Recently, I made the long-awaited switch from an old-school flip phone to an iPhone. (No, this is not a blog arguing if iPhone or Android phones are better, so hold your horses!) I noticed very quickly with the ease in text messaging that the amount I text increased incredibly! Now feeling super cool and newly up-to-date with all the "tech-y stuff", I find myself looking around as I ride the Skytrain. I take note of who is using iPhones vs. Android phones, who is plugged into their music, and the extremely rare and possibly endangered species- the paperback book reader.
I have also been noticing how people use their phones. If you ever find yourself riding the Skytrain, a bus, or in a crowded area, look around and take note of how people are holding and using their phones. Better yet, take a look at how you are holding your own phone. If you are like the majority of people, your pinky finger is likely under the bottom of it, supporting the weight of the phone, while your other three fingers are behind it. Your thumb is in front and you are using it to scroll, type, and click. Am I psychic? Can I see you from where you sit? No. I just spend most of my days observing people and patterns. In fact, if you ever see someone who isn’t using this hold, it can look a little awkward.
The Appearance of a New Injury
After making the switch, I started noticing a pain in my thumb. Being trained in such things, I knew instantly what it was, and I performed a few little tests on myself to confirm my suspicions. I had developed what some teachers in school affectionately dubbed “Texting Thumb”. In the medical community, this is more commonly known as DeQuervain’s Tenosynovitis, and can be caused by activities like typing, holding items in a certain manner, or more recently texting. This is more common than I had originally thought, as friends and acquaintances all started asking me about this random pain in their thumb.
What Causes an Overuse Injury?
We hear all the time about certain activities being at risk of overuse injuries. Runners get plantar fasciitis or IT-Band friction syndrome, golfers get golfer’s elbow, tennis players get tennis elbow, and desk workers are at risk of Carpal Tunnel Syndrome. The simple fact is; if you do one motion continuously, you are at risk of developing an overuse injury. An overuse injury is defined as “a repetitive micro trauma that overloads a tissue’s ability to repair itself.” (Rattray and Ludwig, 2000) What does this mean? It means that when we use specific muscles or tissues in our body, there is a certain amount of stress put on those tissues. In order to build muscle and bone, our body takes those areas of stress and builds on it to make it stronger. It repairs the area and lays more tissue in the area. In the case of overuse, we are not giving our body the time it needs to repair itself. Inflammation in the area is never resolved, and pain develops when the tissues can never repair.
Common causes of overuse injuries include:
An increase in length or intensity of an activity
A sudden change in an activity
Inadequate rest from the activity
Tight fascia (connective tissue that surrounds muscles, bones, etc. Basically, the stuff that holds us all together (imagine a stretchy, moveable saran wrap that covers everything.)
How Do I Know I Have it?
Do you have thumb pain? Are your activities similar to some of those described above? How many hours a day are you using your phone? This may be something you need to look at.
Try this little test. Make a fist with your thumb inside your fingers. Now, move your fist towards the elbow side of your arm, towards your pinky. This test can be uncomfortable for most people, so try comparing hands. Is one more painful than the other? If the pain you have been experiencing is recreated or made worse, that is considered a positive test and may indicate paratendonitis of the thumb, or “Texting Thumb”.
How Can I Fix it?
When patients develop overuse injuries, the first thing any Therapist tells them is to stop the activity and rest. Athletes stop running, playing tennis or golf; desk workers have to get off the computer. This period is called “Relative Rest”. You can still perform activities that don’t use the injured area. Often, this takes a fair amount of creativity. I know it is highly unlikely that anyone will go phone-free for an extended period of time. Doing that could result in some people losing business, friends, or missing out on essential information. So try changing the way you use it. Try putting your phone down on your lap and use your index fingers rather than your thumbs. Try holding your phone with one hand and using the other index finger. Changing how you use the phone will change the method of injury, and keep it from coming back again. It will also give your body the time it needs to heal itself.
Another key to helping an overuse injury is to ice the area after any activity using the thumb. If you find yourself typing a large document, or having a long texting conversation with anyone, finish it with ice. Even icing the area before bed will be beneficial. Get a bag of frozen peas, or small ice cubes and put it in a kitchen towel. Place it on the area of pain for ten (10) minutes, and remove it for ten. Repeat that three times. This is the 10 on, 10 off technique and it helps to flush the area of any stagnant inflammation, and lets the body bring new blood and nutrients to the area.
The next goal is to develop what we call functional scar tissue. Your RMT will use specific techniques to loosen up your fascia and decrease restrictions, as well as line up the already existing scar tissue. Because we can’t fully remove scar tissue, the idea is to line up the fibers into the same direction so the tissues can be moved and not restricted.
Lastly, talk to a medical professional, like a Massage Therapist, Chiropractor, or Physiotherapist to develop a personal plan to help get you back to your regular functionality as soon as possible. The sooner you start your treatments, the faster you can heal.
Rattray F, Ludwig L. Clinical Massage Therapy: Understanding, Assessing and Treating over 70 Conditions. Elora, ON: Talus Incorporated; 2000
Magee DJ. Orthopedic Physical Assessment. 4th ed. St. Louis, Missouri: Saunders Elsevier; 2006.
Hertling D, Kessler R. Management of Common Musculoskeletal Disorders: Physical Therapy Principles and Methods. 3rd ed. Philadelphia, PA: Lippincott; 1990.