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Health and wellness

Tendinitis, carpal tunnel syndrome, back pain: new mother injuries and how to avoid them

New mothers are at risk of all kinds of injuries from repetitive child lifting and carrying. We talk to an expert on how to ease the aches

PUBLISHED : Tuesday, 02 October, 2018, 4:01am
UPDATED : Tuesday, 02 October, 2018, 8:03pm

Becoming a parent can be heavy on a mother’s mind – and her body, too.

A month and a half after her son was born, Ku-Ku Cheung’s left thumb started to hurt, a pain that sharpened whenever she scooped up her newborn and cupped his neck. Before long, the ache started to creep up to her wrist.

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“When I moved my thumb it would hurt. It still hurts,” says the 39-year-old, whose baby is now five months old.

After accumulating more aches that broadened to back and shoulder pains, she consulted two traditional Chinese medicine practitioners, including a bonesetter who said that her “Mama Sao” or “Mother’s hand” is common. The bonesetter pulled and tugged at her wrist, and worked on her back. He also gave her some Chinese medicinal herbs to apply on the affected areas, instructing her to leave them on for eight hours at a time.

But she couldn’t breastfeed during those eight hours and, with the fees racking up, she decided to stop seeing those practitioners. Instead she resorted to carrying her child less frequently, and breastfeeding him while he lay on her bed. Her back pain subsided but her wrist still hurt.

While such aches are common in mothers – and sometimes fathers – sufferers often do not seek medical help, says Dr Josephine Ip Wing-yuk, an associate professor and honorary consultant at the University of Hong Kong’s department of orthopaedics and traumatology at Queen Mary Hospital.

Ip, a specialist in hands and upper limbs, says problems like Cheung’s usually result from overusing certain parts of the body through repetitive motions. Carrying an infant requires the parent to open up their hand, particularly their thumb and fingers, which engages two major muscles: the extensor pollicis brevis and the abductor pollicis longus. When overused, the tendons of these muscles become inflamed – known as De Quervain’s tenosynovitis – resulting in pain in the wrist and lower thumb.

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Verena, new mother

Another ailment is carpal tunnel syndrome, where the median nerve – one of the major nerves of the hand – is compressed as it extends through the wrist. This can result from repetitive finger motions or flexing of the wrist. Symptoms include pain, numbness of fingers and a tingling sensation in the hand.

“The median nerve lies inside the carpal tunnel which is bounded by tight structures including carpal bones and tight flexor retinaculum,” Ip explains. “Repeated movement causes inflammation of flexor tendons which are also inside the carpal tunnel, so the median nerve is compressed.”

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Ip says mothers are particularly prone to such injuries because hormonal shifts during pregnancy mean they tend to retain more fluid in the body. This condition continues after delivery, making them susceptible to tissue swelling and inflammation. Around six months post-delivery, symptoms should improve as mothers’ hormonal levels typically revert to pre-pregnancy levels.

The best solution is to reduce repetitive lifting by getting others to share responsibilities that involve lifting the child, Ip says. She also advises mothers avoid unnecessary child-lifting as much as possible – for example by putting the baby in a cot or cradle to sleep after feeding rather than letting the baby sleep on their body, so the mother can rest. Mothers should also do stretching routines and massage vulnerable areas to relax the soft tissues.

Ip says to use a resting splint if symptoms are severe, which keeps the hand in a functional position and gives overused muscles and tendons a break. Another strategy is to emphasise using the upper body’s larger muscles – known as “proximal muscles” – when carrying the baby to ease the load on smaller muscles and tendons.

For mothers with shoulder pain, Ip says the causes could be poor posture – a hunched back, for example – and overworked muscles in one side of the upper body due to most people having a preferred side for lifting a child. She suggests balancing things out by alternating which side is used.

Stretching exercises should also involve the shoulder areas if possible. Ip says that while keeping the back straight, stretch your upper limbs forwards like a zombie to stretch your tendons. “Make sure they are not kept in a sustained posture – blood supply to contracted muscles is not as good as when they are resting,” she says.

Prevention is better than cure of course, and Ip says that before delivery women should do regular exercise to ensure their body stays strong and better prepared for the physical challenges ahead.

If stretching affected areas does not help, and nor does regular rest, physiotherapy can be effective in alleviating pain thanks to various treatments including ultra-sound therapy, which uses sound waves to micro-massage affected areas, Ip says.

Good nutrition and sleep are also important for mothers to maintain their physical health and stay strong, although understandably this can be challenging for new parents.

Fortunately, new mother aches tend to be transient and fade away over time with rest. New mothers also tend to be relatively young, so they have good regenerative powers.

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Verena, who asked that we use only her first name, suffered aches in both wrists at three months after her daughter was born last year. She immediately visited a doctor, and a blood test revealed a vitamin D deficiency. She was prescribed supplements, which she is convinced helped reduce her joint pains.

The 34-year-old German also visited an osteopath who pointed to muscle overuse and a hunched posture from repeated baby lifting as the cause of her pain. He taught her stretching routines and encouraged her to try Pilates.

“The Pilates worked for me as it strengthened my core muscles, made my whole body stronger and made me sit straighter and have a different posture,” she says.