If you live in the 21st century, chances are your phone is practically an extension of your hand. Every action you perform on your phone activates different muscles. Swiping on Tinder? You're likely overusing your abductor pollicis longus (APL) and extensor pollicis brevis (EPB). Move on to texting, and now you're adding stress to the flexor pollicis brevis (FPB), while awkwardly engaging the flexor carpi ulnaris (FCU) — especially if you don’t use a pop socket. The same scenario applies when scrolling on TikTok, Instagram, or checking emails.

Sound familiar? You might be experiencing what’s commonly known as 'Texting Thumb,' a modern overuse injury. The most commonly irritated tendons involved in this condition are the same ones affected by De Quervain’s tenosynovitis — the tendons you use when lifting your thumb while swiping or rapidly texting.

Try This Quick Thumb Test

Bend your thumb across your palm and wrap your fingers around it. Slowly bend your wrist down toward your pinky side. This is called the Eichhoff’s test.

If you feel pain along the thumb side of your wrist, it could indicate inflammation. (Note: Because this is an unnatural movement, it can sometimes create a false positive. Compare both hands to ensure the discomfort is notably worse on the affected side.)

4 Ways to Heal Texting Thumb

1. Thumb Brace: Once micro-tears occur in the tendon, they’re slow to heal. A forearm-based thumb spica brace that limits both thumb and wrist motion is recommended for at least two weeks. This brace helps retrain your brain to rely on larger muscle groups — like your shoulders — while allowing those small tendons time to rest. You can order one online, but many find that custom-made braces provide a better fit and immobilization, ensuring proper healing without irritation.

2. Gentle Thumb Stretch: Gentle stretching is crucial to promote blood flow, decrease stiffness, and support healing. If you only wear the brace without any motion, you might end up with more stiffness and discomfort.

· Extend your arm with your palm facing down.

· Tuck your thumb into your palm and wrap your fingers around it.

· Slowly bend your wrist downward toward your pinky side (ulnar deviation).

· Hold for 15–30 seconds, feeling a gentle stretch along the thumb side of your wrist.

· Repeat 2–3 times on each hand. If this stretch is too painful, use your opposite hand to gently assist your thumb toward your palm before slowly bending the wrist.

3. Isometric Radial Deviation Strengthening: While your tendon is healing, it’s important to encourage light, non-provocative strengthening. Isometric exercises involve contracting the muscle without changing its length (like holding a plank). They are safe and controlled.

· Place your hand in a neutral position (thumb pointing up, as if holding a cup).

· Hold a stable surface (wall, table, or opposite hand) just above your thumb.

· Gently push your hand outward (as if trying to lift your thumb side upward) without letting it move.

· Hold for 5–10 seconds, then relax.

· Repeat 8–12 times for 2–3 sets on each hand.

4. Change How You Hold Your Phone: Your grip really matters! The small tendons responsible for thumb and wrist movements are extremely thin — about the thickness of yarn. They are not designed to sustain hours of repetitive use.

· Hold your phone with both hands instead of just one.

· Use your index finger to scroll instead of your thumb.

· Keep your wrists in a neutral position without bending or twisting.

The Most Common Mistake

One common mistake I see in my practice is people rushing to get a cortisone shot without changing the way they use their phone. The cortisone shot provides temporary relief, but unless they correct their posture and usage habits, the pain comes back — often worse than before.

Get Professional Help

A Certified Hand Therapist (CHT) can custom fabricate a thumb spica orthosis that fits comfortably and immobilizes the tendon properly, allowing for faster healing.

A Patient Story: The Phone Addict Professional

About a year ago, I worked with a patient who came in after visiting a hand surgeon for both hands. She arrived wearing two large braces and looked completely defeated. Her job required constant phone use and travel. Delaying responses wasn’t an option — her phone was her lifeline.

When I observed her texting posture, it was clear why she was in pain. Her wrists were fully extended backward, and her thumbs were making exaggerated movements — almost like a child playing with a toy phone. She wasn’t aware of her positioning because her focus was on her messages, not her form.

We used a mirror to help her visualize her posture. It took time for her to correct her wrist alignment and reduce excessive thumb extension. Breaking habits is hard — it takes around 66 days on average. We spent months retraining her proprioception, helping her recognize her wrist and thumb position without needing to look.

Eventually, she could text without discomfort, no braces required. Her big moment came at a professional conference, where she wore her favorite outfit — no braces, no unnecessary accessories.

Additional Prevention Tips and Exercises:

· Forearm massage: Use a foam roller or massage ball to gently roll out tight forearm muscles, which can help decrease tension on tendons.

· Scapular strengthening: Building shoulder strength and posture can help reduce overuse in smaller hand muscles.

· Stretch breaks: Set a timer every hour to stretch and move your hands and arms.

· Ergonomic setups: Use pop sockets, stands, or split keyboards for better hand alignment.

Why Proprioception Matters

Proprioception is your body’s ability to sense its position in space without visual input. In cases of repetitive strain injuries, proprioception often diminishes. This patient could not replicate wrist positions without looking — a sign that her brain and body connection needed retraining. We used mirror exercises, bilateral matching drills, and even smartphone posture tracking apps to help her regain awareness.

The Emotional Side of Texting Thumb

People often feel frustrated and embarrassed by this injury. After all, it’s caused by something so simple. But there’s no need to feel that way — our bodies weren’t designed for endless scrolling and texting. Reframing this injury as part of modern life helps patients approach healing without guilt.

What To Do If Your Symptoms Don’t Improve

· See a Certified Hand Therapist for custom splinting and treatment.

· Consult a hand surgeon if conservative treatment isn’t helping.

· Avoid jumping to surgery or injections without addressing posture and habits first.

Long-Term Success

Recovery is not just about rest — it’s about learning new movement patterns. Patients who succeed long term are those who:

· Consistently use proper ergonomics.

· Incorporate regular stretching and strengthening.

· Recognize early signs of overuse and address them quickly.

· Accept that this process takes time but yields lasting results.

At Dexterity Hand Therapy, we’re passionate about helping people regain comfortable use of their hands, whether they’re texting, typing, or creating art. If you’re struggling with pain, don’t wait for it to worsen. Schedule an evaluation with us today and let’s get you back to doing what you love.

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4 Ways to Heal your Texting Thumb