Thumb UCL injury

Have you ever ‘sprained’ or bent your thumb back playing sport??  Chances are that you injured your Ulnar Collateral Ligament or ‘UCL’ on the middle joint of the thumb.  It is the most common thumb injury.

How does this injury occur?  

The collateral ligaments are thick bands of tissue that keep your thumb metacarpophalangeal joint (or MPJ) stabilised to allow you to grasp and pinch.  The UCL is on the inside of the edge of the thumb.   

The UCL injury of the thumb occurs when the thumb is overstretched away from the hand, causing a partial tear (sprain) or full tear (rupture) of the ligament. It can occur after a single forceful incident, for example when is-catching a ball, like in cricket or softball, or in a fall.  It is often called a “skier’s thumb” as the UCL can be overstretched in a fall while holding ski poles. 

Thumb Picture 1

What are the common signs and symptoms? 

There may be pain, tenderness and swelling around the inside edge of the thumb, but the level of pain does not always indicate how badly injured the UCL may be. A full rupture can be pain-free. The thumb may also feel weak, sore or unstable on loading, such as pinching or trying to grasp an object.  

Why is treatment important? 

Your local Accredited Hand Therapist (AHT) will be able to assess and appropriately treat your thumb!!   

Your thumb will need to be immobilised to allow the sprained UCL to heal. Your AHT will custom make an orthosis fit to your thumb.  The orthosis will need to be worn for 4-6 weeks full time.  You will be guided through safe movement exercises at the right timing, not too early nor too late in the healing process. 

Thumb Picture 2

If your injury sprain is unstable, it may be the case of a full rupture of the UCL.   You may need to be seen by a specialist doctor which your Hand Therapist can arrange, to assess if surgery is needed. 

When should you see your Accredited Hand Therapist? 

The sooner you are able to see your AHT the better!  If left untreated, your thumb may be unstable and you may cause further injury to the ligament.   

Should I get an x-ray? 

If you have had an x-ray, bring it to your first-hand therapy appointment. However, your AHT can send you an x-ray and determine if further diagnostic testing, like an ultrasound or MRI, is required.  If there is a complete ligament rupture, you will need to be referred to a specialist doctor. 

How long until I play sport again? 

Your AHT will determine when you can safely return to sport, which may be early with a well-fitted orthosis, or maybe even taping.  

You can find a Hand Therapist in your area by visiting the AHTA website home page and clicking on “Looking for an Accredited Hand Therapist?”.  All you will need is your postcode and you’re on the way to having your sports hand injury treated with excellent care.