Gamer's Thumb: Repetitive Stress Injury

The ergonomics of video game controls are not good for the thumbs

Couple playing video games together

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Believe it or not, the human body is not designed to play video games efficiently.

The most popular style of controller is a two-handed controller with the thumbs doing most of the work. But this is what leads to the repetitive stress injury informally known as gamer's thumb.

Gamer's Thumb Injuries

This condition affects the thumb and wrist. Pain and sometimes a popping sound are present on the outside of the thumb at or near the wrist. There can also be a decrease in grip strength or range of motion in the hand.

The thumb is good at pulling inwards towards the wrist. The muscles and mechanics of human anatomy support this function. This provides grip. The thumb is really good for clamping down on stuff but isn't really made to perform lots of three-dimensional motions. So any motion that requires the thumb to do more than just grip puts a lot of repetitive stress on the thumb joint and the muscles and tendons attached to it.

Inflammation in the Thumb

Gamer's thumb (also known as texter's thumb, since many people send text messages on their mobile phones with their thumbs) can be a form of tendonitis, tenosynovitis or a combination of both of those disorders.

In either case, it means something is irritated, inflamed and swollen. With gamer's thumb, there is an inflammation of the tendons and/or the synovial sheaths that cover the tendons that control the motion of your thumb.

It may also be an inflammation in the tenosynium, a slippery membrane that acts as a sliding surface, in the opening in the wrist that the tendons slide through. Often the swelling from the inflammation in either the tendon or tenosynovitis causes irritation that leads to inflammation in the other after repetitive use. It can be quite painful and reduce your ability to grip.

Whichever part of the anatomy is irritated and inflamed, it squeezes the tendons and constricts their ability to slide within the sheath. The inflammation results in swelling and pain that can run from the tip of the thumb all the way down to the wrist and even the upper portion of the forearm.

Where Gamer's Thumb is Felt

In addition to soreness in your thumb joints, someone suffering from gamer's thumb may feel pain when turning or flexing the wrist or when making a fist. It also can be painful to try to grab something.

Medical Term for Gamer's Thumb

Gamer's thumb is formally known as De Quervain's syndrome. De Quervain's Syndrome can be treated at home effectively if it has not gotten too severe. If you are a serious gamer, you should consider trying to prevent De Quervain's syndrome to keep your hand healthy and your top scores high.

If you flatten your hand out with the back of your hand downward then your thumb can move in two ways. It can move up and back down. This moves your thumb out of the plane of your hand and is called palmar abduction. Your thumb can also move left to right staying within the plane of your hand. This type of movement is called radial abduction.

The tendons in your thumb are housed within synovial sheaths through the wrist passage. Synovial sheaths are kind of like tubes that can bend but don't kink. The result is that when the wrist is bent or twisted, the tendons can still slide back and forth through the wrist passage without getting snagged.

The tendons involved in gamer's thumb are those attached to the extensor pollicis brevis and abductor pollicis longus muscles, or the muscles that move your thumb in radial abduction. The muscles run side by side on the back of your forearm towards your wrist and the tendons run along the thumb from the tip to your wrist through an opening in your wrist where they then attach to the muscles.

So the irritation from repetitive stress causes the inflammation in the tendon or synovial sheath which leads to swelling and enlarges a portion of the tendon making it difficult for the tendon to pass through the opening in the wrist.

Or it causes inflammation in the tensynovium, which results in the same thing. Often, when one is swollen it causes the other to become irritated and inflamed as well, thereby compounding the problem.

Treating Gamer's Thumb

If left untreated, gamer's thumb can worsen and the repetitive inflammation and irritation of the tendon's synovial sheaths cause them to thicken and degenerate. This can result in permanent damage, leading to a loss of grip strength and/or range of motion, as well as constant pain and probably the end of your gaming experience.