Thumb injuries are relatively rare in sports.  Injuries to the thumb can involve the tendons which move our joints, the ligaments that hold the bones together, or a fracture of one of the bones of the thumb.  Ligament injuries such as a “Gamekeepers” thumb are one of the more common thumb injuries.  Many fractures and ligament injuries around the thumb may require prompt attention and surgery.

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Thumb InjuryOur thumb has 3 main bones, three joints and many ligaments trying to hold the thumb together.  In our thumb we have tendons which move our joints and ligaments which hold the joints together.

One of the most common thumb injuries involves one of the ligaments of the MP joint.  The ulnar collateral ligament (UCL) of the MP joint is the most commonly injured ligament in thumb.  The UCL can be stretched, partial torn or completely torn depending on the severity of the injury.   We call these injuries a “Gamekeepers Thumb.”

Thumb UCL tearSevere injuries of the UCL of the thumb can result in a complete tear of the ligament.  A complete tear of the UCL of the thumb can have a significant impact on the function of the thumb.  It can make the MP joint vey unstable.  That means that the joint will “open” when you try to grip something.  That is why most complete UCL tears of the thumb require surgical repair.

Less severe injuries involving the UCL ligament of the thumb will heal on their own.  Some may require that you wear a splint or cast for a few weeks, and very mild sprains may just require a short period of rest.  Thumb ligament injuries tend to take a long time to heal.  The area will remain sensitive and swollen for a number of months.  The joint may feel stiff for a number of months too.  An Occupational or Physical Therapist is very helpful in helping guide you and your thumb back into sports.  Wearing a support or brace may be necessary for a few weeks when you return to play to decrease the risk of reinjury.

Fractures of the bones of the thumb are very rare in sports.  Certain fractures around the thumb will require surgery to repair them.  Fractures such as a Bennett fracture often requires surgery because the broken piece is attached to important ligaments which hold the basal joint together.  If the broken piece is not repaired, then your thumb might be stiff, unstable and painful for life.

Tendon injuries in the thumb are very, very rare.  Tendons allow us to bend and move our thumb in many different directions.   Tendon injuries can occur from a ball hitting the end of our thumb — what you would call a jammed finger.  Tendon injuries can also occur if you grab the jersey of an opposing player and your thumb is caught as they take off or fall.   Injuries to the thumb which result in loss of motion of one of the joints– usually the IP joint in the picture above— should be seen by a Hand or Upper Extremity surgeon quickly to see if a tendon injury requires repair.

Thumb injuries are very rare in sports, but many of these injuries tend to require surgery to repair them. Even mild thumb injuries may bother you for a number of months.   If you suspect that you have a severe thumb injury then you should be seen by an Orthopedics Surgeon or a Hand Surgeon sooner rather than later.