4 Trigger Thumb Exercises

Trigger thumb is a type of stenosing tenosynovitis that affects the flexor pollicis longus (FPL) tendon as it passes through the A1 pulley at the base of the thumb. This condition occurs when the tendon becomes irritated, swollen, or nodular, often from repetitive thumb flexion or gripping activities. As the tendon thickens and the pulley narrows, the normal gliding motion is disrupted—leading to a painful catching or locking sensation during thumb movement. In more advanced cases, the thumb may become stuck in a flexed position and then snap straight with a sudden release.

From a rehabilitation perspective, conservative management is often effective, particularly in mild to moderate cases. Physical therapy typically includes tendon gliding exercises to restore smooth motion of the FPL tendon through the pulley system. Isometric and eccentric loading strategies may be added to strengthen the tendon and reduce irritation. Thumb abduction and opposition exercises are also helpful for restoring range of motion and hand function. Splinting the MCP or IP joint in neutral extension is often used in conjunction with exercise to reduce mechanical stress. Education on activity modification, particularly limiting repetitive gripping or pinching, plays a key role in reducing tendon overload and promoting long-term recovery.

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00:00 Introduction
00:21 What causes trigger thumb?
01:40 Exercise 1: Tendon Glides
03:18 Exercise 2: Opposition
04:12 Exercise 3: Flexor Isometrics
05:43 Exercise 4: Flexor Eccentrics
07:17 My Self-Guided Rehab Book