Effect of general flexibility on thumb-tip force generation - implication for mobilization and manipulation

Pain involving basal joints of the thumb is one of the major occupation-related disorders for orthopedic physiotherapists and manual therapists. The thumb-tip force generation while performing manual techniques may be influenced not only by the specific manual techniques employed but also by general flexibility of the therapist. The purpose of this study was to investigate the influence of general flexibility and different techniques on thumb-tip force generation. Twenty-three subjects with no exposure to manual techniques and 15 physical therapy clinicians with at least 3 years of orthopedic experience participated. The general flexibility of each subject was assessed by Beighton score (BS). Each subject was requested to exert a maximal force on a six-component load cell with the thumb unsupported (T1), with the rest of digits supported (T2), and with interphalangeal joint of the thumb supported by the index (T3).The thumb-tip force was normalized by body weight. The thumb-tip force generation is influenced not only by the differences in technique employed by the therapists, but also by the general flexibility of the therapists. Physiotherapists with excessive thumb flexibility are advised to perform PA glide with IP joint supported to protect the thumb joints from injury.