What is Gamekeepers Thumb? A sprain is a joint injury that causes a stretch or tear in a ligament. A ligament is a strong band of tissue connecting one bone to another. An ulnar collateral ligament sprain of the thumb known as Gamekeepers thumb, is a painful injury that may cause looseness of the thumb joint at the base of the thumb where it attaches to the hand.
Sprains are graded I, II, and III, depending on the severity of the sprain:
- 1. grade I sprain: pain with minimal damage to the ligament
- 2. grade II sprain: more ligament damage and mild looseness of the joint
- 3. grade III sprain: complete tearing of the ligament and the joint is very loose or unstable
How Does It Occur? Gamekeepers thumb is a common injury in skiing. It may occur when you fall onto your outstretched thumb, bending it back toward your arm. This stretches and injures the ulnar collateral ligament. It may also be caused by catching your thumb on your ski pole strap. It may occur in other activities when you fall onto your outstretched thumb or when your thumb gets hooked onto another player's jersey or face mask. The name is derived though from Scottish fowl hunters who used to ring the neck of their prey thus causing this type of injury.
What Are The Symptoms Of Gamekeepers Thumb? You usually have pain, swelling, and tenderness at the inner part of the base of your thumb where it attaches to your hand. It may be difficult to hold an object in your hand and apply force with your thumb. Moving your thumb causes pain. And there may be moderate to extremely looseness of your thumb if the ligament is completely torn.
How Is It Diagnosed? Your doctor will review your symptoms, examine your thumb, and check to see if your thumb joint is loose. Your doctor may order an x-ray of your thumb to see if it is broken.
How Is Game Keepers Thumb Treated? A grade III sprain with a very loose joint requires surgery to repair the ligament. Grade I and grade II sprains may be treated with a cast, taping, or splinting so that the thumb does not move for up to 6 weeks.
Initially, the hand with the injured thumb should be kept elevated on a pillow when you are lying down or on the back of a chair or couch when you are sitting. Place ice on your thumb for 20 to 30 minutes every 3 to 4 hours for 2 to 3 days until the pain goes away. Your doctor may prescribe and anti-inflammatory medication or other pain medication.
When Can I Return To My Sport Or Activity? The goal of rehabilitation is to return you to your sport or activity as soon as is safely possible. If you return too soon you may worsen your injury, which could lead to permanent damage. Everyone recovers from injury at a different rate. Return to your sport or activity will be determined by how soon your thumb recovers, not by how many days or weeks it has been since your injury occurred. In general, the longer you have Gamekeepers thumb symptoms before you start treatment, the longer it will take to get better.
After you have sprained the ulnar collateral ligament of your thumb you may return to your activity when you injured thumb has gained full strength compared to the uninjured thumb. Swelling must be gone and you must have full range of motion.
In sports such as skiing be sure that you are able to grasp a ski pole with full strength. In sports such as baseball or tennis be sure that you are able to grasp the bat and racquet with full strength and without pain. Your doctor may advise you to wear a thumb or wrist brace or tape your thumb before your activities.
How Can I Prevent Gamekeepers Thumb? Ulnar collateral ligament sprains are caused by falling onto an outstretched thumb. Many times this happens during accident that are not preventable. However, in skiing you may be able to avoid this injury by using ski poles that do not have straps.
Game Keepers Thumb Rehabilitation Exercises: If you have had surgery or if you have been in a cast or splint, you may do these exercises when your doctor says you are ready.
1.Thumb range of motion: With your palm flat on a table or other surface, move your thumb away from your hand as far you can. Hold this position for 5 seconds and bring it back to the starting position. Rest your hand on the table in handshake position. Move your thumb out to the side away from your palm as far as possible. Hold for 5 seconds. Return to the starting position. Next, bring your thumb across your palm toward your little finger. Hold this position for 5 seconds. Return to the starting position. Repeat this entire sequence 10 times. Do 3 sets.
2. Wrist range of motion: Move you wrist up and down and side to side. Move through each position until you feel a stretch. Hold the stretched position for 5 seconds. Repeat each position 10 times. Do 3 sets.
3. Thumb strengthening: Pick up small objects such as paper clips, pencils, and coins using your thumb and each of your other fingers one at a time. Practice this exercise for about 5 minutes.
4. Grip strengthening: Grasp a rubber ball or similar round object and squeeze it as tightly as you can. Hold this position for 5 seconds. Repeat 20 times.
All material provided is designed for information purposes only and should not be used to replace the care of a health care professional. Do not rely on any of the information for diagnosis or treatment. It is recommended that you visit a qualified health care professional for individual and personal attention.
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