QUESTION: A 27 year old Physiotherapist presents with concern about her inability to control the alignment of her thumbs while she is performing manual therapy techniques. Is there anything she can do to fix it?
Physiotherapists can find it difficult to control the alignment of the joints of their thumbs while applying pressure through the thumb tips during manual techniques. Sometimes the MP joint collapses into flexion, as the IP joint hyperextends. Alternatively, the MP joint collapses into hyperextension, with the IP joint in flexion. Both of these postures results in assertional stress at the CMC joint, predisposing the therapist to develop pain at the base of the thumb, and potentially interfering with their ability to continue to perform manual techniques.
A combination of education, splinting and specific exercises to improve stability can help reduce pain. There are different types of splints available depending on individual needs, and how much support is required. You will also be provided with:
- Pain management techniques and advice about activity modification
- Graded strengthening and proprioception exercises to help improve stability, coordination and strength in the thumb and hand