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Braces and Supports for a Sprained Thumb

Braces and Supports for a Sprained Thumb

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About sprained thumbs

A sprained thumb is often referred to as skier's thumb or gamekeepers thumb, although medically it is known as an Ulnar Collateral Ligament injury which resides on the metacarpo-phalangeal joint. It occurs when force is applied to the thumb in the direction away from the hand.

It was initially defined as a gamekeeping related injury, having been officially noted in 1955 following a number of cases from Scottish gamekeepers where the repeated motion of twisting a hare’s neck led to the onset of the condition. Since then the condition has been associated with other activities and referred to by other names.

Bones of the Human Hand and Wrist

Skier's thumb is one of the most common thumb injuries. It accounts for around 10% of all skiing injuries, although you do not need to be a skier to incur this affliction. A sprained thumb can result from any activity that forces pressure on the thumb, away from the hand. Football goalkeepers are particularly susceptible and often wear thumb support products such as a brace or taping for protection and rugby players are also at risk. From a skiing perspective there is a risk of injury when falling whilst holding onto your ski pole.

What are the symptoms?

Skier's thumb, once known as gamekeeper's thumb, normally result in pain and swelling over the Ulnar Collateral Ligament. In some cases, bruising may show up after a few days. Severe cases may reveal a constant thickening of the thumb joint accompanied by painful swelling. The joint between the Metacarpal and thumb bone may feel unstable, which can make it very difficult to grip small objects using the thumb and index finger.

Thumb injuries should be given immediate medical attention to ensure correct diagnosis and treatment. A skier's thumb is usually diagnosed on the basis of the symptoms and how it occurred, as well as physical examination. An X-ray may also be taken in order to support the diagnosis.

Where to seek a diagnosis?

If you suspect you have suffered from a thumb related injury which could later diagnosed as skier’s thumb then you should seek medical attention. Your local walk in centre or accident and emergency department will have the facilities in place to x-ray and identify the root cause of the issue.

On arrival you may be asked a series of questions by doctors in to understand more about the condition, such as when the injury took place, how the hand and thumb were positioned at the time of the injury occurring, how long after the injury did you start to feel pain and experience swelling and whether the range of motion has been compromised.

What treatment options are available to me?

Treatment for a sprained thumb can vary, particularly depending on the severity of the symptoms. Immediately following thumb injuries, ice packs and compression should be applied to help reduce swelling. Sometimes anti-inflammatory drugs or gel are also given to reduce inflammation and pain.

Thumb support products such as taping or a thumb brace can also be beneficial, as can physiotherapy and massage treatments to assist with repairing the ligament and improving thumb mobility. Thumb support products that improve grip, strength and dexterity, such as hand therapy balls and therapeutic putty are also highly regarded in treating a sprained thumb.

Skier's thumb usually takes around a month to six weeks to heal. In more severe cases, it can take longer. A total rupture of the Ulnar Collateral Ligament often requires surgery, especially if a scenario called Stener lesion (where the ligament becomes entangled in the tissue of the base of the thumb) occurs. If a rupture does result without Stener lesions, doctors often follow a wait and see procedure, using a plaster cast (or a thumb spica), to see if the thumb will heal without the need for surgical intervention. Sometimes, a sprained thumb can be accompanied by a small bone fracture of the Metacarpal of the thumb. Often this will heal itself, but it may require surgery in some cases.

Many thumb injuries, such as a sprained thumb, can be prevented in people who may be susceptible to injury, by wearing a thumb support product. Taping and a thumb brace, for instance, can help to improve thumb joint stability. A thumb stabiliser can also offer protection to the ligament, without compromising thumb mobility when doing sports. Skiers are advised to avoid putting their hands inside the ski pole, as this can increase the risk of a skier's thumb accident.

Will I fully recover?

In the majority of cases you will see full functionality return to the thumb. A period of physiotherapy will help to strengthen the ligament and minimise the risk of subsequent injury in the future. There are cases however where a patient may experience a weakening in the thumb and reduced mobility and in these cases further surgery may be required in order to remedy the issue.