Oh Thumbs!

Posted by Ove Indergaard on December 20, 2015 . 0 Comments


One of the main things that sparked my interest in Tool Assisted Soft Tissue Massage were the problems I was experiencing daily in my thumbs and my hands. And with thumbs like mine (as pictured below) I guess this was inevitable in my profession. It appears I am not the only one suffering from problems due to my occupation, and several studies has shown the extent of the problem.

Cromie and colleagues (2000) investigated the extent of work related musculoskeletal disorders in physiotherapists. They found that 91% of physiotherapist will suffer from work related pain at some point in their careers, and disturbingly 1 in 6 physios changed their job or left the profession as a result. They also found that you were more likely to suffer from pain if you were in the early years of your practice. Other studies have mentioned that up to 38% of physios changed their work setting due to pain but that most changed their techniques to carry on working.

Another study performed in Australia (West and Gardner, 2001) found the incidence to be a lot lower at 55% and that 40% of those work related injuries had occurred in the last 12 months. They also eccoed the findings of Cromie and colleagues in that 56% of all the injuries had occurred in the first 5 years of qualifying.

There are more studies on the matter, but essentially there is a widespread problem in manual therapy professions with wrist and thumb pain, with several studies reporting the incidence between 23- 83% (Albert et al, 2008,Wajon et al, 2003,). The main factor that have been identified are the use of incorrect/poor mobilisation and manipulation techniques, repetition of these, demanding postures, working whilst injured and excessive workloads (Glover et al, 2005, West & Gardner, 2001, Wajon et al, 2007).

Disturbingly Snodgrass et al (2003) found that 100 % of physiotherapists with thumb pain related it to manual therapy techniques and 83% of these changed the way they practice as a result. What worries me the most is the 23% of the people tested had OA in their thumbs with a mean age of 38.6. It makes me wonder what my own thumbs look like.

I guess finding the Tool Assisted Soft Tissue Massage has been a saviour for my thumbs, once I started incorporating these techniques I found my thumbs started to settle down. Now ,I can’t do everything with the tool, but with thumbs like mine I still get the odd day with aching in my thumb but it has been greatly reduced and not on a daily basis.


An important thing to note as well is in my opinion physiotherapists don’t look after themselves well enough. Snodgrass et al (2003) mentioned that there were increased joint laxity in the 1st CMC joint and decreased pinch strength in physios with thumb pain. So the solution seems to be there for us. Start using Tool Assisted Massage techniques for some of our soft tissue work and start strengthening our thumbs. Below is a great little video with some suggestions for how to do our rehab/prehab work ourselves!


Snodgrass et al (2003) Factors related to thumb pain in physiotherapists Australian Journal of Physiotherapy, Vol 49, p243-250

Albert et al(2008) A survey of musculoskeletal injuries in Canadian Massage Therapists Journal of Bodywork and Movement Therapies, Vol 12. issues 1. 

Cromie et al (2000) Work-related musculoskeletal disorders in physical therapists: prevalence, severity, risks, and responses Physical Therapy, Vol. 80, no 4, p.336-354

West and Gardener (2001) Occupational injuries of physiotherapists in North and Central Queensland Australian Journal of Physiotherapy, Vol 47, p.179-186

Glover et al (2005) Work-related Strain Injuries in Physiotherapists: Prevalence and prevention of musculoskeletal disorders Physiotherapy, Vol 91, Issue 3, p.138-141

Wajon et al (2003) Prevalence of thumb pain in physical therapists practicing spinal manipulative therapy Journal of Hand Therapy, Vol 16, Issue 3, p.236-244

Wajon et al (2007) Work-related thumb pain in physiotherapists is associated with thumb alignment during performance of PA pressures Manual Therapy, Vol 12, issue 1, p.12-16