How to Deal with “Mommy Wrist”
“Mommy wrist” is another name for De Quervain’s Tenosynovitis, a condition that is characterized by pain and inflammation of the tendons on the radial side of the wrist/base of the thumb. New mothers are especially prone to this because of the sudden repetitive and overuse of the thumb and wrist while caring for their babies.
The two tendons most commonly affected are the extensor pollicus brevis (EPB) and the abductor pollicus longus (APL). These muscles combined contribute to radial abduction of the wrist, abduction and extension of the thumb.
Think of all the gripping, lifting, carrying, stabilizing and supporting the baby that is required with infants. The following thumb and wrist movements that tend to be overused with this condition:
Here are some tips to address painful symptoms. As always, it is recommended to see a physical therapist in person (or virtually) for an individualized program.
#1. Change your lifting technique
This is an overuse injury. With that, the most effective way to reduce pain and heal is activity modification, aka changing mechanics of your hands while caring for your child. Here are the most common situations that need modifications:
Lifting your child from the crib/carseat/bassinet under the armpits → instead: scoop hand under the bum and back of the head
Pushing stroller with thumb abducted (working hard to steer/stabilize) → instead: push with thumb tucked in
Holding child on your hip and using thumb to keep baby supported → instead: keep thumb tucked in and switch sides often
Supporting head or breast while nursing with thumb extended → instead: keep thumb tucked, use supports like My Breast Friend pillow, use two hands on breast instead of one, change positions to avoid a dominant side overuse.
#2. Splint the thumb and wrist
Splinting the thumb/wrist to decrease movement and provide external support during daily activities.
Here is an example of one I’d recommend on Amazon.
Wear as needed especially during painful activities that you have trouble modifying. I recommend taking the brace off throughout the day if pain is manageable.
#3. Do some physical therapy
See a physical therapist for manual therapy intervention (I love dry needling the forearm and hand for this) as well as an exercise program with stretching and strengthening.
Stretching: make sure there is adequate thumb and wrist mobility in all planes to avoid compensation from other joints.
Strengthening: this is the good part! In acute cases, it is recommended to start with isometric exercises into thumb abduction and thumb extension.
Progress to resisted movements of the wrist and forearm. Eventually add in grip strengthening exercises gradually increasing weight and intensity: farmers carries, suitcase hold, front rack holds, etc.
It’s always a good idea to strengthen up the chain as well: upper back, shoulder blades, and shoulders. Creating a solid base will offload the smaller joints of the wrist and hand during upper body movements. Exercises that are well tolerated with this are lat pull downs, rows, chest press, and overhead press because you can keep the wrist in neutral and maintain a light grip with your fingers. If dumbbells feel painful to hold, try using a cable machine or bands.
Ultimately, this can be such a frustrating injury because the “show must go on” as far as being a parent goes. Modify your activity as much as you can, get on a strength program, and you should see some improvement.
Again, I highly recommend seeing a PT for an individualized program in conjunction with some manual therapy techniques that can be helpful for pain relief.
