Episode #53: Tips for dealing with wrist and thumb pain postpartum
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In this solo episode, Dayna talks about something that has been coming up in clinic a LOT recently - wrist pain. What is mom wrist? Why do we get wrist pain in postpartum? What are some things we can do about it in the short term - and what can we expect in the long term?
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SHOW NOTES:
(1:02) - What we are talking about today!
(4:06) - Tip #1: Pay attention to how you are using your wrists in a day
(7:21) - Tip #2: Ice
(9:30) - Tip #3: Gentle wrist stretches
(13:00) - Rundown of the tips given so far today!
(13:49) - Tip #4: Try a Spica splint
(16:39) - Wrap up
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Episode #53: Tips for managing wrist and thumb pain postpartum
We're excited to have you join us for this episode of Pelvic Health and Fitness. I'm Dayna Morellato, Mom, Orthopedic and Pelvic Health Physiotherapist. And I'm Rhonda Chamberlain, Mom, Orthopedic Physiotherapist and Pre Postnatal Fitness Coach. On this show, we have open and honest conversations about all phases of motherhood, including fertility, pregnancy, birth, postpartum, menopause, and everything in between.
We also provide helpful education and information on fitness, the pelvic floor, and many aspects of women's health, including physical, mental, and emotional wellness. Please remember as you listen to this podcast that this is not meant to treat or diagnose any medical conditions. Please contact your medical provider if you have specific questions or concerns.
Thanks so much for joining us. Grab a cup of coffee. Or wine. And enjoy!
Hello and welcome to the pelvic health and fitness podcast. It's Dayna here today, just doing a solo episode. I have had a lot of, um, wrist pain coming up in clinic lately. And so I thought I would pop on and do a quick little recording on what is mom wrist? Why do we get wrist pain, particularly speaking in the postpartum period?
And what are some things quickly that we can do about it sort of in the short term? What can we expect in the longterm? So I'm not speaking to sort of carpal tunnel that is very common during pregnancy and definitely can linger or maybe even come up postpartum. What I'm speaking more to today is pain in the wrist and it can be felt sort of on the front or back or, you know, uh, kind of into the arm a little bit, particularly with any sort of gripping.
So it can be picking baby up or holding baby. I noticed it comes up a lot with that sort of, um, I call it the hamburger hole part of me, lactation consultants. Um, but the, the whole that we sort of are taught to hold the breast when we're breastfeeding where we're, we're, you know, if you're watching a video, you can see me sort of.
Like you're holding a sandwich or a cookie upside down a cookie, a sandwich or a hamburger upside down. Um, and it can come, the pain can come from over activation or overuse. It is an overuse injury and it strains some of the muscles that control the thumb that sit higher up in your wrist, along sort of the side of your, your wrist on the thumb side.
The fancy name for this is deQuervains. DeQuervain’s tenosynovitis. And it is sort of like a carpal tunnel in that the muscles, two of the muscles that control sort of the thumbs up, or if you were to make a C between your, your, um, index finger and your thumb with your hand, that sort of movement of your thumb is, they sit higher up in the wrist and the tendons of them are long and thin, and they travel through a rigid piece of tissue or fascia.
Just before entering our hand and it's not. Really great design are these muscles are not really meant for the kind of strain that comes from being a human to be honest, but certainly with the amount of gripping and fine motor skills, you know, doing up little snaps and zippers and onesies. And like I said, sort of always in these awkward postures when we're holding our babies and our wrists are cranking cranked underneath their bums and we're holding a breast during breastfeeding.
can put a lot of strain and inflammation begins and inflammation causes pain. Now the tricky part with this, um, particular strain or tenosynovitis, which is a fancy word for inflamed tendons, is it can be quite acute. It can be quite severe when people feel it and it can be quite long lasting. Um, so if this sounds like something that you are experiencing, You might find some of these following tips to be helpful.
First and foremost, we sort of want to pay attention to how you're using your wrist in a day. And I realized that, you know, if you're in the depths of newborn, fatigue. This is going to seem like something else that you sort of have to figure out. But a lot of times when we're holding babies in the earlier stages, we've got our wrists sort of cranked under them.
If you're watching the video, you can see what I'm doing, but we don't have this nice long straight line from our elbow to our wrist. Our wrist is often bent and maybe even rotated to support baby. Often throughout the day and that can put a lot of tension in and around these tendons as they come around.
We're inadvertently holding a lot of tension in our thumb. Um, it can come like I said from that, that hold of the breast that's often sort of coached, um, for proper breastfeeding. It can come, like I said, from doing all the fine motor tasks, you know, you're sort of doing all these little snaps and buttons up all day long, the stickies on the diapers, and it sort of accumulates into this inflammation.
So I just encourage people to think about your wrist position when you are holding baby, particularly if you are noticing that strain in the moment, just think about straightening your wrist out a little bit. So we've got baby or, Supported on an arm that sort of has a more straighter line from your wrist to your elbow rather than any sort of flexion or bend in the wrist.
Um, I encourage you to speak with any lactation consultants or people sort of in in the feeding realm. to troubleshoot some other positions for breastfeeding or even ones that you can sort of throw into the mix so that you maybe don't have to use the same strategy every feed, particularly in the newborn stages.
If you're doing that several times a day, I, to be honest, forget even how many times a day it is because it feels just sort of constant. Then having even a strategy that gives us a break from that sort of typical hold sometimes that can still be effective for feeding can be a really, really big help. Um, using like zippers instead of a bunch of the snaps, which I don't know why all those snaps exist on onesies anyways, but using little zippers and things like that, just being paying attention to how you sort of use your wrists in a day and trying to adjust.
If and when you do feel pain for me, I used to have this very strange habit of sort of using my thumbs to always loop under baby's pants. when I was changing diapers and I would be pulling their pants down with only my thumb. So, and I developed this. So physios, we are not exempt from feeling these aches and pains.
And it was really troubling to sort of get to settle and it can really, um, make it feel like your wrist is very weak and sore every time you lift and carry your baby. So just getting really aware of when you notice the pain and trying to adjust, always thinking more straight wrist, trying to avoid that sort of repetitive grip between your hand and your thumb or your fingers and your thumb ice.
Ice, ice, ice. Um, obviously we want to protect the skin, but this is an overuse injury. It does have a larger degree of inflammation that can be associated with it. So using a good old bag of frozen peas on your wrist a couple times a day, sort of for 10, 10, 15, 20 minutes at a time can really help get on top of some of that inflammation.
And particularly after baby sort of settled or your partner's home and you can have a little bit of a break at the end of the day before you go to bed, especially if you're starting to find that some of that ache is really bothersome and interrupting your very precious sleep. We want to make sure we're getting some ice on that.
Heat isn't wrong. I often get asked, can I put heat on? I hate ice, especially at the time of this recording at St. Patrick's Day, which is why I'm wearing green, if you can see me. Um, I like green. It's not why I'm wearing green, but I mean, I made a special effort today. Um, but anyways. Where was I going with this?
Right. It's the middle of March. So a lot of people don't love ice because, you know, it's lingering winter and things like that. But I think that ice, especially for decorating should sort of be in the mix, but it's not wrong to use heat, especially if you get, if you put some heat on it and you notice that you get some relief, we get a lot of blood flow to the area for healing.
Um, it can release some muscle tension and just sort of feel nice while it's on. It's also not wrong to alternate between the two. If you're doing sort of 20 minute. Sessions you've got set aside in the earlier part of the day in the later part of the day, you can put some heat on for about 10 minutes and then put some ice on there after and we get a little bit of a pumping action, uh, of the blood vessels, which can help recirculate some of that inflammation that may be hanging out now, obviously.
I don't know you personally. If you are reactive to ice or heat, then choose the one that you're not reactive to. Always protect your skin, um, with towels so that you're not burning or getting frostbite and watch for signs of that. It should feel like you're getting a soothing effect. It shouldn't hurt you.
Okay. Um, Some gentle wrist stretches, as simple as it sounds, good old fashioned range of motion, so if you can think about taking your wrist sort of up and down, bending it back so that your fingers are coming back towards the back part of your forearm, and then bending it forwards. As you're thinking about bringing your fingers towards the front part of your forearm, um, can be really nice and soothing, gentle range of motion of the thumb, thinking about giving a thumbs up, maybe even bringing your thumb across to stretch across your palm to tap your pinky and your ring fingers, just to stretch out those muscles on, in the wrist that are involved.
Sometimes, depending on how acute you are, a stretch that will be given will be to, um, fold your thumb in under your fingers. So you've sort of made a fist with your hand, but with your thumb in the middle and gently take the hand down towards the pinky. Now, I will caution you with this one. This is the test that we sort of use to, um, help us come up with this clinical diagnosis of tenosynovitis.
So it can be very painful. And I tend to caution against giving this stretch. It is one that is commonly out there, but if you get into that position and you notice it's really, really sore, I tend to err on being a little bit more gentle, nice, strong elbow, bring your hand I'm too close to the computer.
Bring your hand back again. So your fingers are sort of coming back towards the, um, back part of your forearm and gently stretching out your wrist, uh, flexors, which actually lie between your wrist and your elbow and the opposite way, taking your fingers down towards the front part of your forearm to stretch out the extensors, which are on the back part of your forearm between the wrist and the elbow and gently just stretching out the forearm.
Um, muscles a little bit more generally first, and if that helps and feels good after a couple days or weeks, when you start to notice that that pain is settling a little bit, you could try that thumb in fist stretch and see if it gives you any relief from there. I also generally will have people do a little bit of foam rolling.
If you have a foam roller. You can gently roll the muscles of your forearm. There is just a lot of physicality in motherhood. I say this all the time. Certainly we talk about it more sort of related to the pelvic floor, usually in this podcast, in terms of load on our bodies, but you are constantly lifting and carrying and changing small humans.
And that's a lot of wrist and handwork as well. And so, as I said, your, your forearm. Uh, muscles between your elbow and your wrist on either side of your forearm, the front and back, do most of the movements of your wrist and travel into your fingers. So by using a foam roller and rolling out those groups of muscles gently, You can start with, you know, 30 seconds to a minute and each muscle group on each side can help reduce some of the tension in the muscles and the connective tissue that overlies these muscles and could give you some relief into that wrist, um, so to prevent pain, um, because it's, it's painful.
Sorry, I'm having a bit of verbal diarrhea. It is March break here. So I'm home with my kids. Forgive me. Um, okay. So as I said, we're going to pay attention to positions and notice anything that is really troubling, painful, try to adjust keeping that nice straight position of the wrist as much as possible.
Obviously life happens, but trying to adjust accordingly, using ice and or heat. Um, I tend to promote ice, especially if it's really acute or it's come on, uh, recently, but heat isn't wrong. Especially if you are sort of have any conditions where ice is not comfortable for you, or you find that it's worse, you could try some heat.
We want some gentle wrist stretches. So range of motion of the wrist in general, we can use a foam roller on the muscles that control the wrist and hand that lie up in the forearm. And we can do some gentle stretches of those muscles as well. And the last thing that I usually recommend for people, especially if you find that this condition has been going on for a while, or it's really quite painful for you is you could try a Spica splint.
They are available over the counter so you can get them at Shoppers Drug Mart. And I encourage you to, you could even chat with a pharmacist while you're there. But the, yes, I asked you not to come get me because I'm recording a podcast. Okay. Well, I'm a little late. Okay. Thank you. If you're editing this, obviously edit that out.
Thank you. So you can go and get a Spica splint, which is available over the counter, just at Shopper's Drug Mart. If you're here, if you're in Canada, um, Walgreens in the States. I don't know, pardon me if you're international, um, any sort of local, uh, place that has just splints in general that you can use, Amazon, a Spica splint goes over the wrist and it comes up and it blocks most of your movement of your thumb.
So if it's more of a typical carpal tunnel brace where the thumb is free to move in all of its directions, it's not going to help with this particular. Uh, condition that we're talking about. That spica splint has to have the brace come right up the thumb. Um, it is not comfortable. It is a pain in the butt and I often tell clients of mine that they will be cursing my name.
Goal please, I'm recording. I need five minutes, okay? Five minutes. Hi, okay, you've told on Cara. Thank you very much. I heard it. I will come deal in a second. Okay. I need five minutes.
Okay. So the brace has to come up the thumb and sort of block that thumb movement in order to restrict some of the strain in the wrist for the muscles that control that thumb. Um, uh, they're not comfortable. They are, I often tell clients that they will be cursing my name a little bit, but they can be massively helpful in helping to reduce some of that inflammation and thus pain.
You want to try to wear it for the majority of the day, especially if you're pretty acute, obviously take it off to wash your hands and give yourself a little bit of a break if you need to. But I tell people to put them on and wear them pretty consistently for two to four weeks until you start to notice that that pain comes down.
I'll be doing the other things as well in the background, the ice and heat, being aware of risk position, um, and the exercises when you're out of it. And hopefully That will help reduce the strain. It can be quite acute and turn even into chronic, meaning it lasts more than that six to eight weeks for some people.
Um, it does tend to be self limiting for most meaning that as you sort of move through that period of time, it will sort of hit a peak and then decrease. Whether in motherhood, that's because we sort of, you know, our babies get older and it isn't as intense. We've got a little bit more bandwidth, our bodies have a little bit more bandwidth for, uh, healing because it's something else that we have to heal on top of recovering from, uh, you know, the marathon pregnancy and delivery, or it's just inherent in sort of the inflammation process.
All of those things are possible in anywhere in between, um, in terms of, you know, combination, but it does tend to be pretty self limiting. If you are sitting sort of beyond that three month mark when you're listening to this, and you've tried all these things, or you go and you try them, I always encourage you to check back with your doctor.
They can refer on, um, if there is anything else that can be done. Um, but I'll leave that with you. Hopefully you found these tips helpful. Um, and you're having a great March break or just a great day depending on when you hear this episode and we'll see you soon.
Thanks for listening to today's podcast. We hope you enjoyed the conversation. If you liked what you heard, we would love if you could share this with a friend, leave us a review, or subscribe to anywhere that you listen to your podcasts. Thanks for being here.
