Skier’s Thumb

Skier’s thumb is an injury that affects a person in their UCL ( ulnar collateral ligament) of the metacarpal phalangeal joint located within the thumb. It is also known as Gamekeeper’s thumb because breaking the neck of small animals while hunting could cause stretching and tearing of the ligament in the thumb. The ligament is injured in a situation when the thumb is bent too far backwards. It is a common injury among skiers; hence the name. Symptoms of skier’s thumb include weakness and pain in the thumb, and joint instability. Other characteristics include bruising and swelling. Skier’s thumb may make it difficult to perform tasks such as tearing a piece of paper or tying shoes, or grasping objects.


As the name suggests, the most common cause of skier’s thumb is skiing. Skier’s thumb actually makes up about 10% of all skiing injuries and accidents. It is caused by falling on to an outstretched hand while still holding a ski pole in your palm. This creates a strong force that stresses the thumb and can tear or stretch the ligament. Falling onto an outstretched hand with nothing in your palm usually does not result in skier’s thumb, because it does not produce the same force. A thumb can be injured if it is jammed into the ground at a high velocity during a fall, however, but this usually results in a break or dislocation. It can be caused in hockey, if a player falls while holding the stick, but this is rare. For non-athletes, skier’s thumb may be caused during a car crash if the driver has the thumb draped over the steering wheel. This too, however, is rare. Ultimately, any situation where the thumb is bent to the side or backwards abnormally can lead to skier’s thumb, especially if there is an object in the palm of the hand that can create more stress on the thumb.


If you think you have skier’s thumb, there are several things you can do at home to reduce the swelling and pain. Begin by resting the thumb, stopping any activity that may put more stress on the injured area. If you are skiing when the accident occurs, you should stop for the rest of the day. Ice the thumb for about 30 minutes at a time, 4-5 times a day. Make sure the ice is wrapped in a thin towel or bag to avoid skin damage such as frostbite. Try to avoid moving the thumb if possible. You may want to create a makeshift splint to immobilize it. If the pain is severe, take over-the-counter pain medications. You will need to see your doctor at some point; the sooner the better. If the injury is only a partial tear, you may have to wear a splint for several weeks. If the ligament is ruptured, however, surgery is usually required, and the hand will be placed in a cast to hold the thumb in place and still as the ligament recovers.


Partial tears treated with a splint or special cast are usually healed after about four weeks of immobilization. A complete tear or rupture that requires surgery, may take 2-3 months to completely heal. Total ruptures can sometimes have long-term complications like chronic pain, although usually patients make a full recovery. It is important to keep the thumb completely immobilized as you recover. Eventually, you can begin rehab exercises to regain strength and movement in your thumb. Make sure you rehab gradually, and stop or slow down if any symptoms return. MedlinePlus has more information on rehab programs for skier’s thumb. Skiers can prevent skier’s thumb by discarding their poles when they fall. For non-athletes, try keeping your thumbs on the outside of the steering wheel when driving to prevent skier’s thumb from happening after a car accident.