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 never thought I’d love PT, but now I do! I’m so appreciative that my first Pt experience has been with the most attentive and patient people possible. I’m thrilled the progress I’ve made and feel confident in my ability to continue improving at home. A huge thanks to the entire A2 team for being so welcoming and understanding. I truly can’t offer any recommendations, as you guys have a great thing going. (except for maybe more fruit infused water. Thanks again!"

− K. Paulson

"Last Sunday I played full court basketball for the first time in 15 years. I will qualify the contest by saying it happened on a court just out of the back door of an elder care center. The teams consisted of a 7 year old, an d8 year old, a young woman in flip-flops (I played in sandals), a woman who proudly stated she was 55 years old (I retorted with my age of 65), and a couple of other young guys that really played well. I ran the court, I played defense, blocked shots, made shots (missed a lot), got lots of rebounds, and talked a lot of smack while playing with a group of people a lot younger than me. I even made a behind the back-twisting fall-away shot, then fell and tumbled on the court. I jumped up and continued to play, and we played for about 45 minutes.
I attribute my ability to play this game that I love so much again to the excellent training receive from Kristy who is a trainer at A2 Physical Therapy. I have worked out and trained since I was very young. I played high school basketball, baseball, and I ran track. I spent 20 years in the Army with all the training requirements associated with that occupation. I played on community and city leagues, and I have trained with weights for many years. The training program Kristy has devised for me at A2 is rigorous, thorough, diverse, fun, challenging, and focused. She prepares workout plans that are age and fitness level appropriate. My work out now is so much different then it was when I first started. She both trains me individually and as a couple. I run, jump, stretch, lift, balance, squat, push, pull, and every other movement you can imagine. I look forward to going to my workout every time. Kristy is completely in charge of every workout. I am retired, and my training at A2 allows me to fill the need to accomplish something positive every day I work out. I am doing physical activity with ease that I would not have thought I would be able be able to accomplish at the age of 65 such as hiking on Mt Rainer and running 4 days per week. Kristy and A2 have really changed my life…"

− William

"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