Texting Thumb


A common task most of us are doing much more of than ever before is texting. This is an extremely wonderful and useful communication tool, but just like any other repetitive motion our body performs, we may be placing certain tendons at risk of overuse if our constant rapid-fire texting continues without paying attention to our extremely mobile and intricate thumbs and wrists. At A2 Physical Therapy, we strive to educate and assist our patients in being proactive regarding their overall health. If texting is something you cannot imagine having to modify or discontinue, give your thumbs and wrists a little TLC today.

The precise movements of our thumbs work the tendons of two specific muscles (abductor pollicis longus and extensor pollicis brevis) which can become irritated from repeated friction and overuse, leading to inflammation and degeneration of the tendons and their sheaths (the membrane surrounding and protecting a tendon). This puts pressure on the tunnel through which they travel. At certain angles of wrist and thumb movements, such as when we’re texting and gliding our thumbs sideways, these two tendons are at an increased risk of becoming irritated and inflamed. Patients with Texting Thumb (clinically referred to as De Quervain disease) may experience swelling, nodules, and increased pain on the thumb side of the wrist. A simple way to a test for this condition is called the Finkelstein test. Simply clasp the thumb in the palm with all four fingers and rotate downward at the wrist joint. A positive Finkelstein test is indicated when pain is experienced on the thumb side of the wrist.

Cortisone injections, surgical release, and immobilization are all options if conservative management isn’t enough. Actions we can take in physical therapy to prevent worsening of Texting Thumb symptoms include:

  • Passive motion (therapist guiding the movement) of the thumb and wrist in pain free ranges; this will progress to the patient actively performing these movements
  • Gradual strengthening of both thumbs and wrists using gravity, rubber bands, putty, or small balls and light weights as resistance
  • Gentle Finkelstein stretch, as well as other wrist stretches (see below) -Ultrasound for pain control and tendon healing
  • Cross fiber massage

Activity modification, icing, and avoiding repetitive thumb and wrist movements are also indicated for anyone who experiences discomfort with the Finklestein test. For Texting Thumb, prevention and early treatment are especially important since these affected tendons can take months to heal once irritated.

So, here’s the takeaway: Put the phone down, do a few comfortable wrist and thumb stretches, and remember these delicate tendons and strong joints were designed to move, but not necessarily in a fixed position across a 2 inch screen thousands of times a day. Here are a few gentle stretches to get you started. Perform at a slow and controlled speed for 10 repetitions with a 5 second hold. 

"Physically and mentally as healthy as I can be is my goal. My father lived to 93 and fairly healthy physically and mentally. My mother is 96 years old and is failing mentally and physically. I have watched the good and bad of aging. My chances of longevity is good but I want to be mentally and physically as healthy as I can be. Not until I started working out with Kristi Cruz at A2 did I know how to prepare myself for my road ahead. Kristi has given me the tools and information for me to understand what I need. She has led me by my hands and feet to improve me physically and talked and explained to help me understand the process. Working out with Kristi two or three times per week is a priority and my recipe for good mental and physical health. My name is Geri Markham and I am 71 years old. I feel as fit as I could be at my age. I have to give all the credit to Kristi Cruz at A2 for walking with me through the process. I would recommend Kristi totally if you are interested in learning to be physically and mentally healthy as you move on in life. Life is good thanks to A2 and Kristi Cruz."

− Geri

"I had a lot of fear after surgery, afraid that I would not regain mobility and strength. I feel that A2 helped me achieve a higher plateau of health, motion, and strength than I would’ve achieved elsewhere. Also, A2 has taught me the exercises to go even further, to strengthen and mobilize my shoulder. I fully trust A2 and will recommend them to all my friends, family, and coworkers. They have all treated both me and my wife with a gentle kindness that is rare today and have made us feel welcome in their care. Very professional, but with a sense of caring; that is how I would describe A2. I will miss them all and am very grateful to have been in their hands."

− Roger

"William and I have been working out with Kristi on Saturday mornings for months now and we love it! We find the couples training so beautiful physically, mentally and relationally. Kristi not only challenges us with cardio and lifting but has introduced us to exercises that relate to balance and stretching. As we enter our 60’s we appreciate these balance routines and can see how it benefits our daily lives. I can’t tell you how many times I’ve heard William say, “I am not doing that, that’s a girl exercise!” and then later he’ll say “wow that was harder than I thought” or sometime that week he’ll bring up an exercise we do on Saturday and how it benefited him that day! Most importantly we have blast encouraging each other, competing with each other and having fun! We appreciate A2 and Kristi for providing a space for us to stay fit and have fun. We wish you all much success! Thank you"

− Pam and William