Skier's Thumb - Thumb Sprain

Although the upper body isn't as susceptible to injury as the lower body is in skiing, areas such as the thumbs are still vulnerable to damage during falls and collisions. Damaging your thumb may seem like a minor problem compared to a broken leg for example, but it can significantly hamper your activities. If your thumb is injured, you won't be able to hold your ski poles properly, and it will also make every day things like eating and writing difficult.

The Thumb Joint

The thumb is made up of three bones: the distal phalanx, proximal phalanx and metacarpal bone. The MCP (metacarpophalangeal) joint is the main joint in the middle of the thumb that makes it bend and allows you to grip things. The UCL (Ulnar Collateral Ligament) at the base of the thumb joins the thumb to the wrist and is quite vulnerable to injury.

What is Skier's Thumb?

Skier's Thumb is so called because this type of injury tends to affect skiers more than other sportsmen and women. It is an indirect injury that is caused by the ski poles during a fall. If the pole gets stuck in the snow it acts like a lever, forcing the thumb into an outstretched position away from the rest of the hand. If a large amount of force is applied to the thumb when it is bent backwards, the UCL at the base of the thumb can become sprained.

What Does Skiers Thumb Feel Like?

The base of the thumb will be swollen and painful. Bruising will appear after a couple of days and the MCP joint may feel unstable. You will find it extremely difficult to grip things between your thumb and index finder.

How is it Treated?

It usually heals in 4-6 weeks with the aid of ice packs, compression and perhaps anti-inflammatory drugs prescribed by a doctor in the short term. Physiotherapy exercise to increase the thumb's range of movement will help the healing process enormously. If the UCL is completely ruptured surgery may be an option, but only in rare cases. If surgery is necessary, recovery will take a lot longer. Following the operation, the thumb will be put in plaster for about 6 weeks, which will be followed by rehabilitation through physiotherapy.

How Can You Prevent Skier's Thumb?

Wearing tape or a thumb brace will help to protect it from damage. The best thing you can do though is to learn how to hold your pole straps properly. This will help you to keep the pole in the correct position and lessen the chances of it indirectly causing damage to your thumb.

Other Types of Thumb Injury

The thumb can also become injured through direct trauma during a fall or collision. Skiers often use their hand to cushion the impact of a fall or a blow, sometimes damaging the thumb in the process. Minor injuries such as cuts and bruises heal on their own quite quickly, but more serious problems like fractures and dislocations may require surgery and involve a lengthy healing process.

Thumb Fracture-Dislocation

This type of direct injury causes a fracture in the thumb bone at the joint where the thumb meets the wrist. It is known as a 'fracture-dislocation' because the fracture causes some of the ligament to detach from the bone, causing a dislocation. If you sustain this injury, there will be a lot of pain in the base of the thumb and wrist, bruising will appear very quickly and movement in the thumb will be severely restricted. Again, wearing tape or a thumb brace and knowing how to use your pole straps correctly will help to reduce the risk of thumb injuries.

Treatment

Surgery is often required to repair it because this kind of injury could lead to long-term problems for mobility of the thumb. There are two main surgical options available, depending on the severity of the fracture-dislocation. The least invasive method is to insert wires into the fractured area to align the bone, which is followed by setting the thumb in plaster for several weeks, after which physiotherapy can begin. If the fracture is more complicated however, the surgeon may need to insert a small screw to realign the bone. This option doesn't require you to wear a cast afterwards, which means rehabilitation can begin much more quickly.