The thumb plays a big role in gripping objects whether it is a pencil or a drinking glass. In hockey, the thumb plays a large role in maintaining grasp of the hockey stick, putting it at risk for a number of injuries, one of the most common being a sprain to the ulnar collateral ligament (UCL), also known as “Gamekeeper’s thumb” or “Skier’s thumb”.
The most common mechanism of injury to the UCL is when the thumb joint is hyperextended. Hockey players may experience this when falling on the ice and landing on an outstretched hand or if the thumb gets caught behind the hockey stick during a fall or collision with an opponent. The mass of the athlete’s body plus the velocity of the fall creates a high force through the hand which may cause the UCL to rupture. Another way to sprain the thumb in hockey is when a player grabs an opponent during a fight, getting their thumb caught in a jersey.
Symptoms of a UCL sprain include pain, swelling and instability. If left untreated this injury can lead to arthritis or chronic weakness and subluxation, thus it is important to seek medical attention right away if experiencing any of the above symptoms.
Conservative treatment including splinting for 6 to 8 weeks is normally the first line of treatment. If this treatment fails, surgery may be required to stabilize the thumb.