The Thumb…

Hello Friends,

I certainly hope that since last month you have been engaging in mindful breathing, enjoying the enhanced energy for your massage practice and beyond. 

If so, a big thumbs up to you 👍. 

Ironically enough, in Chinese medicine, the Lung meridian ends in your thumb. And the Thumb is precisely our topic for this months self-care reminder. 

In other modalities like Polarity Therapy or Digit Reflexology, the Ether element flows through the thumb. 

The “thumbs up” symbol has always been the universal gesture to let someone know you’re in agreement or that everything is ok, More recently the use of the “thumb’s up” sign has been catapulted into mass popularity with our cultural obsession of social media like Facebook. 

However, no one holds the thumb in more reverence than a massage therapist. Specifically their own thumb!  It can be easily argued that by far the thumb is one of the most valuable tools a massage therapist has in their tool belt. After a long full season I have heard several therapists discussing thumb injuries.  

There is no need for these types of injuries no matter how often we utilize this “tool”, so let’s briefly explore the anatomy of your thumb and the proper way to use it in therapy so as to avoid injury in the future. The unique structure of the thumb does make it vulnerable to injuries. 

The carpometacarpal  (CMC) joint, the saddle joint at the radial end of the carpal bones which makes our thumbs opposable, endures the concentration of force that acts on the thumb, especially when used for applying pressure. In their book ‘Save Your Hands’, Greene and Goggins remind us that for every pound of pressure that you apply with your thumb, there can be 10-12 pounds of pressure concentrated on the CMC joint.  

Think about it, if you use your thumb to apply 10 pounds of force to a stubborn trigger point, the result could be as much as 120 pounds of force at the base of your thumb. That would be in addition to all our basic daily activities that ask so much of our thumbs, from simply gripping anything, to sending a text message or hitting the space bar on the computer keyboard. These activities lead to fatigue of the muscles around the thumb and damage to the ligaments, tendons and cartilage around the CMC joint, as well as subsequent inflammation to the joint.

In ‘Body Mechanics and Self-Care Manual’ by Marian Wolfe Dixon, she discussed that “anytime a joint is hyperextended, it puts stress on the tendons and ligaments and can tear fibers. If this microinjury happens repeatedly it becomes a source of inflammation, pain and swelling. Instead keep your thumb close to your fingers so that you are working straight on, and the thumb bears its weight in a vector that moves in line with the rest of the joint.”

In other words, when applying pressure to your clients body with the tip of your thumb, be sure that your thumb is adducted, tucked in as close to the hand as possible, creating a line of force with your joints stacked. 

When the thumb joint is abducted, and in extension from the hand you should NEVER ever apply any kind of downward pressure or force to your client. 

This is one of the most common errors made, and almost always leads to injury of the thumb. 

Once that thumb joint blows out, it is a very difficult road to recovery, time off work, loss of income etc…

As far as suggestions to help the thumb heal, unfortunately, resting the use of the thumb joint is the path to recovery. 

In fact, when meeting people who have professionally left the massage industry, one of the most common reasons it is they injured their thumb joint and could not recover, probably because they did not address the reason for the injury in the first place.


Doing extensive massage and bodywork for the past 17 years and continuing to have healthy thumbs, I can surely testify to the effectiveness of utilizing proper stacking of the joints and use of the thumb. 

I trust that applying this mandatory mindfulness of the use of your most valuable tool, Your Thumb, will keep it healthy for many years to come. Here’s a big thumbs up to a long and fruitful career as a massage therapist. 👍

Dawn Volpe NTS, LMT


Dawn practices bodywork in Bonita Springs at Hummingbird Energy Healing Arts on the historical Shangri-La property. 

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Or 239-273-2270