I have a question for all the hand therapists out there.  My 12 year old 
daughter has been playing the clarinet for 1 year and has now switched to an 
alto clarinet (essentially the same hand holds).  In the last year she had 
developed bilateral DeQuervain's twice.  

To give you a little history, I had bilateral DeQuervain's release shortly 
after she was born 12 years ago.  Since I had been pregnant, there was 
essentially no treatment for it and the case was so severe, my thumbs were 
non-functional.  Surgery was the only option.  After the surgery, the surgeon 
said that I had an anatomical abnormality--2 sheaths instead of one.  My sister 
and aunt both have severe DeQuervain's but won't get it fixed.  This is clearly 
a family trait.  

When she flares up, I splint her with a thumb spica, start anti-inflammatories 
(ibuprofen) and she reduces (or stops) playing if possible.  This seems to 
relieve the pain.  I have already tried to change the way she holds the 
instrument, but in my limited knowledge of an alto clarinet, I can't see any 
way to accomplish this.  The school year is only 3 weeks old and she's already 
had to start wearing the splint 3 or 4 times per week.  She independently puts 
it on at night because it makes her thumbs feel better. She's just in 7th grade 
and we have years to go in band.  

What I'm wondering is if there is anything else I can do?  Are there stretches 
or an exercise program that I can start her on.    

Any suggestions would be appreciated.  Hands are just out of my realm of 
knowledge. 

Judy Hamby, MHS, OTR/L, BCPR

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