Skier's thumb is an injury to the ligament on the inner side of the thumb's main knuckle, caused by the thumb being forced away from the hand. It typically happens in a fall onto an outstretched hand, especially while holding a ski pole, or in ball sports. It causes pain, swelling and a weak pinch, and it needs prompt assessment because a complete tear usually has to be repaired.
Also known as gamekeeper's thumb, thumb ulnar collateral ligament injury, thumb UCL sprain
Anatomy: where the problem is
Palm view of the wrist and hand. Highlighted in the diagram: thumb ligament.
Symptoms
- Pain and swelling at the base of the thumb, on the side nearest the index finger
- Bruising around the thumb and the web space
- A weak or painful pinch, for example when holding a key or pulling up a zip
- Difficulty gripping larger objects such as a jar or a glass
- A thumb that feels loose or wobbly
- A tender lump on the inner side of the knuckle in some complete tears
Causes and risk factors
- A fall onto an outstretched hand with the thumb forced outwards
- Falling while holding a ski pole
- A ball striking the end of the thumb
- Rugby and other contact sports
- Repeated stress over time, which can gradually stretch the ligament
What the evidence says helps
- Early assessment matters. An examination, and usually an X-ray, is needed to check for a small fracture and to judge whether the ligament is partly or completely torn.1
- Partial tears, where the joint is still stable, are treated with a splint or cast for about four to six weeks, followed by exercises to restore movement and pinch strength.1
- Complete tears usually need surgery, because the torn end of the ligament can become trapped behind a neighbouring tendon and then cannot heal back to the bone.1
- A systematic review found excellent results after surgery for both recent and long-standing injuries, with few complications.2
Things you can try at home
- Get the thumb assessed within a few days of the injury: do not wait to see if it settles
- Use ice and keep the hand raised to reduce swelling in the first days
- Wear the splint as advised, and keep the other fingers moving
- Avoid pinching, gripping and contact sport until you have been cleared
- Rebuild pinch and grip strength gradually once the splint comes off
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- A wrist or hand that looks deformed, or severe pain and swelling after a fall: go to A&E or a minor injuries unit
- A hot, red, swollen joint with a fever or feeling unwell: get same-day medical help
- Numbness or weakness in the hand that is getting worse: see your GP promptly
- Fingers that turn white, blue or very cold and painful: get urgent medical help
- A thumb that feels loose or unstable, or a weak pinch after a fall: get it assessed within a few days, as delay makes repair harder
How Apollo can help
If you come to us soon after the injury, we test the stability of the joint and, if there is any doubt about a complete tear or fracture, send you to a minor injuries unit or your GP for an X-ray and a hand specialist opinion. For stable, partial tears and after surgery, we guide you through the stages of rehabilitation: protecting the ligament, restoring movement, then rebuilding pinch and grip strength and returning to sport with taping or a support where needed.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
How do I know if I have torn the ligament in my thumb?
Signs include pain and swelling on the inner side of the thumb's main knuckle after a fall, a weak pinch and a feeling that the thumb is loose. Only an examination, usually with an X-ray, can tell a partial tear from a complete one.
Does skier's thumb need surgery?
Partial tears with a stable joint usually heal in a splint. Complete tears usually need a repair, because the ligament end can get trapped and fail to heal. Surgery works best when done within the first few weeks.
How long until I can return to sport?
After a partial tear, most people return in about six to eight weeks, often with a support at first. After surgery it is usually around three months, depending on the sport and your surgeon's advice.
References
- Ritting AW, Baldwin PC, Rodner CM (2010). Ulnar Collateral Ligament Injury of the Thumb Metacarpophalangeal Joint. Clinical Journal of Sport Medicine 20:106-112. View source
- Samora JB, Harris JD, Griesser MJ, Ruff ME, Awan HM (2013). Outcomes After Injury to the Thumb Ulnar Collateral Ligament—A Systematic Review. Clinical Journal of Sport Medicine 23:247-254. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
