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

"After a three-car rear end accident, I had a concussion and severe whiplash. I picked A2 to help me recover. I will have to honestly say A2's expertise and therapists along with all the other staff, have been the "silver lining". They are very knowledgable and take the time to explain what they are doing. and why they are doing it. They are extremely friendly, thoughtful, and maintain flexible hours. I have followed the home exercises regularly and have seen steady improvement. This is very important as I am a small business owner with a physically demanding job. A2 has it all! Fantastic physical therapists, massage therapist, and personal fitness trainers, all under one roof. Alika is a visionary and A2 is the hidden jewel of PT, but not for long."

− Danielle

"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