Advice from a Certified Hand Therapist: Modifications to Pencil Grip for Handwriting

As a pediatric hand therapist, I see clients who hold their pens and pencils a little bit differently than most. Typically, these clients are using a different grip to compensate for weakness or loose joints. An altered grasp is not in itself a bad thing until it creates a problem.

The problem is usually a complaint of pain with handwriting. An individual with loose joints develops an altered grasp pattern in order to increase stability when writing, thus allowing them to write clearly. An example of a modified grip is excessive extension of the tip of the fingers or thumb along with excessive flexion of the second joint of the thumb.

Another example involves holding the pencil tight in the first web space while using all four fingers and thumb to stabilize the pencil.

Hand pain from using a non-traditional grasp typically comes from the force of grasp and muscle fatigue. Joints can also be painful due to the position of the joint and the amount of stress on the joint.

The goal of hand therapy is to provide alternative methods of pencil grasp to allow decreased force on the joints and muscles while writing.

The grasp most often recommended for those experiencing difficulties is the modified grasp with the pencil resting in the second web space as seen below.

The web space is tight and provides stability and allows the fingertips to move freely.

I suggest a pencil grip to decrease force and increase stability.

This allows a comfortable grip of the pencil and stability for the fingers. At times, a small splint (orthosis) may assist in providing stability of a joint. An exercise program to strengthen the muscles that cross the joints can be a beneficial addition.

For more assistance with pencil grasp or suggestions for a specific exercise contact a Certified Hand Therapist in your area.

Valeri Calhoun, MS, OTR, CHT is a Certified Hand Therapist and is an active member of the American Society of Hand Therapists