1,2,3,4, I declare a thumb war!

Everyday, when using our smartphones,  we are at war. A casualty in this war is the thumb.

I think the thumb on the left is winning. Source: Stock

Like a commander sending troops to battle, we take for granted our opposable thumb, which we use to execute our decisions. Without the thumb’s fine motor skills, humans would never have become the tool wielding, spear throwing and more advanced species. Nowadays we use it to match brightly coloured fruits and candies on our screens.

A case report was recently published in April this year on a 29-year old patient with a tendon rupture associated with excessive smartphone gaming. You can find the article here.

This patient ruptured his Extensor Pollicis Longus Tendon of the thumb from smartphone gaming all day, everyday. Source: http://www.surgerytheater.com/

1. “Playing was kind of a secondary thing”

The patient reported playing a match 3 puzzle video game (games where you match 3 tiles like Candy Crush Saga) on his smartphone all day for 6 to 8 weeks. He played with his non-dominant left hand and used his right hand for other tasks. He stated that “playing was kind of a secondary thing, but it was constantly on.” Essentially he wasn’t really aware of his game play and he wasn’t necessarily playing for fun. He was playing on autopilot.

From this information, gaming unconsciously was likely a form of self soothing for stress or avoidance of negative feelings by dissociation. Although he was on autopilot, gaming still requires some attention. Therefore, he probably wasn’t fully aware of anything in the game or in real life (including negative emotions).

Tip 1: Limit the amount of time you play and be more aware of your game play.

-Games are fun, but studies show that by limiting the frequency of things you enjoy, you are able to appreciate it more and be in the moment. If it is something you really enjoy and helps you to relax, allocate a specific time in your schedule to play.

Tip 2: Look at what could be causing stress in your life and have a repertoire of strategies to cope with stress other than gaming.

-Games are an effective way of coping with stress. However, in the long term, using one strategy such as gaming may prevent us from learning important skills required to deal with problems that cause stress.

Candy Crush Saga the game of choice to cope with negative feelings associated with the SMRT. Source: Supplied

2. “No pain”

The patient reported that he did not feel any pain whilst playing (I am feeling pain in my thumb just thinking about it). Not only is gaming effective in blocking out negative feelings, it can help suppress pain.

Tip 3 – Give yourself a break before you break it.

-Tendons are like rubber bands, use it too much and it might snap, like it did for this patient. Whilst gaming, you may not be aware of pain caused by repetitive use, so give yourself a break between sessions and pay attention to your joints (where tendon strength is weakest). If you are experiencing pain, you need to decide whether constant playing is really worth the long term damage. This patient underwent tendon graft surgery from his finger to his thumb, now that sounds painful!

3. Its all about position

How do you hold your phone? Do you use only one hand? Do you swap hands? Do you only use your thumb or your finger? How you hold your phone could contribute to more strain on your joints. In this particular case, the surgeon noted that the tendon ruptured where the thumb joins the wrist joint. Your thumb was not designed to press the letter A on your keypad at such a tight angle. Your neck was not designed for your head to look down at your belly button.

The hard to reach places for your thumb in red. Source: www.uxmatters.com
Red circle highlighting the hard to reach and tight angle of the letters “A” and “S”. Source: Supplied

Tip 4- Swap positions, stretch regularly and be mindful of how long you hold your phone.

-How long have you been holding your neck, elbow and wrist like that for? Try swapping to the other hand regularly. Try using two hands. How long you been playing your game non-stop? It might be time to take a break and stretch.

How do you hold your phone? Source: Steve Debenport


Take care of your thumb. Excessive use of your thumb on your smartphone can lead to severe physical injury.


Gilman, L., Cage, D. N., Horn, A., Bishop, F., Klam, W. P., & Doan, A. P. (2006). Tendon Rupture Associated With Excessive Smartphone Gaming.Cyberpsychol Behav, 9(6), 772-775.

Quoidbach, J., & Dunn, E. W. (2013). Give It Up A Strategy for Combating Hedonic Adaptation. Social Psychological and Personality Science, 4(5), 563-568.

Das, D. A., Grimmer, K. A., Sparnon, A. L., McRae, S. E., & Thomas, B. H. (2005). The efficacy of playing a virtual reality game in modulating pain for children with acute burn injuries: a randomized controlled trial [ISRCTN87413556]. BMC pediatrics, 5(1), 1.