Q&A: Treatment for skier's thumb

Q: How do I treat skier's/gamekeeper's thumb?

A: For many athletes, few things can be more prohibitive to performance than skier's thumb. In baseball, volleyball, hockey, and — naturally — skiing, you rely on your thumb to grip, extend, and balance yourself. Skier's thumb occurs when your ulnar collateral ligament (UCL) is damaged or torn as a result of a fall or other sudden movement that stretches the thumb and index finger too far. And although the name itself may seem restricted to specific activities, the condition limits sufferers in a lot of ways.

Your UCL is an important stabilizer for your thumb. It is the soft tissue that allows athletes to make intricate changes in grip and pressure. Any disruption of your UCL can greatly impact the function of your hand, so it is important to give these injuries the proper care.

Acute UCL injuries may result from a sudden fall or jolt that overextends your thumb in one direction. With this injury, you may experience pain and swelling around the base of your thumb and have trouble accomplishing simple tasks, such as tying your shoes or tearing a piece of paper. Sprains or partial tears from acute UCL injuries typically require physical therapy and four to six weeks in a splint or cast. However, if the symptoms continue, more advanced treatment may be needed.

Chronic UCL injuries — also known as gamekeeper's thumb — occur over time from repeated use. Instead of spraining or tearing, the soft tissue in the ligament stretches and weakens. Most chronic UCL injuries are treated by placing a splint around the thumb or hand to immobilize the injury and allow it to heal. However, if you have a complete UCL tear, the ligament may not be able to heal on its own. In this case, your physician may recommend outpatient surgery to repair your thumb.

Whether you are an athlete or not, the strength and range of motion of your thumb and hand are crucial to accomplish everyday tasks, so it is important that UCL injuries receive the proper treatment and care as soon as possible. Untreated, lingering injuries can have serious long-term effects. If you suspect you have a hand or UCL-related injury, see a specialist.

Michael Yang, MD, is a sports medicine specialist at Mercy Health System.