Injuries and Medical Advice

All Thumbs

Q:

About a year ago I jammed my thumb on a protruding hold mid-dyno. My doctor said my sprained thumb was a partial rupture of the ulnar collateral ligament (UCL)—a classic case of skier’s thumb. I have been doing my prescribed exercises, but a year on I still have pain and weakness in the thumb. Do you have any tips for getting my pinch strength back? An x-ray showed nothing broken.

—Mark

A:

In medical lands, the longer you have an injury beyond what is considered a reasonable healing time, the more likely it is that the diagnosis and/or treatment regimen need re-evaluating.

Skier’s thumb happens when the thumb is driven back, away from the hand (abduction), and the UCL ligament is damaged.

Here’s the deal (premised on the fact that your thumb is still giving you some gyp 12 months along): I’m not convinced the UCL was only partially torn. Were the UCL to be completely ruptured initially it would go quite some distance to explaining your current presentation. The risk is of a Stener Lesion, where a small bit of connective tissue that helps anchor the adductor pollicus longus muscle in your thumb, is forced into the joint as the ULC ruptures and the joint opens up. This tissue covers one end of the UCL, thereby preventing it from reattaching to its opposing torn end, rendering the thumb permanently unstable. So, is your thumb stable? Can you stress the thumb into abduction without having an anxiety attack? Have you actually stressed it at all?

If stability is not an issue I am at a loss to explain why 12 months later you continue to have issues. You should have all but forgotten about the injury by now. That said, it could just be a slow one to heal; it happens.

Add a pinch routine to your training program. Make some blocks of varying width that you can hold. Drill a hole, and thread a cord through the middle. Hang some weight off it, and treat it like a hang-board routine where you do repetitions of holding and resting, usually in a seven seconds on and three seconds off format. There are lots of good apps you can get for these types of training programs. Another good exercise is to roll a smallish ball around your hand, controlling its course with your thumb only. If your thumb gives way, the question of stability will be answered!


This article appeared in Rock and Ice 246


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