What is it?
This is an injury to the ulnar collateral ligament (UCL) of the metacarpo-phalangel joint (MCP) on the medial side of the thumb when the thumb is forced outwards to the side (abduction). The ligament can either be partially or fully torn, and occasionally there can be an associated avulsion fracture. This is a common injury in skiers who fall against the ski pole/strap or ground whilst the thumb is abducted. It can also be seen in sports people who play ball sports (eg, basketball, netball) and in those who hold sticks (eg, hockey, lacrosse).
Swelling and bruising can appear over the joint and pain is felt around the area on the inside base of the thumb. Activities involving grasping and pinching may be reduced.
From a physiotherapy perspective, the objective of our examination is to differentiate between a Grade 1 or 2 ligament sprain, which will heal with conservative physiotherapy treatment and a Grade 3 injury which requires a referral to a hand specialist for surgical intervention. An X-ray should be performed to exclude an associated fracture if it appears severe on initial examination.
Adequate treatment is important so that the pinch grip can be maintained. Splinting and the application of ice is useful to minimise the trauma and pain. Physiotherapy is important to reduce the swelling and bruising and to restore full movement and muscle strength.
Complications can include osteoarthritis of the MCP joint. However, correct and early treatment carries a good prognosis with regards to return to normal function.
The sooner you see a physiotherapist, they can either treat the milder strains or refer you on to a hand surgeon if the need arises.
If you would like to receive a consultation by one of our expert physiotherapists who can carry out the necessary tests to evaluate the severity of the injury, please call on 020 7183 4436.
BY SERGIO CAMPOS