Allyson Chiu
FOR hours during a trip from her home in Michigan to Ireland, Julie Mueller, 48, had been using her smartphone ‒ holding it as she always did: in one hand, with the bottom of the phone resting against her pinkie, leaving her thumb free to scroll.
What started as a twinge at the base of her pinkie became a constant ache radiating through the outer edge of her hand.
The claw-like grip and its variations are a common sight among smartphone users. But orthopaedists and occupational therapists say the one-handed hold can take a toll on the body.
Dubbed “smartphone pinkie” (which is not a formal medical term) by some people on the internet, the issues that could result from using your smallest finger as a phone stand join a growing list of hand, wrist, elbow and neck problems that experts say is probably connected to overusing handheld technology.
“Over the last five to 10 years as phones have evolved from your standard flip phone or block phone, which are much smaller, to these mini computers in your hands, there has been a rise in overuse injuries and nerve-related symptoms as people spend a lot more time on their smartphones,” said Duc Nguyen, an orthopaedic surgeon at Johns Hopkins with expertise in hand, wrist, elbow and shoulder conditions.
The next time you reach for your phone, here’s what Nguyen and other experts recommend you keep in mind:
* Be aware of how you're holding and using your device.
The musculoskeletal and nerve problems linked to phone use are often the result of how much time you’re spending in “constrained positions” doing repetitive motions, said Dominic King, a sports medicine and interventional orthopaedic physician at the Cleveland Clinic.
A one-handed claw grip, for instance, is “just not a natural position that we normally like to use our hands in,” Nguyen said. In that position, he said, people tended to flex their wrists at an angle, potentially straining tendons and increasing pressure on the nerves that run through the wrist. If, for example, the median nerve at the wrist is compressed, it can cause numbness or tingling in some fingers. The claw grip might exacerbate elbow conditions such as golfer’s or tennis elbow.
Using your phone with one hand can also lead to general muscle soreness and wreak havoc on your thumbs and pinkies. Stretching your thumb across a screen repeatedly can cause tendinitis, pain and possibly even trigger finger, said Eugene Tsai, the director of Hand Surgery Education at Cedars-Sinai Medical Center. The motion may also aggravate existing arthritis at the base of the thumb.
“Our thumbs just weren’t evolved to be doing this non-stop work for long period,” Tsai said.
Pinkies were similarly not designed to support weighty smartphones, despite the number of people who say they instinctively brace their phones against the smallest finger.
That might be the result of pinkies having more mobility than the other fingers, said Ann Lund, an occupational therapist and certified hand therapist with the Mayo Clinic. But, she said, the finger was smaller and wouldn’t “tolerate the pressure and the positioning as well as a larger digit”.
Resting your phone on your pinkie could strain the ligament that connected the finger to your hand, said Michelle Carlson, a hand and upper extremity surgeon at the Hospital for Special Surgery in New York. Where the pinkie contacted the phone could also become calloused and sore, she said.
Aside from hand and wrist positioning, be mindful of your elbow and neck. If you kept your elbow flexed past 90 degrees for extended amounts of time, such as when you’re holding your phone up to your ear or bringing it closer to your face, there was a “very significant increase in the amount of pressure” on the part of the ulnar nerve that travels through the cubital tunnel across the elbow, Nguyen said.
Nerves could also be compressed if you frequently contorted your neck to pinch your phone between your ear and shoulder, King said. And, he said, you could experience strain and stiffness at the back of your neck from looking down at your phone screen.
It was critical, Lund said, to pay attention symptoms that might occur when you were on your phone.
“What your body’s telling you is that you have reached maximum capacity of performance,” she said, “and so what it’s asking for is some rest.”
* Take breaks and change positions often.
The key to preventing mild overuse problems from developing into more serious conditions is decreasing and modifying phone use.
“If you’re anticipating using your phone for several hours a day, you don’t want them to be continuous,” Nguyen said. “Take a break. Stretch out your fingers. Stretch out the wrist.”
Be aware of how much time you usually spent on your phone and establish time limits, King said. Apple and Android devices, for example, allowed users to monitor their screen time and set limits for app use.
Changing positions frequently could also make “a huge difference”, Carlson said. “Even if you’re talking on the phone with your elbow bent, switch to the other side. Don’t try to power through it because that’s going to cause problems that will last way beyond your phone call.”
Consider moving or repositioning at least every 10 to 15 minutes, Nguyen and King said. Tsai recommended five-minute intervals. “Five minutes passes very quickly when you’re using your phone, but it’s actually a long time keeping your hand in one position.”
Any noticeable pain, such as soreness or aches, indicates you need a change.
* Prioritise comfort and ergonomics.
For those who weren’t able or willing to put down their phones, there were ways to use them more comfortably, experts said.
Trying holding your phone with two hands, Nguyen said. That allowed the wrists to be in neutral position and let you use both thumbs to cover more of the screen.
If you were accustomed to using your phone with one hand, don’t rely on your pinkie as the support, King said. Instead, he and other experts suggested buying assistive accessories.
The attachments can also make it easier to adjust your hand position when holding a phone and increase comfort if you were switching to your non-dominant hand, Lund said.
Experts also recommended more hands-free usage or taking phone size into consideration.
“Sometimes it’s as simple as trying to fit the appropriate sized phone to the appropriate sized hand,” Lund said.
If you’re buying a phone, Carlson suggested making sure it feels comfortable in your hand before purchasing it.
* Know when to seek medical care.
Although experts said mild symptoms often resolved with rest and changing your phone usage, they emphasised that it was important not to dismiss worsening or lingering issues.
If the numbness and tingling in your hand and fingers persists long after you’ve stopped using your phone or changed positions, that might be a “sign of very severe nerve compression”, Tsai said. Muscle atrophy could also indicate a more serious nerve problem, he said.
Any pain that didn’t quickly resolve should be assessed by a health-care professional, King said. Neck pain, in particular, Lund added, “should be immediately addressed to just ensure that it’s nothing more than strain and that there’s nothing more insidious going on”.
Remember, King said, technology use was just one factor that could contribute to musculoskeletal or nerve problems.
“Knowing how to reduce some of those larger injuries may start simply with just setting a time limit with your phone.” - The Washington Post