Stenosing Tenosynovitis, commonly known as “trigger thumb,” is a painful condition where the flexor tendon sheath in the thumb becomes inflamed and narrow. This narrowing prevents the smooth gliding of the tendon, causing the thumb to catch, lock, or click when bent or straightened. Taping offers a simple, non-invasive method to manage this irritation by limiting the movement that causes the painful triggering. The goal of this technique is to restrict the metacarpophalangeal (MCP) or interphalangeal (IP) joint, reducing friction at the A1 pulley, the specific site of the tendon sheath constriction.
Preparing for the Taping Procedure
Proper preparation ensures a successful and lasting application. Gather sharp scissors and a roll of tape, choosing between non-elastic kinesiology tape or rigid athletic tape. Kinesiology tape, made of a cotton-spandex blend, offers support with more mobility, while rigid tape provides firmer immobilization and restriction. Before application, the skin must be clean and completely dry, free from lotions or oils, as these substances significantly reduce the tape’s adhesive properties.
Cleaning the skin with soap and water or an alcohol wipe helps maximize adherence and wear time. Individuals with sensitive skin may benefit from using a skin prep spray to provide a protective layer beneath the adhesive. Position the thumb in a comfortable, slightly relaxed position, often slightly bent at the MCP joint, avoiding the painful clicking motion. This resting position prevents the tendon from being strained immediately after the tape is applied.
Applying the Stabilization Tape Technique
Creating the Anchor Base
The taping procedure begins by establishing a secure anchor point on the wrist. Apply a strip of tape, approximately 6 to 8 inches long, around the circumference of the wrist, just below the bony prominence. Apply this anchor strip with no tension to prevent circulation constriction. This base layer provides a solid foundation for the subsequent support strips that will restrict the thumb’s movement.
The ends of the anchor strip should overlap slightly to ensure a strong connection. Rub the tape gently after application to activate the heat-sensitive adhesive and improve stickiness.
Applying the Restrictive Strips
Next, apply strips that directly restrict the flexor tendon’s movement, targeting the A1 pulley at the base of the thumb on the palm side. Cut a strip of tape roughly 4 to 5 inches long and round the edges to minimize peeling. For kinesiology tape, tear the backing paper in the middle and apply the center of the strip directly over the painful A1 pulley area.
Apply the central part of this strip with a moderate stretch (40 to 50 percent of maximum elasticity) directly across the palmar crease at the base of the thumb. Smooth the two ends of the strip down onto the palm and the back of the hand with no tension. This specific tension over the A1 pulley aims to lift the skin and reduce pressure on the inflamed tendon sheath.
Securing the Thumb Position
To prevent the thumb from moving into the painful, full-flexion position, use additional strips to stabilize the MCP joint. Cut a strip of tape about 6 inches long and place one end on the anchor base on the back of the wrist. Bring the strip up and over the back of the thumb, across the joint, and secure the other end back onto the wrist anchor. This strip acts as a check-rein to prevent excessive forward motion.
Apply this strip with light to moderate tension, gently pulling the thumb back into a slightly extended position without causing discomfort. If using rigid tape, this strip will be tighter and more restrictive, effectively immobilizing the joint. For greater stability, apply a second, similar strip diagonally across the first to create an “X” pattern over the MCP joint. This crosshatch pattern offers multi-directional support against both flexion and rotation.
Final Locking Strips
The final phase involves securing all applied tape edges to maximize wear time and prevent premature peeling. Use a final, full-length strip of tape and wrap it around the wrist, completely covering the edges of the initial anchor and the restrictive strips that terminate there. Apply this locking strip with light tension, similar to the initial anchor.
Ensure that any loose edges around the base of the thumb or on the palm are smoothed down thoroughly. Gently rub the entire taped area to generate friction and heat, which fully activates the adhesive bond. Properly securing the edges minimizes the chance of the tape catching on clothing or peeling during daily activities.
Duration of Wear and Safety Checks
The stabilization tape can typically be worn for one to three days, depending on the tape type and activity level. Kinesiology tape often maintains its adherence longer than rigid athletic tape, sometimes lasting up to five days. Since hands are frequently exposed to water and friction, the tape may loosen sooner than applications on other body parts.
Monitor the taped area closely for signs of skin irritation, such as redness, itching, or blistering. If these symptoms appear, remove the tape immediately and allow the skin to recover before re-taping. A primary safety check is monitoring circulation using the capillary refill test: gently press on the nail bed until it turns white, then release. The color should return to pink within two seconds. Any tingling, numbness, or coolness indicates the tape is too tight and must be reapplied more loosely. If symptoms persist or worsen significantly after consistent taping for several weeks, consult a physical therapist or physician.