Of all the things the baby care books warned you about, they likely didn’t tell you about de Quervain’s tenosynovitis, or “mother’s thumb.” It’s a painful overuse injury of the thumb and wrist that moms can develop from repeatedly lifting the baby (or babies, or baby and a toddler). Here’s the deal: You can prevent it, and you can relieve its symptoms without cortisone injections, which can weaken muscles and soft tissue in the injection area.

What is de Quervain’s Tenosynovitis?

What’s the real story? De Quervain’s Tenosynovitis is inflammation of the tendon that moves the thumb. This tendon, called the abductor pollicis longus, extends from the forearm, across the wrist and onto the back of the thumb, allowing you to pull your thumb back, like a hitchhiker. Another tendon, called the extensor pollicis brevis, is connected to it at the base of the thumb. Together, they help extend (abduct) the carpometacarpal joint that moves the thumb – think as if you were giving your partner a thumbs up for being able to sleep through the night.

Bottom line: When you pick up your baby under their arms, you use these tendons to extend your thumb back – over and over and over again, putting strain and weight on the wrist and thumb. When tired new moms pick up their babies with fingers downwards, the tendon is fully stretched causing major overuse. This can lead to de Quervain’s tenosynovitis, where both tendons become overused, causing inflammation. Though it’s often referred to as “mother’s thumb,” the condition can also affect golfers, tennis players, and people texting too much.

Symptoms of de Quervain’s tenosynovitis can include a shooting pain in the wrist and back of the thumb, swelling, weakness, restricted movement, and difficulty lifting things – even small items like a coffee mug, let alone a baby. Multi-tasking with the affected thumb, perhaps lifting a baby and cleaning and texting (ahem), can worsen symptoms.

A quick way to self-check to see if you have de Quervain’s is to put your thumb into the palm of your hand, wrap the rest of your fingers around the thumb and then point your hand and thumb down towards the ground with a straight arm and elbow. If there is any pulling, sharp pain in the thumb or wrist then you have irritation of the tendon and the sheath around the tendon.

How is de Quervain’s Tenosynovitis treated?

For temporary pain relief of de Quervain’s tenosynovitis, you can use a splint or brace, which gives the tendons a chance to rest by keeping the thumb from extending. This is a great initial option when the pain is intense and you are having trouble even lifting your baby. But don’t use this as a crutch long term because the lack of use will lead to a loss of strength and mobility.

That’s not all. Icing can reduce inflammation. Try placing a bag of frozen peas on the affected hand for 20 minutes a day. You may need to place a towel between the bag and your hand to protect your skin from the cold. Make sure to ice for 20 minutes on and an hour off – more than 20 minutes will increase the inflammation.

At Urban Wellness Clinic, we use stretching to increase flexibility in the forearm muscles that can be tight from all the lifting of the new baby, thereby promoting faster healing. We use Active Release Technique, the gold standard in soft tissue massage, relieving tightness in the forearm to improve mobility and blood flow in the tendons. This is key to pushing out the inflammation in the wrist and every woman we’ve seen has had great relief with this approach. We go even further to address the mobility in the midback and the chest, which can become tight by repeated hunching (while carrying that baby). We are careful not to affect nursing breasts, which can be tender to touch.

This is one half of the puzzle, massage and getting everything loose. The second step is getting the shoulders and core strong and stable. If this piece is not addressed then the mommy thumb will come back quickly. We do this by teaching new moms how to move and stabilize their core like they learned the first two years of life. These movements include laying on our back with our knees up at 90, rocking in hands and knees, crawling and breathing in a half kneel stance. You would think this weight on the hands and wrists would irritate the area but actually helps strengthen the wrist with proper biomechanics.

What mechanics are we looking for? If you were on hands and knees, spread the fingers and root the index knuckle down toward the ground. This helps turn on the serratus anterior, an essential shoulder stabilizer. Get long through the back of the neck and a soft chin. Push the floor away as you point your elbow crease towards your thumbs. Now breathe for 10-15 breaths. New mamas feel amazing results in the spine and posture with this single exercise.

I can’t emphasize this enough. We teach good lifting mechanics, helping you engage your core, which can become weakened during pregnancy and birth. Before you lift, take a breath, gently brace yourself, and lift from your legs, not your abdomen. We provide one-on-one guidance based on our BIRTHFIT program, a postpartum class designed to help you establish a solid core foundation, awaken your posterior chain, and improve posture to offset the physical demands of early motherhood.

Some women believe you need a cortisone injection to relieve pain. But these injections can weaken muscles and soft tissue, leading to atrophy, or weakness. There are alternatives to shots to consider first.

Good Belly Breathing Helps After Birth

Why does this matter? It’s estimated that 90 percent of mothers experience problems with breathing after birth. After all, your breath competed for space with a baby for upwards of nine months. We help moms relearn how to ensure that your body receives the oxygen it needs to meet the demands of motherhood while activating spinal stabilization, which is important for proper lifting. Remember, you lift your baby repeatedly throughout the day, putting strain on your body.

You can achieve good belly breathing by first fully exhaling, then breathing in through the nose, filling the belly with air and expanding it outward 360 degrees. Exhale through the mouth and repeat, keeping the lower ribs expanded outward.

Reposition During Breastfeeding

How you hold your baby during breastfeeding can aggravate de Quervain’s tenosynovitis. If you use the traditional cradle hold or the “football” hold, support your forearm and the baby with pillows. Or try lying on your side and allowing the floor or a bed to support the baby during feeding. A baby sling can also help do the work that your forearm typically does during nursing.

If you have mother’s thumb, we are here to help! We’ve seen hundreds of women with this condition recover naturally.

Contact us today at 212-355-0445 or email us at hello@urbanwellnessclinic.com. We’re here for you!

Best in health,

Dr. Emily Kiberd