Sprained thumb; Stable thumb; Ulnar collateral ligament injury; Gamekeeper's thumb
With this injury, the main ligament in your thumb is stretched or torn. The ligament is a strong fiber that attaches one bone to another bone.
This injury can be caused by any kind of fall with your thumb stretched out. It often occurs during skiing.
More about Your Injury
Thumb sprains can be mild to severe. They are ranked by how much the ligament is pulled or torn away from the bone.
Grade 1: Ligaments are stretched, but not torn. This is a mild injury. It can improve with some light stretching.
Grade 2: Ligaments are partially torn. This injury may require wearing a splint or a cast for 5 to 6 weeks.
Grade 3: Ligaments are completely torn. This is a severe injury that usually requires surgery.
Injuries that are not treated properly can lead to long-term weakness, pain, or arthritis.
An x-ray may also show if the ligament has pulled off a piece of bone. This is called an avulsion fracture.
What to Expect
Common symptoms are:
A weaker pinch or problems grabbing things when you use your thumb
If surgery is needed, the ligament is reconnected to the bone.
If your bone is broken, a pin will be used to put it in place.
After surgery your hand and forearm will be in a cast or splint for 6 to 8 weeks.
Relieving Your Symptoms
Make an ice pack by putting ice in a plastic bag and wrapping a cloth around it.
DO NOT put the bag of ice directly on your skin. Cold from the ice damage your skin.
Ice your thumb for about 20 minutes every hour while awake for the first 48 hrs, then 2 to 3 times a day.
For pain, you can use ibuprofen (Advil, Motrin, and others) or naproxen (Aleve, Naprosyn, and others). You can buy these medicines without a prescription.
DO NOT use these medicines for the first 24 hours after your injury. They may increase the risk of bleeding.
If you have heart disease, high blood pressure, kidney disease, liver disease, or have had stomach ulcers or bleeding, talk with your health care provider before using these medicines.
DO NOT take more than the amount recommended on the bottle or more than your provider advises you to take.
As you recover, your provider will check how well your thumb is healing. You will be told when your cast or splint can be removed and you can return to your normal activities.
At some point as you recover, your provider will ask you to begin exercises to regain movement and strength in your thumb. This may be as soon as 3 weeks or as long 8 weeks after your injury.
When you restart an activity after a sprain, build up slowly. If your thumb begins to hurt, stop using it for a while.
When to Call the Doctor
Call your provider or go to the emergency room right away if you have:
Weakness in your thumb
Numb or cold fingers
Drainage or redness around the pins, if you had surgery to repair the tendon
Also call your provider if you have concerns about how well your thumb is healing.
Safran MA, Zachazewski J, Stone DA. Ulnar collateral ligament injury of the thumb (gamekeeper's or skier's thumb). In: Safran MA, Zachazewski J, Stone DA. Instructions for Sports Medicine Patients. 2nd ed. Philadelphia, PA: Elsevier Saunders.
C. Benjamin Ma, MD, Assistant Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.