Have you ever realised how much you need your thumb until you injure it? You might be wondering, “what have I done?” Whether you’re an avid skier or a DIY master, there are many ways in which the thumb can be injured. This blog will tell you about the different injuries that can happen to the thumb and what you can do to help manage your symptoms.
Common Thumb Injuries
- De Quervain’s Tenosynovitis
- Skier’s Thumb / Gamekeeper’s Thumb
De Quervain’s Tenosynovitis
De Quervain’s tenosynovitis is a common overload condition affecting the tendons of the thumb that control thumb extension and abduction. These tendons are called the extensor pollicis brevis and abductor pollicis longus. When overloaded, the tendons can become disorganised and inflamed, leading to pain located at the top of the thumb.
Causes
The most common movements to overload these tendons are repetitive movements of the upper extremity, including DIY work.
It is most prevalent between the ages of 40–50 years and is more common in women, particularly new mothers or care providers due to the demands of lifting and carrying. Often, symptoms in these circumstances occur in both thumbs. It is also more commonly found in people with a history of golfer’s elbow or tennis elbow.
What Is the Treatment?
Here at Hillview Physiotherapy, we can design personalised treatment programmes including exercises that can help to ease discomfort and speed up the recovery process.
Exercises You Can Do at Home
- Isometric Resisted Thumb ExtensionStart by holding your hand sideways in front of you with your little finger towards the floor and thumb on top. Raise the thumb towards you gently. You can either use a hairband or TheraBand, or your other hand to gently press against the thumb as counterforce resistance.
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- Hold for 30 seconds
- Perform 3 sets daily
- Isometric Resisted Thumb AbductionStart by holding your palm facing upwards. Raise the thumb gently and apply resistance using a hairband, TheraBand, or your other hand.
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- Hold for 30 seconds
- Perform 3 sets daily
- Stress Ball SqueezeStart by holding a stress ball or tennis ball in the affected hand. Squeeze gently with 25% effort.
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- Hold for 30 seconds
- Perform 3 sets daily
- Other Ways to Manage Symptoms
- Pain relief and anti-inflammatories such as paracetamol and ibuprofen
- Use of a thumb splint to avoid further overuse and inflammation
- Application of ice and heat over the affected area
Skier’s Thumb
Skier’s thumb refers to a sprained thumb. This involves a partial or complete tear of the ulnar collateral ligament at the thumb’s metacarpophalangeal joint (MCJ).
Symptoms
- Pain at the base of the thumb (in the webspace between the thumb and index finger)
- Swelling
- Difficulty gripping
- Bruising over the thumb
- Pain in the wrist
Causes
This injury is most caused by a hyperabduction trauma of the thumb, for example:
- A fall onto the hand (e.g. from a bicycle or motorcycle)
- Skiing injuries (while holding a ski pole)
What Is the Treatment?
Unfortunately, most injuries usually result in a Stener lesion, where the torn ligament becomes trapped. In these cases, surgery is often needed.
Both surgical and non-surgical cases typically require:
- 6 weeks of immobilisation using a thumb splint
Rehabilitation Exercises
- Resisted Thumb Abduction
- Perform 3 sets of 10 repetitions daily
- Resisted Thumb Extension
- Perform 3 sets of 10 repetitions daily
- Resisted Thumb Flexion
- Place a hairband or Theraband around the tip of the thumb and point your thumb down towards your hand.
- Perform 3 sets of 10 repetitions daily
- Place a hairband or Theraband around the tip of the thumb and point your thumb down towards your hand.
Gamekeeper’s Thumb
Gamekeeper’s thumb involves a repetitive strain injury to the ulnar collateral ligament – the same ligament injured in skier’s thumb.
What Is the Treatment?
Treatment is similar to skier’s thumb, and the same exercises can be performed:
- Hold each exercise for 30 seconds
- Perform 3 times daily
Thumb injuries can limit day-to-day function and can be difficult to treat. It is recommended to seek medical advice if pain does not improve over a few days. Physiotherapy can help improve symptoms and restore function, helping you get back to your hobbies pain-free.
If you are interested in booking physiotherapy, then please get in touch. Book an appointment with a physio online.
