gamekeepers/skiers thumb: information

Gamekeepers or skiers thumb describes a sprain of the Ulnar Collateral ligament of the thumb which is located between the first metacarpophalangeal joint close to the web of the thumb. `

This injury can occur either as a single event or due to a repetitive overload (chronic) injury whereby the ligament becomes stretched and torn leading to pain, swelling, possible bruising and instability. In some cases, this injury is also associated with an avulsion fracture whereby, the ligament fails to tear and instead pulls a small piece of bone off the base of where the ulnar collateral ligament attaches onto the bone.

A common mechanism for this injury is a fall onto an outstretched hand especially during activities such as skiing (hence skiers thumb) whereby the strap of the ski pole forces the thumb into a sudden hyperextended position resulting in injury.

Another common name for this injury is Gamekeepers thumb. This term was initially used back in 1955  by an orthopaedic surgeon named CS Campbell. He observed that this condition tended to occur when gamekeepers exerted downward pressure with the thumb and index fingers in an attempt to try and break the neck of small animals. This repetitive thumb movement led to a chronic sprain of the Ulnar Collateral ligament.

Treatment options for gamekeepers/skiers thumb

When approaching this injury, it is necessary for your healthcare professional to ascertain the degree of injury. If a severe sprain or rupture is suspected, further imaging such as an MRI scan may be recommended (see below)

In the case of more mild or intermediate injury, a course of conservative care will usually be the first course of action. This often involves a period of immobilisation using a thumb splint to give the ligament time to heal. In addition, ultrasound therapy, soft tissue work and thumb mobilisation may also be utilised. In the latter stages of care rehabilitation exercises are the main focus to restore movement at the metacarpophalangeal joint and to improve strength of the muscles in the hand.

If you have any questions regarding this condition, please do not hesitate to contact the Bodymotion Chiropractic and Sports Injuries Clinic (EC2) at enquiries@body-motion.co.uk