Continuing with the winter theme, we would like to address winter sports, in particular, skiing. Skier’s thumb, also known as gamekeepers thumb, is when you tear a ligament in your thumb. This can be quite a debilitating injury.
What is the UCL in the thumb?
At the second joint from the tip of your thumb, called the MCP joint, there are multiple ligaments. The ligament that tears to create skier’s thumb is the Ulnar Collateral Ligament, commonly abbreviated UCL. The UCL runs along the side of the thumb closest to your index finger as in the image below.
Why is it called Skier’s Thumb?
This particular ligament tear is called skier’s thumb because it is often seen in skiers using ski poles. The patient falls while skiing and is unable to let go of the ski pole and it pushes their thumb out sideways. This is why we recommend not using the wrist straps on your ski poles. See the image below for a visual of how this occurs. There many other ways to injure this ligament other than skiing. Anything that causes a sideways force on the thumb joint could rupture or sprain this ligament.
What’s Next After a Ligament Tear?
Will I Need Surgery?
Often this ligament is just sprained. Typically you’ll know if it’s fully torn because your thumb will not stay in place. With a sprain or a minor tear, then your doctor may just cast or splint the thumb. The cast or splint will be worn on average for 4-6 weeks. However, your doctor or therapist will let you know when to begin using your thumb, and there will be restrictions for you to follow to allow your thumb the best opportunity to heal. For a more severe or complete tear, your doctor will recommend surgery to repair the UCL. After surgery, your thumb will be in a cast or splint, and then your doctor will refer you to hand therapy to being regaining the range of motion and strength that you have lost throughout this process.
Therapy for Skier’s Thumb
Your doctor may send you to therapy after a minor tear once you come out of the cast or splint. If you had surgery, it is more likely your doctor will refer you to hand therapy. Typically after a UCL repair, you can expect a 6-8 week course of therapy. This can be longer depending on complications.
At the beginning the focus of hand therapy will be swelling reduction and gentle hand exercises. Once cleared by your physician you can begin thumb strengthening exercises in therapy. Your therapist will work with your doctor to help you progress to the best result possible.
For more information on skier’s thumb, please visit the American Academy of Orthopedic Surgeons. Have you sustained an injury between or including your shoulder and fingertips? Do you suspect that your workplace environment is causing you pain? If so, you could be a candidate for hand therapy services at LB Hand Therapy in Maryland. Visit our Where to Begin page to become a patient.