De Quervain’s tendonitis can be a very painful condition. First described by De Quervain in 1895, this condition involves inflammation of the tendons of the extensor and abductor muscles of your thumb which run together in a common canal. This inflammation produces a stenosis or narrowing of this canal, which is located at the base of your wrist. De Quervain's tendonitis exercises, then, are designed to reduce this strain, restoring normal mobility and function of your thumb. Stabilizing your wrist with a prescribed splint and resting these inflamed thumb muscles, avoiding the activities which provoked the inflammation in the first place is essential before beginning your rehabilitation exercises.
After two to three days of rest, your pain and swelling should have dissipated and you are ready for rehabilitation. However, consult your physician before beginning any rehabilitation program.
Stretch Tightened Thumb Musculature
Begin by gradually stretching your affected thumb extensor and abductor muscles. Hold a 3 to 5 lb. dumbbell in your affected hand so that your palm is facing inward. Slowly let your hand drop toward the floor until you feel a comfortable stretch. Hold this stretch for a count of five, lift the dumbbell back up to the neutral position with the opposing hand to avoid straining your thumb muscles, then repeat.
Another stretching exercise involves touching the palm of your hand with your thumb and holding this stretch also for a count of five. Repeat ten times. (ref 3)
Restore Pain-Free Thumb Movement
As the inflammation subsides, try actively straightening your thumb both upward and outwards from the palm. This movement should be pain free. In addition, with your hand and wrist in a neutral position, palm facing downward, gently move your hand away from your body 10 times. Finally, touch your thumb to your ring and little finger, also known as thumb opposition, at least 10 times. All motions should be pain free.
Perform Strengthening Exercises
As your pain subsides, gradually add strengthening exercises for your thumb and hand musculature. These exercises, according to the Brigham and Women's Hospital, function to increase your metabolism, promote healing and restore your ability to perform functional tasks. They can be done isometrically by tightening your muscle in a pain-free range or isotonically, by actively moving the joint. According to C. Lowe, it is important to begin with brief repetitive isometric exercises for the hand and wrist musculature--specifically, five reps, six seconds each, performed once daily. You can also provide light resistance for your thumb by holding a yellow theraband loop in your unaffected hand and repeating the aforementioned upward and outward movements. Repeat 10 times.
Gripping and pinching exercises are also an important program to restoring these weakened functions.
References
- “Ninth Edition of Shands Handbook of Orthopedic Surgery”; H. Robert Brashear, Jr., MD; 1978.
- YouTube: De Quervain's Syndrome Exercise
- Standard of Care: de Quervain’s Syndrome: Nonoperative Management
- " J Hand Ther."; Treatment of Tendonitis, Tenosynovitis, and Other Cumulative Trauma Disorders of Musicians’ Forearms, Wrists and Hands…Restorative Function withHand Therapy; C. Lowe; May 1992.
