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. 

"I came to A2 PT to assist in my recovery of a torn Achilles tendon. Not fully knowing what to expect, I was pleasantly surprised. Using a combination of PT (for strengthening and stretching) and massage (for scare tissue Break up) I feel my recovery has been accelerated. The whole crew Alika, Kristi, and Sophia are very kind, spirited, and passionate about their jobs! On a personal note, the word massage should be removed from the phrase deep tissue massage. It is very misleading-but it does work!
Keep up the great work gang!!"

− Christopher

"I came in to A2 with a knee injury that left me with very limited mobility and muscle weakness. Danny and team did an excellent job of diagnosing exactly what my issues were and designing a treatment plan that allowed me to regain strength, balance, and confidence. I would recommend A2 without reservation as a skilled and professional team."

− Margo

"My wife was trying to get me to go to A2 after she was enjoying the classes. I am busy and wanted to go but always had an excuse. Well one she pre-paid for me to go. Time for me to face my fears about why I hadn’t been going because now I am going. First, I was in ok shape active just not work out shape plus what if I couldn’t beat my wife or the other women in class? What if I passed out?

As Saturday approached my fears rose and my brain searched for an excuse. Yet when I arrived at the class what I found was nothing like I was fearing, quite the opposite. Everyone is focused on their own pace. While being motivating Kristi is not forceful but positive and supportive, coaching each person at their ability.

It has not been a month of one day a week, my body has reacted by toning up, my six pack is back. My wife was mad and happy at the same time. I have been seeing a chiropractor for maintenance and recently my body is firming up and I do not feel the aches and pains of getting older. Was I sore after the first workout? Yes for a few days I was sore, but each week the soreness would decrease. After a month I am not sore but stiff the next day, feeling stronger each workout.

Thank you, A2 Physical Therapy and Kristi, for the good music and for pushing us without pressuring us."

− Mike