A Patient’s Guide to Ulnar Collateral Ligament Injuries of the Thumb

The following information is from the American Society of Hand Therapists and is available as a handout from their website: http://www.asht.org.

What is a sprain or injury to the ulnar collateral ligament in the thumb?

The UCL, or ulnar collateral ligament, is located in the middle thumb joint, and provides support to the thumb during grip and pinch. It is the most common ligament injury in the thumb. This injury is known as skier’s or gamekeeper’s thumb.

Image from fairview.org showing the location of the ulnar collateral ligament in the thumb.

What causes a UCL injury in the thumb?

Most often, injuries occur during sport or recreational activities such as skiing, football, biking, and soccer. Any extreme force to the thumb in the opposite direction can cause a sprain, but injuries can also occur as a result of a fall, or jamming the thumb.

Image from http://www.schreibermd.com.

What are the symptoms of a UCL injury in the thumb?

Pain and swelling in the middle joint of the thumb can occur right after injury, with possible bruising and stiffness in the joint. With this injury, activities such as holding a drinking glass or writing may be difficult. Weakness may be a symptom as well, with a decreased ability to grip or pinch any object with the thumb and hand.

What is the treatment for a UCL injury in the thumb?

The doctor will likely order an X-ray of the thumb to rule out a broken bone. The doctor will also test the stability of the thumb with gentle pressure from each side, and compare this to the other thumb. If there is a sprain to the UCL of the thumb, the physician may prescribe a custom orthosis to rest the joint and ligament for a period of time. If the ligament is torn or ruptured, the doctor may recommend surgery to repair the ligament.

What can a hand therapist do for me?

A therapist can make a custom orthosis to rest the thumb ligament as it heals. While the ligament is healing, the therapist will provide gentle exercises for the other joints of the hand. After the ligament was healed, the therapist will progress exercises to increase function and strength in the hand and thumb.