Skier’s Thumb, Don’t Let it Slow Down Winter Fun

Winter adventures can be some of the best we’ll have all year – from a cross country hike around snowy mountains to skiing down their slopes.  And while not the worst injury that could occur, skier’s thumb is among one of the more common hand injuries associated with these winter sports.  If not properly treated it can affect pinch and grip strength, hindering overall hand function and predisposing the joint to chronic instability and osteoarthritis.

What is Skier’s Thumb

Skier’s thumb, which is also referred to as a thumb sprain or Gamekeepers thumb, is an

Ulnar collateral ligament damage

Skier's Thumb, Ulnar Collateral Ligament Damage of the Thumb's MCP Joint

injury to the ulnar collateral ligament (UCL) of the thumb’s metacarpal phalangeal (MCP) joint.  It is the result of forced abduction or hyperextension of the proximal phalanx of the thumb, caused by abnormal pulling of the thumb, such as in a fall, while affixed to the ski pole/hoop.  While this type of injury is often seen among skiers, it is also frequently seen in athletes or those sustaining a fall on an outstretched hand.

Signs of Injury to the Ulnar Collateral Ligament Include:

  • Pain at the base of the thumb between the thumb and index finger
  • Swelling of the thumb
  • Weakness pinching or grasping
  • Tenderness along the index finger side of the thumb
  • Blue or black discoloration of the skin over the thumb
  • Thumb pain that worsens with movement in any or all directions

Diagnosing Skier’s Thumb

A physical examination and patient history are used in diagnosing this condition. To determine the extent of damage to the UCL, the thumb is moved in various positions to assess stability of the thumb joint.  A stress x-ray may be recommended to confirm that there are no broken bones.

Treatment and Rehabilitation for Skiers Thumb

Treatment for Skier’s Thumb depends on the extent of the damage.  Most cases respond well to conservative, nonsurgical treatment, which may entail immobilization in a cast initially – followed by a splint for a total of six weeks.

If the UCL is completely torn, surgery may be indicated to reconnect the ligament to the bone and restore range of motion and full thumb function.  Any bone damage that occurred during the tear is also repaired during this time.  Following surgery, patients are put in a splint and undergo range of motion exercises with protected activities for four to six weeks. This is then followed by conditioning and strengthening of the thumb.