How to Handle High-Tech Hand Injuries

Experts explain how to avoid hand problems that may be related to using some of our favorite gadgets.

Medically Reviewed by Louise Chang, MD

In a recent New Yorker cartoon, two dogs sit discussing the strangeness of humans. "It's just a theory," says one, "but perhaps it's their opposable thumbs that make them crazy."

That's not a bad theory. Thumb problems are indeed making some people crazy these days, especially people who spend hours typing text messages into their cell phones, answering email with their BlackBerrys, and scrolling through music lists on their iPods. Such uses of the thumb, carried to an extreme, can lead to strain, pain, and repetitive stress injuries.

"When we hold one of these devices in our palm and try to manipulate the keyboard with the thumb of that hand, it's an awkward movement for the thumb," says Stacey Doyon, incoming president of the American Society of Hand Therapists (ASHT). "If you overdo it, you're probably going to have a problem. I had a patient recently, and the entire time I was working on one of his hands he was using the other to work his BlackBerry."

"BlackBerry thumb," as some call it, is not exactly widespread.

"I think it's kind of overinflated," says Peter Evans, MD, head of hand and upper extremity surgery at The Cleveland Clinic. "I've heard of patients who complain about soreness at the ends of their thumbs from all that pecking, but as soon as they stop, the problem goes away."

Still, hand problems caused by overuse of the thumb have become more common in recent years, according to Doyon. Nintendo thumb may have come first. Nintendo's instruction book now recommends 10 to 15 minutes of rest for every hour of play. As electronic devices become even smaller and acquire more features, they will encourage even more use and require the use of smaller muscles, she says, which may lead to even more problems.

Common symptoms of thumb strain include weakness, tingling, throbbing, or pain.

What's the best way to deal with these problems?

Lynn Bassini, a certified hand therapist in Brooklyn, N.Y., offers these suggestions to BlackBerry users:

  • Don't push down so hard. "That puts pressure on the nerve."
  • Use the nail of your thumb to scroll instead of the thumb itself.
  • Write short text messages, and don't write so many at one time. "After 15 or 20 minutes, get up and do something different.
  • Alternate fingers. "The less you move your thumb, the better. Share the work among your fingers; don't let the thumb do it all."
  • Put the BlackBerry on your briefcase or support it on your lap. "That way at least you're not holding it -- you're supporting it on something."

The ASHT offers other tips:

  • Adopt a neutral grip that keeps the wrist as straight as possible, because bending the wrist can add to the strain.
  • Take a break! They're called repetitive motion injuries because they result from performing the same task over and over. Allow your hands to rest, or at least switch activities frequently.
  • Switch hands frequently. That way you will be distributing the stress over two hands.
  • Sit up straight. You are more likely to strain your elbows and wrists when you lean or slouch while operating a handheld device.

The ASHT also recommends stretching exercises that may help stave off repetitive motion injuries or alleviate early symptoms. Hold each stretch for 10 seconds and repeat each eight times.

  • Fold your hands together and turn your palms away from your body as you extend your arms forward. You should feel a gentle stretch all the way from your shoulders to your fingers.
  • Fold your hands together and turn your palms away from your body, but this time extend your arms over your head. You should feel the stretch in your upper torso and from your shoulders to your hands.
  • Extend an arm in front of you, making sure the elbow is completely straight. With your palm down, take the opposite hand and bend the hand on the outstretched arm down toward the floor. Then turn the palm up and stretch the hand up toward your body. This stretches the forearm and wrist muscles.
  • Open the hands and spread the fingers as far as possible.

Joy C. MacDermid, a physiotherapist and epidemiologist who is also the secretary-treasurer for the ASHT, advises people to remember that psychological stress brought on by conflict at work or home also contributes to the type of strain that brings on BlackBerry thumb.

"It's hard to isolate the BlackBerry as the cause of these problems," MacDermid says. "Other sources of stress contribute. Do you dislike your supervisor? Do you encounter rudeness at work? Rudeness causes stress. People under stress have tense muscles, and their levels of cortisol (a stress hormone) tend to rise. That has to contribute to muscular problems. We try to separate physical and psychological health, but the connection is stronger that we realize."

One surefire way to prevent BlackBerry thumb, she says, is to rest.

"Shut it off once in a while," MacDermid says. "People don't seem to realize there's an off button."

Show Sources

SOURCES: Stacey Doyon, OTR/L, CHT, incoming president, American Society of Hand Therapists. Peter Evans, MD, head of hand and upper extremity surgery, The Cleveland Clinic. Lynn Bassini, CHT, certified hand therapist, Brooklyn, N.Y. Joy L. MacDermid, co-director, Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario; secretary-treasurer, American Society of Hand Therapists.

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