De Quervain’s tenosynovitis was named after the swiss surgeon Fritz de Quervain who first described the condition in 1895. This condition involves the tendons of two important muscles of the thumb–the abductor pollicis longus and the extensor pollicis brevis–which move the thumb away from the index finger and help to straighten the joints of the thumb. The tendons, which connect the muscle belly to the bone, are covered with a slippery sheath called the synovium. Normally the tendons move freely within this synovium and receive nutrients from it. De Quervain’s tenosynovitis describes a condition in which swelling of the tendons or thickening of the synovial sheath causes friction and rubbing of the abductor pollicis longus and extensor pollicis brevis tendons with movement of the thumb and wrist.

Symptoms of De Quervain’s tenosynovitis include:

• Pain, swelling and tenderness at the wrist near the base of the thumb
• Pain or weakness when pinching objects between the thumb and fingers
• Pain or discomfort when bending or twisting the wrist
• Weakness or discomfort when gripping and turning items such as when opening a jar or using a hammer
• A feeling of stiffness in the thumb where it meets the wrist
• A snapping or catching sensation when you move the thumb
• Localized swelling or a fluid-filled cyst may develop at the wrist near the base of the thumb

WHO IS MOST LIKELY TO DEVELOP DE QUERVAIN’S TENOSYNOVITIS?

This condition is fairly common and often considered to be an overuse condition caused by repeated movements of the thumb and wrist. Pregnant individuals and parents who are breastfeeding or cocking their wrist to support an infant or repeatedly lifting their child are more likely to develop these symptoms. Other repetitive tasks involving the wrist and thumb like gaming or tennis can also contribute to this condition. Women tend to be affected by De Quervain’s more often than men and we most likely see this condition in middle-age adults from 40-50 years old. Another risk factor for developing this condition is the presence of other inflammatory conditions like rheumatoid arthritis.

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If you decide to work with a physical therapist to help with De Quervain’s tenosynovitis related issues, your entire treatment plan could consist of around 8-20+ different physical therapy sessions that will each last 60-90 minutes. Once you complete your customized physical therapy treatment plan, you will be able to continue to do the prescribed stretches and exercises utilized during your PT sessions yet in the comfort of your own home.

Looking for the cause of an injury

While full recovery and return to play is the ultimate goal when it comes to injury rehabilitation, a physical therapist has much more to offer. We are interested in identifying the factors that may have predisposed you to the injury in the first place so that we can make a plan to address them. This helps decrease your risk for future injury. Here are some factors that we look for when assessing a player:

• Muscle strength, power and endurance
• Flexibility and mobility in muscles and joints
• Sleep, nutrition and recovery time
• Training schedule
• History of prior injury
• The physical demands of a player’s position on the team

While some injuries are unavoidable, there may be times when internal and external factors play a role. Identifying these factors allows us to address them with a good physical therapy program or give advice on beneficial modifications to your training.

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