Opposition ladder
Thumb tip-to-fingertip then slide to fifth metacarpal base
Goal
Combines discrete opposition contacts with a controlled translation for real-world arcs.
Motion taxonomy (reference)
Also called: thumb flex ext · thumb in out · thumb opposition with stroke · thumb to fingertips and base
Muscles — abductor pollicis brevis, adductor pollicis, extensor pollicis longus, flexor pollicis brevis, opponens pollicis, thenar muscles
Tendons — thumb flexor and extensor tendons, thumb opposition tendons
Bones / joints — CMC joint, finger phalanges, first metacarpal, IP joint, little finger phalanges, MCP joint, thumb CMC, thumb CMC joint, thumb IP, thumb IP joint, thumb MCP, thumb MCP joint
Indexed benefits: builds coordination · helps pinch control · improves opposition · improves thumb mobility · supports functional pinch arc · supports opposition · supports thumb reach · trains smooth movement
Common contexts: buttoning and pinch · CMC rehab · dexterity training · fine motor rehab · opposition training · pinch recovery · thumb mobility · thumb stiffness
Best for
- Functional opposition arc
- Dexterity after CMC irritation
Default dose
6 reps • 3×/day
Avoid when
- Acute basal joint synovitis
Measurement targets
- Time to complete ladder
Setup
- Forearm supported; fingers gently curved.
Steps
- 1Touch thumb tip to index, middle, ring, and small fingertips in order.
- 2Slide the thumb down the side of the small finger toward the MCP line.
- 3Return along the same path.
Cues
- Light pressure only.
- Smooth path, no grinding.
Common mistakes
- Forcing the thumb into the palm.
Stop if you feel
Stop rules
- Sharp pain (≥ 4/10)
- Increasing swelling during or after
- New or worsening numbness or tingling
- Color change in fingers (pale, blue, red)
- Wound opens, drains, or feels hot
- Next morning is worse than the day before
Progressions
- Slightly faster cadence if pain-free.
Regressions
- Stop at index and long only.
Used in
What to do next — not a dead end
Suggestions use body region, goal, motion type, and allowed phases — not your medical record. After surgery or a flare, follow your clinician first.
~2–5 min as a focused practice block
6 reps · 3×/day
None required — table or bodyweight only.
Phases 2, 3, 4
Generally lower load — still respect pain and swelling.
Next best movements
Later phase or richer progression when you are ready.
Prerequisite / gentler lane
Same region and intent — usually earlier phase or lower risk.
Commonly paired with
Different primary goal, same region — typical mixed sessions.
Related movements
Similar mechanics, goals, or anatomy.
Keep momentum without overdoing it
Log a short check-in to protect your streak — even one quality set counts.