Randosteve’s skier’s thumb. Note the piece of bone separated from the rest of the thumb.
Courtesy: Orthopedic Associates of Jackson Hole.
I know you’ve all heard of it and I bet most of you have had one. Over the past few year’s, I’ve had a few instances of “skiers thumb”, and my most recent injury happened while skiing the Chouinard Couloir on the Middle Teton last week. I thought I would just tape it up and live with the pain for a few days, but an orthopedic surgeon friend of mine said he would comp me some x-rays to make sure everything was okay ligament and bone-wise. Unfortunately, the x-rays showed a small fragment had been broken off my thumb bone. But luckily, the ligament wasn’t completely torn. Though the orthopod recommended immobilizing it for four weeks, I think I’ll be lucky if I can keep it splinted up for more than two. Though it won’t keep me from skiing, once it starts to feel better, I’m sure I will have a hard time continuing to wear the brace.
How many times have you had Skier’s Thumb?
Skiers Thumb (aka, Gamekeeper’s Thumb) is an injury where the thumb is abnormally bent backwards or to the side, and causes injury to the soft tissue that connects the bones of the thumb or the ulnar collateral ligament the stretches from the base of the thumb to the bottom of the index finger. Often, a ski pole in the hand is what creates enough force to cause injury…and a ski pole strap often magnifies the effect. There are different severities of “skier’s thumb” people can incur, ranging from a sprained ligament, a complete tare of the ligaments, or the ligaments pulling a piece of bone off of the thumb. For most cases, immobilization is the answer, but complete ligament tares will often require surgery.
Steve,
When I was a kid I remember a friend having a pair of ski gloves with built in hinged splint/brace on the thumb specifically to prevent/reduce skiers thumb. Don’t know if they still exist but if might be something to keep an eye out for. Don’t know why these never caught on more- I’m told this is the #1 injury in skiing.
if both thumbs counts then i hade about 7….. (competiton isnt that healty)
I have put Life Link grips with releasable straps on my BD poles to hopefully ammeliorate this problem.
So many times that it goes out sometimes folding a Tshirt. Last time on a surfboard at lunch Counter, both thumbs at once.
i had skiers thumb/steners lesion. surgey on the left thumb. i am really careful in low snow conditions and even use a modified hockey glove in real scketcky stuff. if your around bozeman and see a guy with a hockey glove on one hand…that me.
I do wish the BD poles had releaseable straps. Hmmm.
spica splint…it’ll only make your thumb really stiff
I had a reverse skiers thumb going on a few years ago after crashing on my bike, same deal, didn’t bother with surgery, just let it heal up on its own
It is certainly true that many of these injuries heal on their own. Very few require surgery. Many of the surgical repairs I have been involved with were Stenner Lesions unrecongnized at the time of the initial evaluation. These simply won’t heal right. In spite of the experience of some of the commenters above, being too casual about the immobiliztion of the injury can result in an unacceptable outcome down the road. Not a risk I would be willing to take and not one I recommend to my patients. This results in chronic thumb instability leading to pain and poor grip strength. These often get surgery late with a formal reconstruction. Talk about stiffness!! Your best bet is to get a good evaluation, radiographs and then a custom palm-based thumb spica splint that will easily fit into a ski glove. Some surgeons would even cast you for the first 4 weeks to ensure compliance (hello, Steve!). You get the best, most comfortable immobilization while allowing for the highest degree of function for the rest of the hand and wrist. These are not cheap! They can be fabricated in this town at Teton Hand Therapy. It should be worn for 6 weeks and then it is probably best further protected while skiing/mt. biking for an additional 6-8 weeks.
I’m not sure how severe it is…but like most of the skiers here…it has happened before and both my thumbs click and pop a little. The doc recommended a cast…but there was no way that was going to fly with BC skiing and such. It was an informal appointment…so I opted for the brace.
If it were July/August right now…I would have been more likely to have opted for the cast.
I am not a doctor, I am a speech therapist and a yoga teacher. My contribution to this thread is that even though the thumb is a long ways away from the shoulder, there are some alignment issues that begin in the shoulder and travel all the way down the arm to weaken the thumb. Really. Holding the correct shoulder alignment while skiing would be optimal, but if you’re just looking to relieve pain in between skiing and begin to strengthen the body’s ability to naturally hold correct alignment to decrease the chances of this continuing to happen, some yoga could help. Will trade for Megawatts. 🙂
I’ll keep that in mind when next years skis come in. So where do my back and knee pain come in to play? Are they related to my thumb too?
Don’t get me started!
I also got “reverse” skier’s thumb, from a rock-scrambling fall. I tried to ignore it for months, but just when I thought it was getting better I’d bump it and start all over. Finally got the x-rays, three weeks in a cast the doc formed to fit a ski pole, three weeks in a brace, and all’s well. In my opinion, getting is checked out/fixed right away is well worth it.
As a therapist at Teton Hand Therapy, I can say I fabricate these splints to fit around ski poles almost as often as I fabricate them to not fit ski poles. Most of my patients continue to wear these splints as preventative measures seasons after their injury has healed. They are low profile, functional, and allow you to keep using your hand while protecting your UCL ligament. If it were me, I wouldn’t want to risk falling and tearing the ligament completely, because then surgery and casting/splinting isn’t as much of an option.
Thanks for the info Cassie! How much does one of these puppies cost? I have a pretty high deductible.
That sucks about your thumb, but I did enjoy watching Jamie ski the Couloir with you.
Ssshhhh. That’s ones only for my Facebook buddies right now. 🙄
Tight hips
I get that all the time from jiujitsu. It’s to the point where it will fold all the way back now under very little pressure. However, life is short and I’m not too worried.
I suppose it’s not skier’s thumb, but I did manage to do this in mid-December:
http://picasaweb.google.com/erFink/MyHandFails#5281233019496279986
2 months of no skiing while nerves mend is an awfully long time, but I got back to skiing on Tuesday in time for 12" of untracked on 25 short =)
I used to call what that Mogul Mitt, because I got it a bunch driving the poles hard on frozen bumps…
Thanks to the backcountry, I haven’t even thought about skiing frozen bumps for a few years.
Oh, and Fink, It may be against the law, but after having surgery on my collarbone that sliced a whole lot of nerves, I can really attest that very small bits of weed really helps a lot with that itching/tingling/burning sensation that you get with nerve damage. Also, the ganj is way easier on your system than the “legal” narcotics. Don’t over-do it, or you’ll probably end up aggravating the injury doing something dumb.
Hi Steve, I am a physiotherapist in New Zealand currently doing my post-grad study, and one of my assignments is on Skier’s thumb. I was wondering if I could have permission to use this x-ray image in my assignment?
Thanks,
Haylee
No problem Haylee. If you can give me some credit…it would be appreciated.
I got this in gymnastics. I was walking backwards in a handsttand. Im waiting on wat the doc. Want to do. It happened 9 mounths ago and it still hurts. How can i ease thevpain till the doc decides