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Ulnar Collateral Ligament Injury of the Thumb Hand Therapy

Our thumb's UCL, or ulnar collateral ligament, is located in the middle thumb joint, and provides support to the thumb during grip and pinch.

Unfortunately, our thumb's ulnar collateral ligament is also the most common ligament injury in the thumb. This injury is known as skier’s or goalkeeper’s thumb.

What causes a UCL injury in the thumb?

Most often, injuries occur during sport or recreational activities, such as

• skiing
• football
• biking
• basketball
• rugby and
  
• soccer

In fact...any extreme force to the thumb in the opposite direction can cause a sprain or strain, but injuries can also occur as a result of

• a fall,
  
• or jamming the thumb at a hard surface,
  
• or the thumb catching onto something that pulls the thumb in the opposite direction

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

Pain and swelling in the middle joint of the thumb usually 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 ulnar collateral ligament 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 uninjured thumb.

If there is a sprain to the UCL of the thumb, the physician may prescribe a custom thumb spica splint to rest the joint and ligament for a period of time.

That being said, if the ligament is torn or ruptured, the doctor may recommend surgery to repair the ligament.

What can a hand therapist do for me?

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

Custom orthosis to protect UCL injury to the thumb

Patients may also receive the following hand therapy treatment modalities:

• cold therapy
• heat therapy
• moist heat paraffin wax therapy
• manual therapy
• joint mobilization
• ultrasound therapy
• stretching exercises
• strengthening exercises
• scar management
• etc