Tendonitis…from having children?

Yes, today’s tendon topic concerns tendon problems that can come with having a baby.  I admit my title is slightly misleading; it’s not bearing the child that actually causes tendons to become painful (not the ones I can help you with, anyway), but afterwards there is at least one type of chronic tendon condition that is specifically associated with parents and newborns.  Naturally, it’s the parents who get it.

So what is this mystery condition?  It’s called de Quervain’s syndrome, and it has to do with your thumbs.

What happens is this: parents welcome a small new member of the family with (literally) open arms.  And at first there isn’t any problem.  The baby doesn’t weigh much and can’t move around very well.  But then that little guy or gal starts getting bigger.  And soon, s/he starts becoming mobile.  Even before the crawling stage, babies develop the ability to squirm around pretty violently, and will often do so when being picked up or held. And they have no idea that they might be causing someone else pain.

So here’s the scene: you pick your baby up. The standard grip is under the armpits, thumbs in front and fingers around the baby’s back.  The child squirms a bit, and twists in a way that puts unusual pressure on one thumb or the other.  Do this a few dozen times a day for weeks and months on end and you’ve got a perfect environment for a repetitive stress injury to occur.  In this case, it happens to a couple of the tendons that attach to the thumb.

If you want to see which tendons in particular, place your hand flat on a table and rotate your thumb out as far away from the fingers as it will go.  You should be able to see two tendons standing out at the base of the thumb, where it meets the side of the wrist.  (If you can’t actually see this, you should at least be able to feel the tendons by using the fingers of the opposite hand.)  The top one is the extensor pollis longus, which doesn’t concern us here.  But the bottom one is actually two tendons that split further up the thumb (you probably won’t be able to feel this).  These are the abductor pollicis longus and extensor pollicis brevis, and they are the culprits in de Quervain’s syndrome.

Tendons involved in de Quervain's Syndrome
Tendons involved in de Quervain’s Syndrome

Although de Quervain’s can affect both parents, mothers are especially prone to it (in fact, one of the colloquial names for de Quervain’s is “Mommy Thumb”).  Several factors contribute. First, they generally pick the baby up more frequently than the father.  Second, women’s hands and forearms usually aren’t as strong to begin with as men’s.  And third, after delivery women’s bodies are flooded with a hormone called relaxin.  As the name implies, relaxin helps women’s joints and connective tissues to “relax” and stretch out a bit during pregnancy – mainly around the hips, but the effect is present throughout the entire body – which of course is necessary for successful delivery.  The thing is, once Baby has made the journey out, Mommy’s relaxin doesn’t immediately shut off.  There isn’t a lot of good research on exactly how long relaxin continues to make a new mother’s connective tissues remain abnormally loose, but a good guess would be at least three or four months.  (Estimates – and different types of evidence – make the range anywhere from a couple of weeks to as long as a full year, depending on the particular circumstances of the birth.)

Up to now, I haven’t talked much about de Quervain’s on this blog because it’s actually a problem with the tendon sheath rather than the tendon itself, and so I wasn’t sure whether or not my techniques would work to help get rid of it.  But recently I’ve had several people order the Target Tendonitis ebook and video package for this purpose, and the feedback has been very positive.  And doing some research into the condition, I found that the same terminology problem that the medical community has with tendon pain also exists with conditions relating to their sheaths.  If you look at the Wikipedia entry for de Quervain’s, for example, it lists the condition as being a type of tenosynovitis. But then further down the page, it says “Evaluation of histological specimens shows a thickening and myxoid degeneration consistent with a chronic degenerative process.”(Here’s the link if you’re interested.)

As I’ve pointed out many times before, any kind of “itis” is inflammation, not degeneration.  However, despite the official classification, de Quervain’s is not primarily inflammation but actually a degenerative condition that changes the structure of the tendon sheath itself.  And that fits perfectly into what Target Tendonitis is designed to fix.