Mommy Thumb: What it is, why it happens and what to do about it
Imagine this: You are a new parent. You constantly use your hands to pick up your baby, hold them while they sleep or feed, put them down, hand them off to someone else, pat them, support their head, pick up the carseat and push the stroller. You are fine at first, but over the next few days and weeks, the base of your thumb and your wrist begin to ache. Every time you hold or pick up your baby, you feel a dull pain at the base of your thumb and in your wrist that begins to get worse. You think, what is happening to me?
To answer this question, we sit down with guest writer, Dr. Thuy Tran, an occupational therapist who specializes in hand therapy in Australia, to talk about one of the most common, but least talked about afflictions of parenthood: De Quervain’s Tenosynovitis or Mommy Thumb.
Can you share a bit about yourself, your professional and academic background? How did you get involved in upper extremity rehabilitation?
My name is Thuy (pronounced “Twee”), I am an Occupational Therapist with over a decade of experience specializing in hand and upper limb rehabilitation from Perth, Western Australia. I completed my PhD which focused on hand therapists providing a more holistic and person-centred approach to managing work-related Lateral Elbow Tendinopathy. Currently, I am balancing my many roles of being a mum to a 4-year-old boy and a 2 year old girl, research scholar, a university lecturer, and working clinically as an Accredited Hand Therapist in both the private and public sectors. Since graduating from university, I have always had a keen interest in hand and upper limb rehabilitation. We use our hands for everything! So, when an injury happens, you can really see the impact this has on a person’s ability to do what they love. It has been so rewarding, helping clients recover from all types of injuries, from minor sprains to catastrophic cases. My job is so rewarding, and the best thing is I get to teach the next generation of OT students.
In your experience, what common upper limb conditions do you see with parents? What are some common activities that cause these?
One of the most common injuries seen in new parents, especially mothers, is De Quervain’s Tenosynovitis also known as “mummy’s thumb”. De Quervain’s is characterised with pain and swelling on the side of the wrist which is aggravated when the thumb is extended and when the wrist is moved sideways. This common condition is caused by repetitive use of the thumb and wrist. Some activities that may aggravate these symptoms include lifting the baby when breast/bottle feeding, bathing, transferring the baby in/out of the car, in/out of the pram etc. All these movements require the thumb to be extended and when overused can cause the tendons to become inflamed. Other conditions we commonly see with parents include carpal tunnel syndrome, lateral elbow tendinopathy, extensor carpi ulnaris tendinopathy and medial elbow tendinopathy. All these conditions have risk factors associated with the way the upper limb is overused and positioned when performing daily activities.
Are there any resources that you recommend for parents who have upper extremity pain and discomfort?
Before we have a baby, we are exposed to so much information about the birthing process, and after we have a baby, we learn about feeding and sleep etc, but we rarely hear about the prevention or what to do if we have upper extremity pain and discomfort pre and post-partum. I suggest that parents who have any pain and discomfort in the hand and upper limb when pregnant or at any stage post-partum to seek advice from a certified hand therapist in their country. For example, here in Australia we have a directory for Accredited Hand Therapists and there is also one available in the USA (Therapist Directory | American Society of Hand Therapists (ASHT)). Hand Therapists may be occupational or physical therapists and will be able to provide parents with specialised recommendations in the management (such as splinting and physical therapy) of common upper limb injuries and also on preventative strategies (such as education on positions to avoid and use of adaptive methods) for parents to combat their symptoms. For example, in the case of De Quervain’s, as a hand therapist, I would discuss alternative methods of performing activities when caring for the baby to reduce the aggravation of symptoms. These recommendations include using a bath aid when bathing the child, using a pillow for support when breast feeding and to remind parents to “scoop” rather than lift with their thumbs out when carrying or transferring the child.
Can you share a story of a parent you have helped that sticks out to you?
One of my clients had twin babies and really struggled with her bilateral thumb and wrist pain (De Quervain’s tenosynovitis) which was caused by repetitive use. As a result, she was not able to lift her babies and care for them without severe aggravation of pain and swelling. Her husband was supportive but worked full-time and she didn’t have much family support. Being such a new mum and with everything else going on as you can imagine, this took a massive toil on her mental health. She would cry during our appointments, and I found that I wasn’t just providing her with hand therapy, but I was also listening to her story and trying to brainstorm how best we can manage this situation. I not only provided her with physical therapy, but took a holistic approach and together, we managed to come up with solutions on how to overcome these barriers.
In your professional opinion, is there anything unique about parenting with an upper extremity difference or injury?
Our role as occupational therapists is so unique, although we may work in different fields, we always take a person-centred and holistic approach to enable clients to do what is meaningful and important to them– it is the core of our profession. Therefore, in my experience, I believe that despite upper limb differences or injuries, if we work collaboratively with our clients to formulate goals relevant to them, we can almost always remediate and/or adapt the way they perform their meaningful activities. However, not all parents may know that there are hand therapy services available to help them or may not be able to access these services. I think these parents may struggle both physically and mentally if they are faced with an upper limb injury as this may hinder them to perform the daily tasks of parenting.
Anything else parents and families should know about you or what you do?
Since becoming a mum, myself four years ago, I have become intrigued with the process of matresence. I am really interested in researching further in the perinatal mental health of mothers and looking at how having a hand and upper limb injury may impact this journey. I hope to conduct research in this space in 2024. If you are a new mum and have an upper limb difference or injury, and may be interested in contributing to my research, please contact me at thuy.tran@ecu.edu.au
