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Paddlers Wrist: Dequervain's Syndrome

by Jane Hodgson 16 November 2009


Summary:

A common repetitive injury in paddlers and rowers is wrist pain. One of the most frequent causes of this is De Quervains syndrome

What's De Quervain's syndrome/ Paddlers Wrist?

De Quervain's is a condition that causes pain at the wrist on the side of the thumb

What causes De Quervain's/ Paddlers Wrist?

There are two tendons which control the movement of the thumb away from the hand. These tendons are called abductor pollicis longus and extensor pollicis brevis.

The two tendons start off in the forearm and pass into the wrist under a band a fibre called the extensor retinaculum. This holds the tendons in place and stops them from bow-stringing. Sometimes when the tendons are made to slide backwards and forwards through this space repeatedly they become inflamed and because the space is constricted this causes pressure and pain.

The movement that uses the two tendons is anything that requires thumb control such as gripping, wringing. Sports people who are affected commonly include canoeists, kayakers, golfers and rowers

What are the symptoms of De Quervain's/ Paddlers Wrist?

  • Pain on the outside of the wrist at the base of the thumb
  • pain increased by griping and twisting movements
  • pain decreased on avoidance of activity, but returns when activity resumed
  • pain on pressing around the side of the wrist at the bottom of the thumb
  • sometimes crepitus (a grating/ crackling sound) this is caused by swelling in the sheath that surrounds the tendon

What's the treatment for De Quervain's/ Paddlers Wrist?

  • ice
  • Anti inflammatory medication
  • A corticosteroid injection
  • relative rest: the avoidance of aggravating activities
  • alteration of any at fault equipment or technique. For canoeists/ kayakers this may include loosening grip and increasing trunk rotation. Rowers may benefit from an alteration in oar handle size or a larger gate size.
  • After the acute phase eccentric strengthening exercises are important to prevent recurrence of the problem
  • graduated return to sport

Disclaimer: The information on this page is written to help you understand your injury. There are many possible causes for hand pain and should you have any concerns you should always seek advice from a qualified health professional such as a Chartered Physiotherapist or your GP.

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About the author

Jane Hodgson - Chartered Physiotherapist Jane Hodgson Jane specialises in lower body injuries and has raced competitively in running, orienteering and adventure racing.

Did you know

Paddling in rough water is more likley to cause wrist problems than paddling in placid water


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