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Thumb Ulnar Collateral Ligament (UCL) Injury

A sprained thumb is a common injury among athletes. This injury happens when an ulnar collateral ligament (UCL) — tough and flexible tissue that connect bones in the thumb — gets stretched too far or tears.

Thumb Ulnar Collateral Ligament (UCL) Injury Hero Image 2

A sprained thumb is a common injury among athletes. This injury happens when an ulnar collateral ligament (UCL) — tough and flexible tissue that connect bones in the thumb — gets stretched too far or tears. This injury is sometimes called “skier’s thumb” because skiers are prone to this injury when they fall with their hand strapped to a ski pole. A thumb UCL injury can be very painful and make the thumb feel unstable. The injury can limit movements, such as squeezing and gripping, needed for many sports.

What causes Thumb Ulnar Collateral Ligament (UCL) Injury?

A thumb UCL injury often results from a fall onto an outstretched hand that causes the thumb to bend away from the palm. A thumb UCL injury is most common in these sports:

• Skiing
• Snowboarding
• Basketball
• Football
• Baseball
• Racket sports (e.g. tennis or racket ball)

Symptoms

Pain is a common symptom of a thumb UCL injury, though you may or may not feel pain right away. The degree of pain and other symptoms will depend on the severity of your injury. Other common symptoms include:
• Pain that worsens when moving your thumb
• Bruising, swelling, and tenderness at the base of the thumb
• Thumb feels loose and not secure
• Weakness when grasping or squeezing with the thumb and index finger
• A lump and swelling on the inside of the thumb

When to see a doctor

If you suffer an injury to your thumb and have symptoms, even if they feel mild, you should see your doctor. Proper treatment of a sprained thumb is important so it doesn’t get worse over time. Your doctor will ask questions about your injury, as well as your medical history and physical activity. During the physical exam, he or she will move your thumb in different directions to test the stability of your thumb joint. This movement will help assess if your UCL is stretched or torn. X-rays or other imaging tests may be taken to determine the severity of your injury and whether any bones are broken.

Non-operative treatment

Treatment of a thumb UCL injury will depend on the severity of the injury. Mild and moderate sprains can be treated conservatively without surgery. These treatments include:

• Rest: Avoid activities, such as racket sports, that involve heavy use of the hands and gripping movements.
• Ice: Apply cold packs to reduce swelling.
• Compression: A compression bandage may be worn to reduce swelling.
• Medication: Nonsteroidal anti-inflammatory (NSAID) medication like ibuprofen can help to relieve pain.
• Cast: For moderate sprains, your doctor may recommend a bandage, splint, or cast to keep your thumb joint immobilized until it can heal.
• Physical Therapy: Gentle exercises can help reduce stiffness and increase mobility in your thumb joint.

You can also try these exercises at home:

Thumb Ulnar Collateral Ligament (UCL) Injury

Surgical Treatment

For severe sprains, such as a complete rupture of the UCL, conservative treatment may not be enough to restore stability of your thumb joint. In these cases, your doctor may recommend surgery to reattach the UCL to the thumb joint and repair fractured bones if needed. Patients who undergo surgery typically must wear a cast or splint for several weeks after the procedure to aid in their recovery.

Recovery

With proper diagnosis and treatment, athletes can expect to regain their full range of motion. Your doctor can advise you on exercises that aid in your recovery and ensure you are ready to return to play. Left untreated, thumb UCL injuries can lead to complications such as arthritis, chronic weakness, and compromised function of the thumb.

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