Thumbs Up: All About Skier’s Thumb/Gamekeeper’s Thumb Injuries

A fall on the hand or sudden force to the thumb can overstretch the ulnar collateral ligament (UCL) located at the base of the thumb. Often called skier’s thumb or gamekeeper’s thumb, this injury most often occurs during falls while performing activities like skiing or bicycling. However, contact sports injuries contribute to 1 out of 3 instances of this injury.

Fortunately, skier’s thumb or gamekeeper’s thumb injuries are often mild and generally heal well with conservative treatment. However, it is easy to understate the severity of this injury, so a thorough evaluation should be done to ensure a rupture of the ligament or a fracture to the bone or growth plate has not occurred. If not diagnosed or treated properly, this injury can lead to chronic issues such as pain, weakness, and loss of function of the hand.

DESCRIPTION

The UCL is one of several ligaments that help join the base of the thumb to the hand bones (MCP joint). Its function is to maintain the stability of the joint while performing motions like bending, holding, grasping, or pinching. When overstretched, the UCL can tear or rupture.

CAUSES & TRIGGERS

  • Hyperabduction and hyperextension of the thumb
  • A fall on the hand or tip of the thumb
  • Repetitive stress to the joint and ligament
  • Direct blow or collision 

SIGNS & SYMPTOMS

  • Sudden onset of pain
  • Bruising
  • Swelling
  • Tenderness to touch/palpation
  • Pain and weakness with grasping/pinching
  • Pain and difficulty fully opening the hand
  • Popping or clicking (instability) with use of the hand

TIPS & TREATMENT

  • Initial Treatment
    • Wrapping or splinting the wrist and thumb
    • Icing 10-20 minutes, 3-5x per day to reduce pain and swelling
    • Elevating the hand as needed to reduce swelling
  • Diagnosis and Professional Treatment
    • A physical exam by a physician, x-ray, and an MRI are typically needed to determine an accurate diagnosis
    • Splinting up to 6 weeks for Grade I-II sprains
    • ROM and strength exercises to regain function of the hand
    • Surgery and rehabilitation are often required for Grade III-IV tears

When an athlete has an injury, there are several ways your Orthopedic ONE Sports Medicine Team can help by providing recommendations, aiding in diagnosing the issue, and providing treatment and prevention tips! To learn more about our Sports Medicine specialty and for a list of our Sports Medicine physicians, click here! 

Sources: Madan, S. S., Injury to Ulnar Collateral Ligament of Thumb. Orthopaedic Surgery. 2014;6:1–7; Mandhkani M, et al. Rupture of the ulnar collateral ligament of the thumb – a review. Int J Emerg Med. 2013; 6: 31. doi: 10.1186/1865-1380-6-31PMCID: PMC3765347

Photo credit: Physio-pedia