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"Mastering The Art of Thumb War" - a review of the rehab and injury prevention

How to Dominate your Opponent


How Physiotherapy Can Help You Proclaim Victory!

“One, two, three, four. I declare a thumb war…” This common elementary school rhyme can be heard across playgrounds all around the world. This game may be viewed as “child’s play”, but believe it or not, there’s actually a World Thumb Wrestling Championship that (prior to the Covid pandemic) was held annually for the past 11 years with adult competitors! (1,2) One man claims that his grandfather invented the thumb war game in order to “lampoon war, and get people shaking hands” (3).

Now let’s get down to business…to defeat the thumbs! As Sun Tzu, the masterful author of the Art of War states “He will win who, prepared himself” (4).

The key to winning is:

1) Maneuverability – maximize the range of motion of your ENTIRE thumb

2) Speed – be able to move your thumb quickly

“Let your rapidity be that of the wind”

– Sun Tzu, The Art of War (4)

3) Strength – to pin down your opponent’s thumb

“Let your plans be dark and impenetrable as night, and when you move, fall like a thunderbolt.”

– Sun Tzu, The Art of War (4)

In terms of anatomy, your thumb actually extends almost all the way down towards your wrist.

What should my thumb’s range of motion be?

A quick check to see if your thumb has good range of motion is:

· Place the tip of your thumb to the tip of your little/pinky finger

· Slide the thumb along the little finger – towards the base of the little finger and into the palm

How far can you go?

  • Normal range is being able to reach either:

    • the base of your little finger (Kapandji Stage 9/10)

    • or the first major crease below your little finger (= the distal transverse palmar crease in anatomy textbooks; Kapandji Stage 10/10) (5)

  • This results in approximately:

    • 80-90˚ of bend (or flexion) at the outermost joint (IP/ Interphalangeal joint) (5,6,7)

    • 43-70˚ of flexion at the second joint down (MCP/Metacapophalangeal joint) (5,6,7)

    • 50-71˚ of palmar abduction at the CMC (Carpo-Metacarpophalangeal joint) (5,6,7)

If you find that you cannot reach your thumb to the base of your pinky or into the palm, you may find yourself at a disadvantage if you enter battle! To maximize your thumb range of motion we must address all 3 joints! Assuming that you are pain-free at your end of thumb range of motion, here are some exercises to help improve your thumb’s maneuverability at each of the 3 joints:

NOTE: If you are having pain and/or difficulty with any of these exercises above – please stop immediately and contact a physiotherapist for further investigation.

The 2nd component is Speed.

As Maverick & Goose from the 1986 classic “Top Gun” would attest “I feel the need…the need for speed!”(8). At the level of the thumb, this means practice drills – going as fast as you can while still under control.

- Thumb tracing out circles: clockwise and counterclockwise

- Thumb tracing out the alphabet: both in upper case (A, B, C…) and lower case (a, b, c…)

- Tapping drills: quickly tap the tip of your thumb to the tips of your index, middle, ring, and little fingers

And finally, Strength!

One can be “swift as the coursing river” (9), but without “all the strength of a raging fire” (9) to pin and hold down your opponent, you will most certainly be on the underside of your opponent’s thumb in no time! Try the following thumb “bootcamp” exercises to help get your thumb into fighting shape!

What should my grip strength be?

Grip strength data from a Statistics Canada assessment is summarized in the following tables (10). You can test yours with a hand grip dynamometer. If you’re interested, check out your max grip strength norms – based on your age and sex.

Grip strength is not merely important for dominating thumb war battles. A weaker grip strength can be associated with conditions such as high blood pressure/hypertension (11,12), type II diabetes mellitus (11,12), stroke (13), longer stays in ICU (12), and more complications after surgery (12).

Even more motivation to whip our hands into shape – a stronger grip can also make carrying groceries and opening jars easier, improve endurance when working outside, and give you a better quality of life!

So (keeping within your social bubble of course!) – strike up a quick game of thumb war and go forth with your strong thumbs and conquer the world!

By: Susan Herdman, Registered Physiotherapist – Specializing in Upper Extremity and Hand Telerehabilitation.

Book a telephysio / online physio / virtual physio appointment with a registered physiotherapist in British Columbia. InReach Online Physio services communities in northern and rural BC, such as Masset, Queen Charlotte, Fraser Lake, Fort Nelson, Fort St James, Dease Lake, Fort St John, Dawson Creek and more. Learn more

REFERENCES: 1) WTWC (2019). About: Thumb Wrestling Championships. Accessed May 14/2021:

2) Inside Edition (2019, July 30). The World Thumb Wrestling Championships Is an Actual Thing. Youtube. Accessed May 14/2021:

3) Davidson, Paul (2007, May 18). Who Invented the Game Thumb War. Accessed May 14/2021:

4) Sun Tzu (translated into English by Giles, L) (1910). Sun Tzu on the Art of War: The Oldest Military Treatise in the World. Allandale Online Publishing England (2000). Accessed May 14/2021:

5) Barakat MJ, Field J, & Taylor J (2013). The range of movement of the thumb. HAND 8:179-182. DOI 10.1007/s11552-013-9492-y Accessed May 14/2021:

6) Eaton, C. The Electronic Textbook of Hand Surgery: Range of Motion. Accessed May 14/2021:

7) Patel, N (2021). Range of Motion. Accessed May 14/2021:

8) Top Gun. Dir Tony Scott. 1986. Paramount Pictures. Film.

9) Mulan. Dir Barry Cook & Tony Bancroft. 1998. Walt Disney Pictures. Film.

10) Statistics Canada – Wong, SL (2016 Oct 19). Grip strength reference values for Canadians aged 6 to 79: Canadian Health Measures Survey, 2007 to 2013. Health Reports (27) 10 – pg 3-10. Accessed May 16/2021:

11) Mainous AG 3rd, Tanner RJ, Anton SD, & Jo A (2015). Grip strength as a marker of hypertension and diabetes in healthy weight adults. Am J Prev Med;49(6):850-8. doi: 10.1016/j.amepre.2015.05.025. Accessed May 16/2021:

12) Bohannon RW (2008). Hand grip dynamometry predicts future outcomes in aging adults. J Geriatr Phys Ther; 31: 3-10. doi: 10.1519/00139143-200831010-00002. Accessed May 16/2021:

13) Leong DP, Teo KK, Rangarajan S, et al. (2015 July 18). Prognostic value of grip strength: findings from the Prospective Urban Rural Epidemiology (PURE) study. Lancet 386(9990):266-73. doi: 10.1016/S0140-6736(14)62000-6. Accessed May 16/2021:

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