Skier’s Thumb

You don’t have to be a skier to suffer skier’s thumb, according to hand, wrist and elbow specialist David Wei, MD at ONS.

Along with other skiing-related injuries such as concussions, torn knee ligaments and shoulder dislocations, injuries to a skier’s thumb are one of the most common conditions Dr. Wei and the other specialists at the ONS Hand & Upper Extremity Center see during ski season.

While not as serious or debilitating as the other skiing calamities, skier’s thumb can be extremely painful and can limit the ability to perform many common daily tasks such as grasping or opening jars, pinching your fingers to pick up something or writing with a pen.  And it’s a stubborn injury. It can take 4 – 6 weeks to heal and sometimes longer.

WHAT IS SKIER’S THUMB? 

Skier’s thumb occurs when one of the two main ligaments that support the thumb, the ulnar collateral ligament, is abruptly stretched beyond its limits. It is typically referred to as skier’s thumb because it commonly results when a skier falls with an outstretched hand while holding a ski pole. But, this condition can occur in other contact sports where the thumb is vulnerable to injury, such as football, rugby, or lacrosse. Most often, the ligament is strained when the thumb is jammed backwards and out to the side, but strains can occur on any side of the thumb.  Although skier’s thumb is typically caused by a single accident, repetitive gripping and twisting motions can create a painful chronic condition.

SYMPTOMS OF SKIER’S THUMB 

The most common symptoms of skier’s thumb include swelling, throbbing pain, and decreased range of motion. Bruising can appear a few days after the incident.

• Pain is at the base of the thumb, usually at the side of the web space between the thumb and index finger

• Swelling is usually at the base of the thumb

• Pain, weakness or difficulty gripping using the thumb and index finger

• Bruising along the inside of the thumb

• Pain moving the thumb

TREATING SKIER’S THUMB 

Moderate, partial ligament injuries may be managed with ice compression, anti-inflammatory medication and immobilization using a splint.  However, Dr. Wei, notes, “If the thumb is unstable during physical exam, an MRI can help determine if a special lesion, known as a Stener lesion, is present.  If this is the case, surgery may then be required for proper healing of the ligament and stability of the joint.”  Surgery may also be necessary if the ligament suffered a complete tear and is very unstable.

During recovery from this injury, either with nonoperative or operative treatment, a certified hand therapists may be called in to help rebuild strength and mobility to the thumb.

PREVENTING SKIER’S THUMB 

There is no single precaution that can be taken to prevent thumb injury. For skiers, many experts suggest keeping the hands outside of the straps at the top of the poles so that the poles are easy to drop during a fall.