Winter is coming and so are those dreaded winter sport injuries……

Do you have pain on the inside of your thumb?

Do you have pain on the inside of your thumb? The pain could be from an injury at the ulnar collateral ligament (UCL) of the thumb metacarpal phalangeal (MCP) joint.

What is the UCL?

The UCL is a ligament located at the inside border of the thumb metacarpal phalangeal joint. It is an integral structure for stability of the thumb, preventing excessive sideways movements, especially during pinch and grasping objects.

How is the UCL injured?

An injury may involve the ligament itself in isolation, or the ligament may pull off a bony fragment at the site of ligament attachment; this is known as a UCL avulsion injury.  The mechanism of injury can be from a traumatic event involving sudden, forceful pulling of the thumb away from the fingers, known as Skier’s thumb. Although it is less common, repeatedly stressing the UCL over a long period of time may also lead to weakening and instability, referred to as Gamekeeper’s thumb.

Ligament injuries are graded into categories dependent on severity of the ligament instability. Your hand therapist can assess the injury and recommend appropriate treatment. 

How do I treat my UCL injury?   Your hand therapist will fabricate a custom-made thermoplastic thumb orthosis to optimise ligament healing, reduce oedema and relieve pain.

When the ligament is deemed stable, your therapist will prescribe specific exercises to regain your thumb range of motion and strength to enable return to your previous level of function.  

If the UCL ligament is assessed as unstable, your hand therapist will also appropriately refer you to a hand surgeon for surgical opinion. Unstable UCL injuries may require surgical repair.  If you suspect you have an injury to your thumb, please don’t hesitate to call us.