Monday Medical: Be mindful of skier’s thumb
For Steamboat Pilot & Today
It’s not often that the name of an injury is as straightforward as skier’s thumb.
“Skier’s thumb occurs when the thumb is forced into abduction, or forcefully pushed away from the palm, by a ski pole and/or strap when the hand hits the ground during a fall,” said Lisa Buckner, a certified hand therapist and occupational therapist with UCHealth SportsMed Clinic in Steamboat Springs. “It’s a very common injury with skiing and can be often overlooked.”
Below, Buckner outlines specifics about the injury, including how to prevent it.
Injury to ligament
The injury occurs to the thumb ligament, or ulnar collateral ligament, of the joint at the base of the thumb.
“The (ulnar collateral ligament) stabilizes the joint at the base of the thumb, also known as the metacarpal joint. Injury to this ligament causes instability, weakness and pain when pinching,” Buckner said. “Having instability with pinching can cause pain and decreased strength with hand function in everyday activities.”
While the injury is typically acute, it can become chronic if not treated at the time of injury and instability develops at the joint. Repetitive activity stressing the base of the thumb can cause a chronic condition as well.
Buckner recommends seeing an orthopedic specialist if you suspect you may have sustained a skier’s thumb injury.
“The specialist will be able to examine the thumb and determine if an X-ray is needed and what course of treatment is required,” she said.
Depending on the severity of the injury, treatment can range from immobilization to surgery. Healing can take anywhere from three weeks to three months.
Surgery is usually recommended in cases where a complete tear of the ligament has occurred. Less severe injuries will require immobilization in a splint for three to six weeks.
“The orthopedic specialist and therapist work as a team to develop a treatment plan, which often includes therapy and fabrication of a custom hand splint,” said Buckner. “A certified hand therapist will help guide the progress in regards to splinting and immobilization, range of motion and strengthening at the appropriate time.”
Strenuous activity with the thumb is usually discouraged until three months following injury if treatment is necessary.
A skier herself, Buckner knows what it’s like to hold a ski pole. If she’s going to fall, she tries to not stick her hand out to catch herself, decreasing the chances of injuring her thumb.
“The debate between using pole straps or not hasn’t been shown to substantially reduce the incidence of thumb injuries,” she said.
Thumb spica splints are available over the counter and can provide support for the thumb and help prevent injuries, similar to how wrist guards can help prevent wrist injuries.
And while ligaments cannot be strengthened, the muscles around the thumb can be strengthened to provide dynamic stabilization to the thumb joints.
Does it really only occur in skiers?
Despite the name, the injury can happen in other sports.
“It can occur when the fingers and thumb are spread and a force pushes the thumb farther into abduction,” said Buckner. “A snowboarder doesn’t use poles but can also get skier’s thumb by catching a thumb during a fall.”
Lindsey Reznicek is a communications strategist at UCHealth Yampa Valley Medical Center in Steamboat Springs. She can be reached at firstname.lastname@example.org.
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