What is Skier’s Thumb?

The terms Skier’s Thumb and Gamekeeper’s Thumb both refer to injury of a ligament at the base of the thumb. The ligament is called the ulnar collateral ligament (or UCL).

Whilst Gamekeeper’s Thumb refers to a chronic condition caused by repetitive stress to the UCL (think using a wrench or wringing out cloths), Skier’s Thumb is an acute injury, usually caused by a fall.

What causes Skier’s Thumb?

Skier’s Thumb usually occurs when a person falls on an outstretched hand whilst holding something - ski poles will do it, which is how the injury got its name. However, football, hockey, basketball and rugby can also be culprits. Falling from a bike or motorcycle is actually the most common cause, and even a firm handshake can sometimes be enough to rupture the UCL! The force of impact while the thumb is extended is what causes the damage.

What are the symptoms of Skier’s Thumb?

Skier’s Thumb accounts for 86% of all injuries to the base of the thumb, so it’s a common problem.

If you’ve developed Skier’s Thumb, then you’re likely to experience the following:

● Pain at the base of the thumb or in the web space between your thumb and index finger
● Swelling at the base of the thumb
● Tenderness to the touch
● Weakness in your grip
● Bruising around the thumb
● Pain in the wrist (referred pain from the injury site)

How is Skier’s Thumb treated?

How your injury is treated will depend very much on the severity. Mild injuries may only require stretching and pain relief techniques. More serious injuries might require immobilisation for a period, whilst very severe cases may need surgery.

When you come to see us, we’ll assess the damage and determine whether the ligaments have been torn or just stretched - and if they have been torn, to what degree.

Elevation and cold compresses can help to reduce swelling and bruising, and if necessary, we will apply a thumb cast to immobilise the joint while it heals.

Once the cast comes off, we can show you exercises to help build your strength and flexibility in the joint.

If you do require surgery, we will help you afterwards to regain the function in your thumb and grip, and to shorten your recovery time as much as possible.

If left untreated, damage to the UCL can lead to long-term weakness and joint instability. So, make sure you get it checked out!

How can Skier’s Thumb be prevented?

If you’re a regular skier, sports player or (motor)bike rider, there are a few things you can do to reduce your risk of Skier’s Thumb:

● Make sure you’re using the proper technique for any equipment, like ski poles, hockey sticks or carrying a ball - get instruction from an expert
● For skiers, you can train yourself to release your pole as you fall, meaning you’re less likely to land on an extended thumb - you can also get special gloves to help with this
● Wearing ski gloves or sports gloves can protect your thumb joint in case of impact

References

1. Physiopedia. 2021. Skier’s thumb [Online https://www.physio-pedia.com/Skier%27s_thumb]
2. Brukner, P. and Khan, K. 2017. Clinical Sports Medicine. Australia: McGraw Hill Education

Uploaded : 4 November 2021