Thumb Spica brace, this will help to hold the thumb and wrist in a good position to limit overuse of these muscles. Amazon braces not fitting great? A Certified Hand Therapist can make you a custom molded one to ensure the perfect fit.
Next, it is important to stretch that area, complete the finkelstein stretch gently and hold for 30 seconds, unlike when we used this as a diagnostic test, now it should be slow, controlled and gentle to slowly stretch out those tight muscles, not irritate them. Do this stretch as much as you can throughout the day. Additionally, start to massage your forearm. If there is a tender spot, keeping going! You’re in the right spot! Finally exercises will help to get everything strong, improve muscle balance. Download or print our exercise guide for free!
Finally activity modification is the most effective long lasting tip- be conscious of your wrist position when lifting and holding your baby. They to use your forearms for support as muscle as possible as opposed to your hand and wrist. Use pillows to help hold you’re baby when feeding to limit demand on the wrist. Bath time always the most painful part of your day? Wear a brace (as mentioned above) on your thumb and wrist to protect it just during that activity. And finally, ASK FOR HELP! It’s OK to need a break or help from a friend, spouse or therapist. WE ARE HERE FOR YOU.
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