The stability of the human hand relies on the ligaments to stabilize both the thumb and fingers. An injury to these structures can greatly affect the ability to grip, write and impair the functional use of the hand for everyday tasks such as fastening clothing, opening containers and performing daily tasks at home, work or for leisure. An injury to the ligament between the two bones on the interior side of the thumb is often referred to as Skiers thumb. The term Skiers thumb originates in the event a skier tries to brace from a fall and lands on an outstretched hand and thumb, while holding on to a ski pole. This causes the thumb to bend sideways, causing a sprain or even a tear in the Ulnar Collateral Ligament, or UCL of the thumb.
How Skiers Thumb Can Occur
Of course, this type of injury can also occur without holding a ski pole. A few of these examples include when the thumb is forcefully pushed sideways from a fall, when the thumb is caught sliding onto a base, catching a ball on an outstretched thumb or having the thumb caught on a steering wheel during an accident. The injury can also occur from repeated forceful pressure on the inside of the thumb when using a wrench, performing twisting motions, or wringing heavy cloths. Even though skiers thumb accounts for about 10% of all skiing injuries, the same injury was formerly referred to as Gamekeepers thumb. Gamekeepers thumb describes a more chronic repetitive strain to the thumb metacarpal joint, whereas Skiers thumb is more of an acute, sudden injury to the UCL. Either type of injury will cause pain and instability, thus decreasing functional hand use.
Can Skiers Thumb Be Prevented?
First, when heading to the slopes, skiers should be taught to consciously discard the ski pole during all falls, as this can reduce the amount of force on the thumb should one fall. Second, choose ski poles that have finger groove grips that don’t have restraints such as a wrist strap or closed grip. To prevent injury when driving, keep your thumbs on the outside of the wheel, along with the fingers. This may take a conscious change as most are taught to grasp around the wheel, which places the thumb in a compromised position during a collision.
Skiers Thumb Symptoms:
- Pain at the base of the thumb on the web space, between the thumb and index finger that worsens with movement. Pain may be referred from the thumb to the wrist, as well.
- Significant weakness or the inability to squeeze or hold things between your thumb and index finger, or these activities significantly increase pain.
- Bruising, swelling and tenderness to the touch along the side of your thumb close to your index finger.
Our Hand Therapists Are Here To Help
If you are experiencing any of the symptoms above, seek help from the Hand Therapy experts at Athletico. Proper diagnosis and early treatment are key to managing an injury to the UCL. Without proper treatment, this can lead to severe arthritis and weakness in the thumb. In less severe cases, recommended treatment may consist of immobilization in a thumb orthosis, made by a Hand Therapist, or a cast that to be worn for up to four weeks. In the case of a complete tear, surgical repair is indicated after immobilization or surgery, followed by hand therapy for stretching and strengthening exercises to facilitate optimal functional use of your hand and thumb.
If you have any questions or concerns about your thumbs or wrists, Athletico Hand Therapists are available to help you recover.
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By Shelia M. Tenny, OTR/L, CHT for Athletico Physical Therapy
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