by: Rob Stanborough PT, DPT, MHSc, MTC, CMTPT, FAAOMPT
I’ve written about Wii-itis, which is another name and cause for Tennis elbow or lateral epicondylitis. There is also a Gamer’s Thumb, otherwise known as de Quervain’s Tenosynovitis.
It is a real problem and I’m not making this stuff up. Gamer’s thumb or de Quervain’s Tenosynovitis can be very painful and debilitating. For those who use their hands for work it may hinder such tasks.
De Quervain’s Tenosynovitis occurs when a sheath around the thumb tendon’s gets inflamed. Two particular tendons that move the thumb are surrounded by what is called a synovial sheath.
When the sheath is abnormally stressed or rubbed by the tendons, it gets inflamed and causes pain.
It’s called Gamer’s Thumb because it most commonly effects gamers, those who play video games, Xbox, Play Station but can also be a problem for those who text a lot or even some jobs where the hands are used a lot. For that reason it is categorized as a repetitive stress injury.
De Quarvain’s Tenosynovitis is often diagnosed with the Finkelstein test. The test is performed by folding the thumb down into the palm. While maintaining that position, the grasped thumb and hand are bent in the direction of the pinky, as if one were casting a fishing pole.
If a sharp pain is produced over the thumb, wrist or arm, a diagnosis may be made. Other tests are done to confirm and/or rule out similar problems. The tendons are also very tender with palpation.
Conservative treatment can be quite easy and successful. The first thing to do, and sometimes the most challenging, is to first remove the stress from the tissues. This is something easier said than done for habitual texters or gamers.
If necessary, the thumb can be taped in a way to protect the tissue or placed in a splint, which is more restrictive. Treatment may also include soft tissue manipulation or joint manipulation if they too are restrictive. Eventually stretching is performed followed by strengthening.
Reversing the effects of Gamer’s Thumb does not take long, provided the stresses through the thumb are reduced.
It’s just a matter of controlling the stresses, allowing the tissues to heal and then slowly working on proper function.
In chronic or reoccurring cases, adaptive equipment may be prescribed such as built up grips or larger electronic devices.
The therapists at First Coast Rehabilitation are familiar with Gamer’s Thumb either by diagnosis or personal experience. If you are experiencing this type of pain, please call either of our offices to schedule an appointment: (St. Augustine: 904-829-3411 or (Palatka: 386-325-2721). We’re happy to help.
Rob Stanborough is a physical therapists, president and co-owner of First Coast Rehabilitation. He is co-author of Myofascial Manipulation: Theory & Application, 3rd ed by Proed Inc. He has been in practice for over 14 years, is a Fellow of the American Academy of Orthopaedic Manual Therapists and trained/certified in a number of soft tissue techniques.