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Think Twice Before You Text That Message

A hand surgeon explains the dangers, especially for boomers

By Deborah Quilter

Several years ago, one of my ergonomic clients was warned about not abusing the hand — especially the thumb — during repetitive activities such as using a computer keyboard or mobile phone.

“My work demanded more constant contact, and I was away from my computer a lot, so I needed a smartphone,” recalls Geraldine S., a Manhattan marketing executive in her mid-50s. “I knew about BlackBerry thumb, but I thought, ‘That’s not going to happen to me. I take B6, I exercise and I eat an alkaline diet.” Today, she says: “I blew it. Slowly, slowly I got a lot of discomfort.”

Her pain was mainly in the thenar eminence, the wad of muscle underneath the thumb on the palm side of the hand, a common site for texting-related injuries according to a study by Dr. Deepak Sharan in the journal Work.

(MORE: How Texting Can Give You a Permanent Pain in the Neck)

What Can Go Wrong

While "text thumb," itself, is not a medical diagnosis, it can include a number of recognized syndromes:

  • Arthritis and other changes in the joints
  • Strained thenar muscles under the thumb in the palm of the hand
  • Trigger thumb, where the thumb can get “locked” in a bent position; sometimes people have to manually release the digit with the other hand
  • Carpal tunnel syndrome, median nerve compression which can lead to numbness, tingling and pain, especially in the thumb, index and middle finger
  • DeQuervains disease, a painful condition which affects the tendons on the thumb side of the wrist

Are We Addicted to Our Phones?

According to a report released by Bank of America, younger folks regard their smartphones as more important to their daily lives than the Internet, deodorant or toothbrush. In contrast, 29 percent of boomers say they could give up their mobile phones indefinitely, and hate the idea of round-the-clock accessibility.

(MORE: Should You Buy the New Apple Products?)

Yet, 80 percent of boomers are using their phones to text. Many claim it’s the only way to get their children or grandchildren to communicate with them.

But as quick and convenient as texting can be, boomers are at special risk for thumb problems for a number of reasons.
Dr. Robert E. Markison, a hand surgeon and clinical professor of surgery at University of California, San Francisco, summarized some of the reasons people over 50 are more vulnerable to texting injuries (though younger people are also quite likely to get it, too):

Force and Repetition in an Unnatural Position

When you repeatedly put your thumb through the up/down, up/down movement on the glass surface of a cell phone (or on the spacebar of the keyboard), it can eventually cause pain, soreness and fatigue. “That can aggravate pre-existing arthritis in the age demographic that gets it, which is 25 percent of women over age 50,” explained Markison, who noted that the repeated up-and-down movement is one of the worst things you could do to your thumb.

The natural movement of the thumb goes inward toward the base of the other fingers, not up-and-down.
Posture and Force

Maintaining a head-forward, limbs-forward posture while sending too much force through the thumbs is a setup for injury, says Markison. “Two pounds of the thumb tip would be 20 to 22 pounds at the basal thumb joint,” he adds. This force, which is pulling — and pulling maximally — against the joint where the thumb joins the body of the hand, can lead to extreme wear and tear on the vulnerable thumb. While the thumb has the capability of describing a circle in the air (circumduction), this very flexibility makes it inherently unstable, making it prone to injury if not used in a natural way.


Cool Hands and Poor Circulation

Cool-handed people — whether due to a cold environment or poor circulation — are at greater risk for injury than those with warm hands because of inadequate microcirculation to tendons, joints and nerves.


If you’re running dry, circulation can shrink from the hands in favor of supplying the body core.
Drug Side Effects

Cholesterol-lowering medications such as Lipitor (statins) are well known for independently causing musculoskeletal and, to a lesser extent, neurological problems, Markison noted, adding that 25 to 33 percent of statin consumers suffer intolerable musculoskeletal side effects requiring discontinuation of the medications. 

(MORE: Should You Now Start Taking Statins?)

Endocrine/Metabolic Status

Thumb problems are more likely if you are hypothyroid, hyperthyroid or hyperparathyroid. If you have gout, even with mild elevation of serum uric acid, you’re going to have factors contributing to — or independently causing — small joint and tendon pain in the hands.

Vitamin Deficiencies

According to Markison, about 58 percent of women over 50 are vitamin D deficient and about 25 percent of them have work-disabling vitamin D deficiencies. He recommends supplementing with 2,000 to 5,000 international units of liquid vitamin D3 a day. Markison said it’s worth getting a blood test to check your vitamin D3 level — and also vitamins B6, B12 and C.
In addition to being the primary feature that sets us apart from the apes, the thumb takes up a very large portion of brain space. Without it, hand use is much diminished — how would you open a jar, hold a baby or operate a power tool?

“Think twice before you manually text anyone any time,” counsels Markison, “and if you really must send a text, dictate it!"

Deborah Quilter is an ergonomics expert, a certified Feldenkrais practitioner, a yoga therapist and the founder of the Balance Project at the Martha Stewart Center for Living at Mount Sinai Hospital in New York. She is also the author of Repetitive Strain Injury: A Computer User's Guide and The Repetitive Strain Injury Recovery Book. Read More
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