Skier's Thumb
A fall or forced twist can tear the thumb's main stabilising ligament, leaving it weak and painful to pinch. Assessment, splinting and rehabilitation to restore a strong, stable thumb.
- Certified Hand Therapist (CHT)
- Consultant Hand Therapist
- Hand, wrist & upper limb specialist
What is Skier's Thumb?
Skier's thumb is an injury to the ulnar collateral ligament (UCL), the ligament on the inner side of the thumb's big knuckle (MCP joint). This ligament is critical for pinch strength and thumb stability. When it is sprained or torn, the thumb becomes weak and painful during gripping and pinching activities.
The injury gets its name from its common occurrence in skiers who fall onto an outstretched hand while holding a ski pole. However, it can occur in any situation where the thumb is suddenly forced away from the hand. Gamekeeper's thumb is a chronic version of the same injury, developing gradually through repeated stress to the ligament.
What you might notice
- Pain on the inner side of the thumb along the big knuckle (MCP joint)
- Swelling and bruising around the thumb
- Weakness of pinch grip: difficulty holding objects between thumb and index finger
- Instability of the thumb: a feeling of looseness or giving way
- Tenderness directly over the UCL on palpation
- Difficulty with everyday tasks such as writing, opening jars and turning keys
Why it happens
- Falling onto an outstretched hand with the thumb stretched out: the classic skiing mechanism
- Ball sports where the thumb is struck during catching or tackling
- Contact sports and martial arts
- Direct impact to the thumb during everyday activity or work
- Chronic repetitive stress to the MCP joint's UCL in manual workers (Gamekeeper's thumb)
How it's treated
After a thorough assessment, a personalised treatment plan is built around your needs and goals.
Ms Razo fabricates a custom, thermoplastic orthosis to immobilise the MCP joint in the correct position during healing. This protects the ligament while allowing wrist movement and use of the fingers.
Following the protection phase, a carefully progressive exercise programme restores range of movement to the thumb without overstressing the healing ligament.
Targeted strengthening of the thumb muscles and progressive loading exercises restore grip and pinch strength to pre-injury levels.
Where surgical repair or reconstruction of the UCL has been performed, Ms Razo provides specialist post-operative hand therapy from the earliest stage to optimise functional recovery.
Common questions
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Not always. Partial UCL tears can be successfully managed with splinting and Hand Therapy alone. Surgery is typically recommended where the ligament is completely torn with significant instability, or where a Stener lesion is present (read more below).
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Non-operative management typically involves 4–6 weeks of splinting followed by 4–6 weeks of graded rehabilitation. Surgical cases require a longer overall recovery. Returning to full sport or heavy manual labour, after a significant UCL injury, usually takes 3–4 months.
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A Stener lesion occurs when the torn thumb MCP joint UCL becomes displaced and folds back on itself, with a portion of the adductor pollicis muscle getting stuck between the two ends of the ligament. This prevents the ligament from healing without surgery. A Stener lesion can be diagnosed both clinically and via imaging.
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Return to contact sport is not advised until stability has been restored to the thumb. Playing through an unstable thumb MCP joint UCL injury risks converting a partial tear into a complete rupture. Ms Razo will advise on appropriate return to activity timelines based on your individual assessment.
Related hand conditions
Clinically reviewed by Ms Michelle Razo CHT · May 2026