I use hand trackballs instead of thumb trackballs and find them much easier to use. I have a
Trackball Explorer at work and a
Cordless TrackMan Optical at home. I used to have the Microsoft one at both home and work but went wireless at home. The Logitech one is superior; while the Microsoft one is actually really nice, it requires a lot of maintenance (it gets insanely dirty and starts to skip and drag).
The main issue for me is that the thumb trackballs have always required extremely precise movement and perfectly still hands, lots of dexterity, while largely ignoring the rest of the hand. The hand trackballs make much better, IMHO, use of the space.