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PrintNew mums: Pain in the thumb?
Its common knowledge, that pregnant women and new mothers are prone to experience low back pain. Lots have been said to why, and such women have successfully been treated with strengthening exercises to stabilise the pelvis.
However did you know that pregnant women and new born mothers were also prone to wrist and thumb problems?
Carpel tunnel is widely recognised as a problem experienced by women antenatally and postnatally. This condition arises due to an increase in the blood volume circulation and swelling commonly experienced during pregnancy.
The carpel tunnel itself comprises of the bones and ligaments that form a canal at the base of the hand and as the median nerve passes through this, it can be compressed and impinged.
The median nerve gives sensation to the thumb, the index, middle, and half of the ring finger and is responsible for movement of a muscle at the base of the thumb. Pressure on this nerve can therefore cause a loss of either sensation or strength in these areas.
In addition Deqeurvain tendonitis is also seen during the last trimester of pregnancy and in new mothers. In fact some statistics have suggested that 50% of new mothers will experience these symptoms and the older the new mother (40 plus) the more likely. An increase in the incidence of dequervain also relates to the increase in the weight of new born babies over the last 30 years.
This condition involves irritation to 2 muscle tendons that mobilise the thumb causing pain with pinching, grasping, lifting and other movements of the thumb and wrist.
The root cause of this problem in the pregnant clientale is believed to be due to the repetitive and frequent improper lifting and cradling of the child.
Improper lifting and cradling
As a mother bends down to lift her child she often places her thumb under the child’s armpit. In doing so she put a lot of strain on the thumb joint and muscles. This is a movement that is often done repetitively and for a long period and from various heights (floor to standing, cot to standing). As the child continues to grow and gets heavier the strain may potentially worsen, causing inflammation, waekening and scarring to the tendon.
Also whilst cradling the child, some mother will use an L shape index finger and thumb to cradle and support the child’s head. Again overstraining the tendons of the thumb leading to the above problems.
Save your thumbs
New mothers could place their hand around the ribcage of their child and gently squeeze as they lift the child. This will alleviate the pressure exerted on the muscles of the thumb.
Alternatively supporting the child from the bottom and behind the head to lift the child can also reduce the pressure on thumbs.
Have a read of the carpel tunnel and Deqeurvain tendonitis articles for more informarmation about these conditions and physiotherapy treatment options to help your hands.
Carpal Tunnel Syndrome Video
In the earlier article on Carpal Tunnel Syndrome, we have shared on the causes and management of the condition. This following video will give you a better visual understanding on what is going on in our wrist when CTS happens.
Wrist Sprain – a common wrist injury
Wrist injuries are extremely common injuries. Typically they occur as the result of falling and landing on the wrist as you attempt to break your fall. This causes a traumatic injury to the ligaments and other soft tissues surrounding the wrist.
What is a wrist sprain?
Sprains occur when the wrist ligaments are forcefully stretched into positions beyond their normal limits. A ligament is strong, fibrous tissue or band that limits and controls the motion at a joint. Ligaments around the wrist joint stabilize the position of the hand and allow movement and weight bearing through the upper limb.
Sprains can be considered
Ø Grade I: Mild injury – wrist ligaments are stretched, no rupture.
Ø Grade II: Moderate injury – wrist ligaments partially ruptured.
Ø Grade III: Severe wrist sprain – wrist ligaments are completely ruptured and the wrist may be unstable.
Who is at risk?
Wrist sprains tend to occur after falls. Wet weather may cause slippery surfaces leading to increased numbers of falls. Sprains are also very common in sports such as football, rugby, basketball, skiing, snowboarding, rollerblading etc. The elderly population who are more prone to falls are at greatest risk or serious wrist injuries.
Signs & Symptoms of a wrist sprain?
Pain with movement of the wrist
Swelling at or around the wrist joint or into the hand
Bruising of the skin at wrist or into the hand
Tenderness over the wrist
Burning/tingling/pins and needles at the wrist or into the hand
Reduced function particularly with weight bearing and gripping activities
Diagnosis can be made by piecing together the mechanism of injury to the objective physical findings. There are several other conditions including wrist fractures and or tendonitis which can present similarly to wrist sprains.
An X-ray is important to exclude any possible fracture at the joints. In severe cases an MRI will be useful in determining the extent of ligament soft tissue damage. MRI can also be effective at determining a precise diagnosis if the wrist is failing to heal after the initial diagnosis is made.
Hand Infections
When discussing about sports injury, we tend to focus on the big traumatic stuff like fractures, broken bones, dislocations, torn ligaments or massive swellings. Minor injuries are often brushed off especially with the more physical contact sports. After all, isn't discipline and perseverance part of the game?
As a result we tend to overlook hand infections, particularly lacerations (cuts and grazes) and for the more contact sports, bite wounds are not uncommon.
Lacerations
Cuts and grazes to the hands and fingers are a common occurrence in sports as a result of accidental contact with equipment, playing surfaces and between players or participants.
All cuts and grazes have the potential to become infected and should therefore be taken seriously.
Standard practice should be wash and clean all cuts and grazes hygienically with antiseptic solution monitored carefully for a number of days for any signs of infection.
If an infection develops the following signs symptoms may be present:
- severe , throbbing pain
- fever
- movement of fingers reduced with pain
- swelling and redness in the hand
If two or more of the above signs and symptoms are present then the risk of an infection is high and you should immediately report to the nearest doctor or hospital.
Bite Wounds
Skin of the hand broken by human teeth is a particularly dangerous wound. Human saliva contains such high levels of bacteria that these injuries should always be presumed to be contaminated. Skin is broken either from a punch to the mouth or a bite wound.
It is highly recommended that a course of a broad spectrum anti-biotic be administered by a doctor immediately and the wound not covered over or closed.
Why taken lacerations and bite wounds seriously?
Because due to the continuity of tendons of the hands into the wrist and forearms, infections can spread rapidly if not treated. Consequences can be highly destructive and hand infections frequently require hospital admissions for more specific anti-biotic therapy and or surgical intervention. In serious cases the tissue can become necrotic and die.
So please do take these sometimes rather innocuous and minor wounds seriously and seek medical treatment immediately if required.
Carpal Tunnel Syndrome
You’re going about doing your everyday work when you notice yourself shaking your hand to get rid of the tingling in it. It’s starting to really bother you because you’ve had the tingling at night too. You’re probably wondering if it’ll go away on its own. Does this sound like you? You might have Carpal Tunnel Syndrome. (more…)
Wii Right, Wrist-Wise
Wii Gamers often complain about wrist injuries. Here are some exercises and holding technique that Wii gamers can follow to better protect themselves from Repetitive Strain Injuries (RSI).
DeQuervain’s Syndrome
Do you have pain on the outer side of your wrist during several activities such as cooking, lifting a bag, and playing music? You might have DeQuervain’s syndrome. Also known as DeQuervain’s tenosynovitis or washerwoman’s hand or mother’s wrist, it is a condition which affects women more commonly.
Trigger Finger
Trigger finger or ‘stenosing tenosynovitis’ is among the top five causes of disability in the hand. It presents with pain and locking of the fingers and is due to pathology of the tendons and tendon sheath. Interestingly it commonly affects two very different age groups, children under eight and adults(more common) in the fifth and sixth decade. (more…)
