Although the name suggests that this injury occurs in Skier’s, it is actually an injury common to a number of other sports as well, such as rugby, football, mountain bike riding….the list goes on!! This injury is also known as ‘Gamekeeper’s thumb’ and a thumb UCL injury.
It occurs when the thumb is pulled hard away from the rest of the hand resulting in damage to one of the main structural ligaments located on the inside of your thumb – the ulnar collateral ligament of the metacarpophalangeal joint. This can be the result of a ball knocking the thumb, a fall or as the name implies when the skier’s poll pushes the thumb away from the hand.

Depending on the force applied to the thumb the injury could result in a partial tear, a complete rupture or a tear associated with a fracture – known as an avulsion fracture. There is usually immediate pain, swelling and bruising at the base of your thumb. If there is a complete tear of the ligament you may also notice that the thumb does not feel strong or stable when trying to use it.
It is important to get this looked at as soon as possible. Our therapists will be able to assess your thumb, looking at the available movement you have and stability of the thumb by performing a ligament laxity test – this is to determine if there is a strong ‘end feel’ to your ligament which can indicate if the ligament is partially or completely ruptured. Your therapist may recommend investigations and point you in the right direction if you need to see a surgeon.
Whether you require surgery or not, hand therapy is important for your recovery after this type of injury. Your therapist will make you a custom-made forearm or hand thumb splint also called an orthosis which will need to be worn full time for between 4 and 6 weeks to protect and allow the ligament time to heal.

Treatment will also involve techniques to reduce swelling and address pain. Once the ligament is strong enough your therapist will provide you with individualised exercise program and guide your return to activities and sport.
If you have injured your thumb and want a thorough assessment please get in contact with our clinic to arrange an appointment.