New Parent Injuries: Dequervain's Tendinosis

New Parent Injuries: Dequervain's Tendinosis

My son is now 9 months old and standing in his crib. He also likes to stand in his playpen, next to the couch, by the kitchen table, and any other surface that hold his weight (did I mention he was a chunker?). With all this standing, he requires me to pick him up from his standing position which inevitably places my wrist twisted in some start awkward position. This constant lifting can cause something called Dequervain's Tendinosis

Dequervain’s Tendinosis is a chronic irritation to the thumb tendons of the hand and wrist. This is caused by repetitively lifting babies and other objects with the thumb placed in the “thumbs up position” such as the picture below.

http://grhsonline.org/lifting-your-child-safely/

http://en.wikipedia.org/wiki/Anatomical_snuff_box#mediaviewer/File:Gray424.png

Cooking and cleaning repetitively also stresses the thumb tendons and will increase the amount of pain that you feel with other activities such as lifting your child. Obviously these activities are unavoidable as a new parent, thus it is necessary to modify these activities in the following ways: 
1. Attempt to not lift your child with your “thumbs up”.

2. Avoid lifting pots and pans with your hands in the “thumbs up” position.

3. Use baby carriers as much as possible

4. Possibly use hard wrist/thumb brace to take load of tendons. (see picture below). Although bulky, these brace remove much of the tension and pressure off those thumb tendons that are already irritated.

http://www.betterbraces.com/procare-comfortform-wrist-wabducted-thumb

5. Try PT and possible trigger point dry needling! (More info in coming blogs) TDN has been very effective in treating this condition for many of our patients. Call us for more info!

New Parent Injuries: Neck strain

When my daughter was first born she would not go to sleep without being held and rocked for 20mins to an hour (Yes, I was that guy). She would take about 30 mins to an hour to drink her bottle (yes, she was that baby). This inevitably led to many hours of me holding and looking down at my infuriatingly stubborn but adorable child. This caused me to have some very significant neck pain; my daughter literally became a pain in my neck (insert rim shot).

The cervical spine and the spine in general, is intended to be placed in a certain position for extended periods. This “ideal position” is what we can a neutral spine. This is where the head is supported and balanced on top of the neck. This allows the head to be supported by the underlying structure of the vertebrae. When this spine is taken out of this “ideal” position it relies on other structures to support the head. The muscles of the neck are not designed to be place in sustained flexion or extension (looking up or looking down) so when placed in these positions it causes undue stress and strain across the muscles of the neck.

http://en.wikipedia.org/wiki/Cervical_vertebrae#mediaviewer/File:Cervical_vertebrae_lateral2.png

To avoid strain to the neck it’s important to avoid sustained bending of the neck. It is easy for me to say this but let me give you a few techniques to avoid sustained neck flexion.

1.       Try to place the baby higher during feedings so you do not have to look down.

2.       Try feeding baby in a baby carrier.

3.       When carrying baby in carrier, ensure that baby weight is supported by your waist and not your shoulders.

4.       Try feeding baby in a bouncer or on a bed if they are not yet mobile.

Some stretching activities will help prevent injury.  Two of the most common muscles to be injured are the upper trapezius and the levator scapulae (Pictured below). Stretching the upper trapezius and the levator scapulae will help decrease the chances of sustaining a neck injury as well as help after injury.  

http://en.wikipedia.org/wiki/Levator_scapulae_muscle#mediaviewer/File:Levator_scapulae.png

Levator Scapulae Stretch:

http://www.humankinetics.com/excerpts/excerpts/levator-scapulae-stretch

Upper Trap Stretch: 

http://babyboomerfitnesschallenge.com/

The most effective way to prevent injury is to use common sense. Do not sit in sustained flexion for prolonged periods, do not fall asleep while holding the baby (this is more for the baby’s safety than yours), do not place neck in awkward positions for prolonged periods. Improving posture throughout the day is the most effective way to prevent injury but a more indepth discussion of this topic would be necessary.

If and when you get injured make sure you Ice, rest, stretch (do not over stretch), use anti-inflammatories (Advil) and do not perform painful activities. If after 2 weeks you still feel pain, call a PT!