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What is an Ulnar Collateral Injury of the Thumb? A Physiotherapist’s Experience

What is an ulnar collateral ligament injury of the thumb?

A Physiotherapist’s personal experience and perspective!

Author: Bryce Damin (former PhysioWest Physiotherapist)

Bryce highlights specific details about the injury, treatment modalities and his own experiences with an ulnar collateral ligament injury of the thumb.

How common is it?

Injuries to the hand make up around 25% of all athletic related injuries, making them very common in the sporting population.

How do you do an ulnar collateral injury of the thumb?

An ulnar collateral injury of the thumb, often known as “skier’s thumb,” occurs when the ligament on the inner aspect of the thumb (connecting the thumb to the hand) is damaged. This can happen during a fall, especially when holding onto a ski pole, and the thumb gets forcefully bent away from the hand.

In Bryce’s case, he was playing football. A seemingly unremarkable play led to an awkward fall onto his thumb. Immediately he felt pain on the inner aspect of his thumb, but with the help of some great club trainers and some strapping tape, he was able to return and finish the game.

It wasn’t until well after the game when he began to process the potential severity of his injury. In the heat of the moment, with adrenaline pumping, it’s easy to push through! But once the final siren goes, reality often settles in. We will explore this again shortly, but for now we’ll discuss the injury in more depth and talk about the treatment options.

What is the ulnar collateral ligament and what does it do?

Ligaments are strong, fibrous connective tissues that play a crucial role in the musculoskeletal system. They are primarily responsible for connecting bones to other bones in joints, providing stability, and limiting excessive movement.

The ligaments primary function is to maintain the integrity of joints by preventing excessive movement in undesirable directions. They act as stabilising structures, ensuring that joints move within their normal range of motion and maintain proper alignment. When a ligament is injured, it can lead to pain, swelling, and difficulty using the injured body part. In more severe cases, the ligament may tear completely, and if it doesn’t heal properly, it can result in long-term issues with function.

How do you treat an ulnar collateral ligament injury?

In most cases, regardless of where in the body the injured ligament is, treatment involves rest or splinting to give the ligament time to heal. This is followed by a period of rehabilitation to gain strength and range of motion that was lost during the period of rest and immobilization before returning to sport.

However, the ulnar collateral injury is slightly different. A Stener lesion is a specific type of injury to the ulnar collateral ligament. In a Stener lesion, the ligament is torn completely and retracts up the hand. Unfortunately, given the close proximity of muscles in the hand, a nearby muscle can slip into the space created by the completely torn ligament. As a result, the ligament will not heal as there is something blocking the torn ends of the ligament.

Treatment for a Stener lesion often involves surgical intervention to reposition the muscle that has slipped into the space and reattach the torn ends of ligament. If not treated appropriately, a Stener lesion can lead to chronic instability and functional impairment of the thumb.

How did Bryce heal his ulnar collateral injury?

Unfortunately in Bryce’s case, he had suffered a Stener lesion. This was highlighted by a severe amount of instability of his thumb which was confirmed with an ultrasound investigation. Unfortunately this meant the ligament was never going to heal and he needed surgical intervention to regain the stability in his thumb. Fortunately, with the support of some his great colleagues, he was able to find a temporary solution in the form of a brace for his thumb – which meant he could finish off the season of football. Thank goodness!

At the end of the football season he knew that surgery was the next step. He was nervous about the inherent uncertainties associated with any surgical procedure which we think anyone who has had surgery can relate to. However, with a clear understanding of its necessity for the long-term stability and functionality of his thumb, he was excited to get stuck into the rehabilitation process, return to work and continue playing football.

At the time of writing this blog, he was 4 weeks post-surgery and the journey so far had been relatively easy.

All that had been required was total immobilisation in the form of a brace that he wore full time and some very basic, gentle stretches. That was the easy part. But, adjusting to life without a thumb was a significant challenge. But, it gave Bryce and his colleagues great insight into the impact a surgery can have on your independence and day to day life!

At the 6 week mark, Bryce came out of the brace and that’s when the rehabilitation really began. Anyone that has had an orthopaedic surgery knows that the journey is long and not linear. At 6 weeks post-op, the focus became restoring the lost range of motion and strength, over another 6 week block. Bryce had the goal of returning to football at the 12 week mark.

How did Bryce describe the surgery and rehabilitation experience?

In conclusion, Bryce’s journey through his thumb injury, specifically a Stener lesion, had been both a personal and professional challenge.

From the unexpected incident on the football field to the surgical intervention that followed, this experience has provided Bryce with valuable personal insights into the world of sports injuries. Not to mention the insights that his colleagues at PhysioWest had by supporting him throughout his journey.

As he continues to navigate the rehabilitation process, we are reminded that the road to recovery is not always easy, and the temporary loss of independence will always be a significant adjustment. Looking ahead, Bryce is eager to embark on the next phase of his rehabilitation journey, hopeful for a successful recovery and a swift return to the football field!

We wish Bryce all the best with his thumb injury, and with his little family and new home!

Our Physiotherapists are passionate about supporting our clients throughout their treatment journey from start to finish. If you have a sporting injury and would like to see one of our experienced and knowledgable Physiotherapist’s, book online via the link below now! Alternatively, give us a call on 8352 3582 to book.

We can’t wait to see you in the clinic soon!

 

 

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