What is a UCL Injury of the Thumb?
A UCL injury of the thumb, commonly referred to as “skier’s thumb” or “gamekeeper’s thumb,” affects the ulnar collateral ligament—a key stabilizing ligament located at the base of your thumb near the web of the hand. This ligament helps you grip, pinch, and perform everyday tasks like opening jars or holding tools. When the ligament is stretched or torn, it can lead to pain, weakness, and instability in the thumb.
Causes of Thumb Ulnar Collateral Ligament Injuries
Thumb UCL injuries are generally athletic injuries, often resulting from a sudden, forceful movement that pushes the thumb away from the hand.
Common causes include:
- Falling on an outstretched hand while gripping a ski pole (hence “skier’s thumb”)
- Sports-related impacts
- Repetitive stress or overuse
- Accidents involving the thumb being bent backwards or sideways
Symptoms of Thumb UCL Sprain or Tears
A UCL injury can range from a mild sprain to a complete tear. Symptoms typically include:
- Pain and tenderness at the base of the thumb
- Swelling or bruising near the web of the hand
- Weak grip or difficulty pinching objects
- A feeling of looseness or instability in the thumb joint
- Pain when moving the thumb away from the hand
In more severe cases, a bump may be felt along the side of the thumb where the ligament has torn and retracted.
Diagnosing Thumb Ulnar Collateral Ligament Injury
At OrthoConnecticut, our hand specialists begin with a thorough physical exam, checking the stability of the thumb joint and assessing pain or laxity. To confirm a diagnosis and evaluate the extent of the injury, we may use:
- X-rays – to check for fractures or joint alignment
- MRI or ultrasound – to visualize soft tissue damage and determine if the ligament is partially or fully torn
Early diagnosis is key to restoring thumb strength and preventing long-term joint problems.
Treating UCL Injuries of the Thumb
Treatment depends on the severity of the injury:
- Mild to moderate sprains: These can often be treated non-surgically with a thumb splint or brace to immobilize the joint for several weeks. Anti-inflammatory medications and activity modification may also be recommended.
- Complete tears or avulsions: Surgery may be necessary to repair or reattach the ligament, especially if the thumb joint is unstable or if there’s a piece of bone pulled off with the ligament.
Following surgery or immobilization, a guided rehabilitation program helps restore strength, stability, and range of motion.
FAQs
Partial tears or mild sprains may heal with rest, bracing, and physical therapy. However, complete tears generally do not heal on their own and may require surgery to restore thumb function and prevent long-term instability.
It often feels like a sharp pain at the base of the thumb, especially during pinching or gripping. Swelling, bruising, and thumb weakness are also common. In severe cases, the thumb may feel unstable or misaligned.
Healing time varies. Mild sprains may heal in 4–6 weeks with proper immobilization. After surgery, recovery can take 8–12 weeks or longer, depending on the severity of the injury and adherence to therapy.
If you experience persistent pain, swelling, or weakness in your thumb after an injury—or if you can’t pinch or grasp objects—it’s important to get evaluated by a hand specialist. Delaying treatment could lead to long-term joint problems.
Without proper treatment, a torn UCL can lead to chronic pain, joint instability, weakness in pinch grip, and early arthritis at the thumb joint.
Not always. If the ligament is only partially torn and the thumb joint remains stable, non-surgical treatment may be successful. Complete tears or joint instability, however, usually require surgical repair for optimal recovery.
Yes. Whether treated surgically or non-surgically, physical therapy is important for regaining strength, flexibility, and proper thumb function after the ligament heals.
