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De Quervain’s Tenosynovitis Stretches & Exercises

by Jaydee Vykoukal, PT, DPT June 16, 2020 0 Comments

Wrist Stretching

De Quervain’s tenosynovitis stretches and exercises can be a lifesaver when addressing strength and flexibility in the hand. Designed to speed your recovery process, they’re one of the best ways to get you back to normal activities and keep wrist and thumb muscles strong. Keep reading to learn more about De Quervain’s tenosynovitis stretches and exercise.    

Stretches

Addressing flexibility is always important for restoring function to the thumb and wrist. If you’re having trouble tolerating these simple stretches, a physical therapy assessment can help guide you.

Thumb Abduction Range of Motion

Bring the thumb across the hand to touch the tip of the pinkie. Hold for 2-3 seconds before returning to the starting position and repeating. Alternate bringing the thumb to each finger before returning back to the little finger. Keep the motion slow and controlled and don’t force it if it becomes painful.

Repeat 5-10 rounds alternating through each finger.

Thumb Stretch

Bring the thumb across the palm and rest it on the fingernail of your bent little finger. It will make an “O” shape with your palm, thumb, and pinkie. To progress the stretch, you can reach farther down the little finger toward the knuckles.

Hold 30 seconds for up to 3 sets.

Ulnar Deviation Stretch

Hold your arm out in front of you with the thumb side facing up toward the ceiling. Then, use your opposite hand to push the entire wrist (in a sideways motion) down toward the floor until a stretch is felt on the inside of the forearm. Having the elbow straight can increase the intensity, so decide what elbow position is best for you to start and build from there.

Hold 20-30 seconds for up to 3 sets.

Wrist Flexion and Extension

Start with the arm out in front of you with the palm facing down and elbow straight. Then, use the opposite hand to push the palm down toward the floor until a stretch is felt in the top of the forearm. After holding 20-30 seconds, switch directions so that you are now bringing the top of your hand up toward your shoulder. You will feel the stretch in the bottom of the forearm. Hold again for 20-30 seconds.

Alternate between the two stretches 2-3 times.

Wrist Exercises

General wrist strengthening exercises are ideal for keeping local tissue healthy and limber. These all have an added bonus of addressing the wrist range of motion at the same time. Try these without weights if you want to focus on flexibility more than strength.

Wrist Extension

Support your forearm on a table, your knee, or with your opposite arm. Hold a small weight in your hand with the palm facing down. Simply extend the wrist up toward the ceiling and shoulder as far as you can before switching directions and letting it fall (with control) down toward the floor.

Repeat up to 15 times for 2-3 sets total. Keep the motion slow and controlled.

Wrist Flexion

Start with the same set up as the above exercise, but this time have your palm facing up toward the ceiling. Then, bend the wrist as you bring your palm up toward the ceiling. Go as far as you can tolerate before switching directions and letting the wrist move with control toward the floor.

Repeat up to 15 times for 2-3 total sets.

Wrist Pronation and Supination

Support your forearm again, this time with the thumb facing up toward the ceiling. If you have a dumbbell or a hammer, hold it so that most of the weight is above the hand for more leverage with this move. Then, rotate the wrist as you alternate between the palm facing the ceiling and then the floor. Make sure the motion is coming from the wrist only, rather than the shoulder.

Repeat up to 15 times in each direction for 2-3 total sets.

Radial Deviation

Be cautious with this one since it is directly addressing sore tissues in the thumb. Start again with the thumb side of your wrist facing up toward the ceiling. Then bring the thumb up toward the ceiling (as you bend the wrist sideways), this motion is meant to be small so don’t force it.

Repeat 15 times for up to 3 sets.

Grip Strength Exercises

Keeping the hand and fingers strong is always a key component for wrist and thumb health. You can use household items or try a tool specific for strengthening your grip.

Not sure where to start when shopping for grip strengthening tools? See our complete guide here.

Full Finger Spread

For this exercise, you can use therapy putty, a hand extension exerciser, or even a plain old rubber band for this exercise. Start by bringing all your fingers and thumb together as you place your exercise tool around the outside of all your fingers. Then, spread the fingers apart as far as they will go before returning to the starting position. Focus on keeping the motion controlled in both directions.

To increase the intensity and focus more specifically on the thumb, spread the fingers as far apart as possible and hold for 2-3 seconds. Repeat 10 times for 3 sets.

Finger pinch

Using therapy putty or some other soft material, place a small piece of it between the pointer finger and thumb. Pinch the two fingers together and hold 2-3 seconds. Focus on keeping good alignment in the fingers. They should create an “O” shape with minimal extension of any of the joints, particularly the thumb. Pinching the fingers together can be aggravating at first so start slowly with minimal pressure.

Repeat 10 times for up to 3 sets. 

Power Squeeze

Roll your therapy putty into a ball or grab a small towel roll or a hand exercise ball. Place your strengthening tool in the palm of your hand, then squeeze the object as hard as is comfortable to work all the muscles in the fingers and hand. Hold 5-10 seconds and repeat. Again, keep the fingers in good alignment to avoid aggravation.

Complete 10 repetitions for up to 3 sets total.

How Exercises Help

A well-balanced exercise routine promotes good overall health. This is no different for the thumb and wrist. Here are a few of the many benefits of regular stretching and exercise:

  • Optimized muscle balance for biomechanically sound movement
  • Better tolerance for regular activities like typing, gripping, cutting, and texting
  • Swelling management to reduce inflammation of the affected wrist synovium (connective tissue)
  • Increased circulation to promote healing and tendon health
  • Decreased pain
  • Improved tolerance for hand and wrist range of motion
  • Overall improved quality of life

Stretching and Exercise Tips

To maximize the results of your exercise program, keep these tips in mind:

  • Initially, try to minimize time doing any activities that irritate the thumb (especially texting) to allow healing. You may also consider wearing a splint. 
  • Pair your exercise program with home remedies to optimize recovery, such as ice, heat, ibuprofen, and massage. 
  • If you are having trouble tolerating exercise, you can try loosening up the hand first with your home treatments as well. 
  • Complete your home program every day at first and then at least 3 times per week for maintenance on your thumb and wrist are feeling better. 
  • Always pay attention to your symptoms with exercise so that you can modify or progress as tolerated.
  • Keep good form in the wrist and thumb when performing any exercises. Do not force a move especially if you can’t control hyperextension of the thumb. 

Exercising Safely

Having a good exercise program can greatly improve your quality of life and prevent or treat issues related to wrist and thumb overuse. If you feel unsure of where to start you can consult your physical therapist or physician for more guidance and proper Finkelstein Test. With a routine that addresses wrist and thumb strength and flexibility you should be feeling better in no time.

Sources:

https://www.healthline.com/health/de-quervains-tenosynovitis-exercises

https://www.summitmedicalgroup.com/library/adult_health/sma_de_quervains_exercises/

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Jaydee Vykoukal, PT, DPT
Jaydee Vykoukal, PT, DPT

JayDee Vykoukal is a Doctor of Physical Therapy, owner of the healthy habit platform Health Means Wealth, and freelance medical writer. She loves traveling and spending time with her family in nature. Her passion is helping others continue to participate in the activities they love through education and proper exercise.



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