Skiers (Gamekeepers) Thumb

Skier’s Thumb Treatment or Gamekeeper’s thumb is when there is a tear of the ulnar collateral ligament, when your thumb is pulled back or to the side, away from your fingers. This most often happens when skiers fall on their outstretched hand while holding a ski pole

Skier’s thumb occurs when the ulnar collateral ligament at the base of your thumb gets stretched or torn. This ligament keeps your thumb stable when you pinch or grasp objects. Your range of motion may be limited.

If you have overstretched or injured your thumb you may be experiencing these symptoms:

• Pain and/or inflammation at the joint or base of your thumb
• Bruising 
• Pain or weakness when pinching an object between your thumb and forefinger
• Tenderness with or without movement

If the ligament in your thumb is partially torn, a splint or cast is usually worn for six weeks. After the splint or cast is removed, exercise therapy can help get your thumb to correctly move again. It will take several weeks for movement and strength in your thumb to return.

Depending on the severity of your injury, recommended treatments are:

• Rest, ice, compression, and elevation (RICE).  Resting your thumb by trying not to use it. Apply ice for 20 minutes every hour  Wrap your thumb in special tape or bandages. Elevate your hand above your heart.
• Non-steroidal anti-inflammatory drugs (NSAIDs). Over-the-counter drugs such as ibuprofen or naproxen can help reduce swelling and help with the pain.
• Prescription painkillers. If your pain is severe, Dr. Pournaras may prescribe pill medication, patch, cream, or gel.
• Splint, cast, or brace. Your thumb will need to rest. A splint, cast, or brace can help immobilize your thumb as it heals. .
• Physical therapy. Prescribed exercises are very helpful with increasing your range of movement and strengthening your thumb, hand, and wrist.

Your thumb will be swollen, bruised and very painful after this injury.

Treating this can will involve of a few weeks of having a splint on your thumb or in some cases, repair of the ligament with an surgery.

The most important part of deciding which treatment method will be used is to identify whether the ligament in your thumb is partly or completely torn. If it is torn, whether the ligament has been put into a position where healing may not be possible. (Sometimes called a Stener Lesion).

Dr. Pournaras will make this decision after a gentle examination to assess the degree of your  injury. Sometimes he will inject a local anesthetic around your thumb and examine the joint. An x-ray will help to determine if there is a fracture of the bone which the ligament is attached to.This may indicate a complete tear. An ultrasound can also help with this determination of surgery.