Thumb-side wrist pain, six weeks in. Why the answer is almost never in the wrist.
Pain along the thumb side of the wrist is one of the most common physical complaints in the first year after birth.
The reason is mechanical. Tendons running from your thumb pass through a narrow tunnel at the wrist. Picking up and feeding a baby puts your hand in nearly the same position every time: thumb out, wrist bent sideways, taking the weight of a head. Do that fifty times a day and the tendons and the sheath around them become irritated.
It usually appears between six and twelve weeks, often in the dominant hand first. It gets worse with the exact movement you cannot avoid, which is why it rarely settles on its own.
It is also rarely about the wrist alone.
A lift starts at your feet, runs through your trunk, out along your shoulder blade, down the arm and finishes at your hand. When any part of that chain is not contributing, the parts further along take more.
After birth, the parts higher up the chain are frequently the ones with least capacity. The abdominal wall has stretched. The mid back has spent months rounded forward, feeding. The shoulder blade sits differently on a rib cage that changed shape through pregnancy.
So the hand takes more of the lift than it should. It is the smallest structure in the chain and it has the least to give.
The wrist is the third or fourth thing we look at.
Start with what the arm does all day. Holding a baby, then a toddler, keeps the wrist and elbow bent for hours with the forearm rotated palm-down. Not lifting. Holding. The same position, without rest, for months.
The elbow takes that badly. There is a joint at the top of the forearm, on the thumb side, that lets the forearm rotate. When the forearm lives rotated one way, that joint stops moving properly and gets stuck. Most women have no idea it is involved, because it does not hurt. It has simply stopped contributing.
Above it, the shoulder has rolled forward and now sits closer to the front of the body than it should. That is what months of feeding, carrying and looking down builds.
Above that, the neck is tight and tender to touch, and intermittent headaches are often somewhere in the story.
By the time the wrist starts complaining, three things above it have already changed.
A wrist brace helps. Ice helps. Resting it would help, if resting it were an option, which it is not.
None of that alters why the wrist is doing more than its share. That is the difference between relief and change, and it is worth understanding before you spend six months managing something.
The elbow that stopped rotating properly does not hurt, so nobody looks at it. The shoulder that rolled forward feels like posture rather than a problem. Both are quietly sending more work down to the hand.
Change the grip, not the baby. Lifting with a flat hand under the chest and body, rather than a thumb-out scoop under the arms, takes the strain off the tunnel immediately. It feels awkward for about three days.
Get support under your arms when you feed. If your elbows are unsupported, your shoulder and forearm hold the position for the entire feed. A pillow under the elbow, not only under the baby, changes the load on every feed from that point on.
Turn the forearm the other way. Several times a day, let the palm face up and let the elbow straighten. Ten seconds. The joint that has stopped rotating needs the opposite of what it has been getting.
Vary the position. Any position held long enough becomes the problem, including a good one.
Give the mid back something to do. Ten minutes twice a week of pulling and pressing movements builds capacity where it has been drawn down. That is not a fitness goal. It is the reason your hand stops carrying the whole lift.
If it has been there more than two or three weeks, if it wakes you, if your grip has changed, or if you have started avoiding the movement rather than adjusting it, get it assessed.
An assessment looks at the whole chain rather than the sore point. Where the movement is coming from, what is not contributing, and where capacity needs rebuilding.
It hurts in your wrist. The answer is usually further up your arm.
If you would like it looked at, call the clinic on 08 6280 1210 or book a visit online.
Dr Kyna Hamilton is co-founder of Wild Chiropractic in Shenton Park. She is Webster Certified, trained as a birth doula before she trained as a chiropractor, and has spent over a decade working with pregnant patients and families.
Wild Chiropractic is a nervous system-led chiropractic practice in Shenton Park, Perth.
