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. 

"A2 Physical Therapy has been an amazing place to be at for the past 3 years training with Kristi Cruz. I have had knee and shoulder issues and Alika has been great getting me back to doing the things I love. The staff here is always so loving and kind. I know when I come here I am always excited to be here. I love getting the warm smiles from everyone!"

− Haeli

"Before I started coming to A2 I was always tired and could barely pick up or carry my grandchildren a ½ block. After the first 6 weeks of working with Kristi I got a big surprise when I took my grandchildren to a festival and carried the youngest 4 blocks before she woke up enough to walk. I then picked her up and put her on my shoulders so she could see better without effort. I was amazed at how much strength I had gained in a short time. I continue to see improvement in my strength and I’m no longer tired all the time."

− Jacki

"I’ve had 4 surgeries with different physical therapy clinics and this was my favorite. I felt comfortable and felt like I mattered to my PT which was a good feeling. My progress was as I had expected and any time I had a question or concern it was always answered and my PT adjusted. If it needed to be to avoid the pain I had I didn’t feel pressured to have more PT appointments or pressured to do workouts that aggravated my pain. Thank you for your help! I think offering stem and ultrasound for every patient will be really beneficial. Great experience overall."

− A.S.