What I changed:

• I stopped doing finger-specific exercises. They were helpful at first for relieving tension and improving endurance, but they weren't addressing the root cause of the problem.
• My physical therapist added two new exercises, and we also increased the weight/resistance on some of the existing ones.

Strength exercises that helped:

• Prone T raises: Lie face down on a bench with your arms extended in a T position and your thumbs pointing toward the ceiling. Slowly raise your arms until they reach shoulder height (about a 90° angle), squeeze your shoulder blades together for 2–3 seconds, then lower them in a controlled manner. 3 sets of 5–8 reps, resting 1–2 minutes between sets.
• Resistance band overhead ("military") press: Using a neutral grip, press the band overhead. Hold the top position briefly, then lower it under control. Use the same sets, reps, and rest periods as the previous exercise.
• Resistance band serratus anterior exercise: Hold the band at rib height with your elbows bent at 90°, forming an L shape. Keeping your elbows straight throughout the movement, raise the band in front of your chest and continue upward until your hands are above your head. Hold for 3 seconds at the top. 5 repetitions.
• "Demons and Angels": Finish with this well-known shoulder mobility and stability exercise.

Finally, there are two additional exercises that are more complementary than essential. One is a chest-opening stretch, and the other involves shoulder presses while also providing a light stretch for the back of the legs.

I saw this setup on X. It makes sense to a point, and I tested it — but only for 2 days. I paused it because I felt it wouldn't be worth it long-term, but I'm about to give it another shot.

What problems did I think I'd run into? First, that Cost Cap in theory leans on your pixel's learning and goes after the hottest audiences / most qualified prospects — so if it can't find more of those audiences, it just won't spend.

On day 2 of my test, it spent almost evenly across all the ad sets. In my normal CBO (Highest Volume), Meta picked 2 ad sets to put 80% of the budget into. With Cost Cap, on the other hand, almost all of them spent roughly evenly.

That worried me a bit at first — I thought I was burning money. But then I realized that ads which supposedly got no purchases under Highest Volume ended up converting for me under Cost Cap.

Another thing that worried me: that the pixel would never learn new audiences, since Cost Cap sticks to what it already knows works — so if I launched new creatives aimed at a different audience, they probably wouldn't get delivery. That's what I believed... until the above happened, and Meta spent on ads it previously wouldn't touch or that seemed dead.

But those are just my own theories. I'm going to test it now — because I launched a Cost Cap and it hasn't spent anything. But that's with winning ads only, not with all the filler I had loaded in before.

A bit of context so my habits/personality can help this resonate with you: I'm 25, a PC gamer since I was 6, hypermobile (mostly in the wrists), flat-footed, etc. I was doing calisthenics and I'm not sure if that sped up the problem, but I'd already had some symptoms for a few days before that.

I used to be a pretty intense Warzone player — sometimes I played so much it caused wrist discomfort that would go away after a few days, or I'd alternate between an ergonomic mouse and my gaming mouse.

Back to the calisthenics: I trained for about 3 months, everything was fine, then I stopped because it was giving me bad posture (all push exercises, zero pulling). Even after stopping, one day I just woke up with a burning pain, my wrist was swollen, and I couldn't even use a mouse or hold a fork properly.

Here's the plan I followed and some things I learned:

Ice and Heat — 10 min cold, 5 min rest, 10 min heat. You can also do shorter cycles of 5-3-5 (x2) for more circulation. This is key because you need to help reduce inflammation in the area.

Rest — I recommend this especially during acute flare-ups, when you can barely eat properly or use the computer for long periods.

Are you hypermobile in the wrist? There are some tests online that can help you check. If you are, your priority isn't reps — it's time under tension. Our type of tendons respond better to prolonged tension. So if you see an exercise programmed as 8 reps x 3 sets, adapt it to something like 1 rep held for 45 seconds x 3 sets.

Rest between sets should be almost mandatory at 2+ minutes, and you don't need to start at 45s — you can start at 15s and build up from there.

What exercises should you do? There are many options. I used a combination from Mr. Physio (there are posts with his videos here) plus another source, but again — it depends on whether you're hypermobile or not, so adapt accordingly.

What else did I discover that might apply to your case?

De Quervain's isn't just about wrist weakness or overuse. In my case, I originally assumed it was overuse — hours of Warzone — but that explanation stopped making sense after a while. My body was already conditioned to that many hours of play, so why would it suddenly stop holding up? Did I really get that weak? No.

The reality is there's more going on behind the scenes, and one major factor is the nerves. There's a nerve called the radial nerve that runs through several areas — from your pec minor, through the armpit, down the arm, all the way to your fingers. If it gets irritated or compressed anywhere along that path, it can trigger De Quervain's-like symptoms even though the actual problem isn't in the wrist at all.

How do I know if this applies to me?

1. Bad posture — rounded/forward shoulders, tightness in the chest.
2. Discomfort, pain, or tension — an easy way to check is grabbing a tennis ball or massage ball and rolling it across your upper back, around your armpit area. If you feel pain there, that's likely your subscapularis, which was my main issue. Weakness/tightness there can create tension and stiffness that radiates down to the wrist.
3. Your neck — there's a separate post on this too. Tension in the back of the neck can also contribute to wrist pain.

Bottom line: your wrist might just be reflecting a problem elsewhere, not the actual source. That's why so many people end up getting surgery and still have the same issue afterward, or grind through countless routines without ever fully fixing it — because you're only strengthening the area to compensate for instability elsewhere, not addressing the actual instability.

And that's the whole point of this post: I healed in 3 months with a mix of massage, targeted exercises, ice, heat, nerve mobility work, and — most importantly — figuring out where my real weak link was.

My budget isn't that large, so burning it on an ABO doesn't seem viable to me. Also, in some tests, I noticed that if a CBO campaign doesn't spend on certain ads and I force it in an ABO, they ended up being losing ads anyway.

However, that's not always the case, just as scaling is also much more complicated.

My structure is the following:

1 CBO - 1 ad set - 3-10 ads (10 ads if they are images and 5 ads if they are videos).

I force the budget in two ways:

• Minimum budget floor (target CPA / 4); this way, by the fourth day, it should have given me either a purchase or some data.
• 50% of my total budget is divided between the testing ad sets and the new one to be implemented.

Now, here is my framework for filtering winners and losers:

• Days 3-4: Here I decide whether to turn off the ad set or force the budget for a few more days (7 in total). Or simply remove the forced minimum budget and see what Meta Ads does.
• Day 7: Here again, I make the decision to turn it off completely, or keep it if it's a winner and force a higher minimum budget on it.

Now here come some doubts and my experience or hypothesis:

Why force budget in CBO on new ad sets? A CBO aims to give you the lowest cost per action (purchase). Therefore, it almost always tends to prefer ads with the same or a similar concept to the existing winners.

The other thing is that sometimes it might spend little crumbs of budget, but then after 7 days you look at the total and it almost reaches your target CPA, or it actually hits it. Therefore, it's better to save myself time and force it from Day 1.

Why turn off ad sets? Personally, I used to prefer not turning them off, thinking that Meta would give them a little budget, keep testing, and one day they would hit. The truth is that Meta Ads must give you a purchase. Even with top-funnel ads, if it doesn't, you are wasting your budget.

But then, how do I know if the ad would work in the future? (We'll look at that later).

To use or not to use a forced minimum budget? This might sound contradictory, but it's something I'm still debating. For some reason, sometimes Meta Ads gives you low CPMs (low-quality, garbage prospects) just to force the minimum budget you asked it to spend.

It hasn't happened to me just once or twice; it's been several times. And this isn't very good, because it messes up the learning at the campaign level.

It's something I'm still evaluating because, as I said above, sooner or later Meta will spend the target CPA anyway—not in 4 days anymore, but maybe in 8, 12, or 2 days, etc.

How do I know the paused ad set wasn't a potential winner? Run a graveyard campaign. You can use bid cap or cost cap; I prefer cost cap. Throw everything in there with a small budget. If Meta sees an opportunity, it will spend, and if it gives you a purchase or a relevant add to cart, you can bring it back to test again.

Final note: This is my structure and framework; there are certain details I didn't mention and am still developing. Another option I've seen some people use is CBO + Cost Cap. You put everything in there and Meta gives you ease of scaling. I haven't tried it because I feel like it's dangerous.

You depend 100% on Meta's AI, you rely on it respecting the target CPA, normally Meta will look for warmer audiences rather than cold ones, etc.

What do you guys think?