Sprained Thumb

What is a thumb sprain?

A thumb sprain (sometimes called skier’s thumb or gamekeeper’s thumb) happens when a ligament (tissue that connects bones at a joint) in your thumb stretches too much or tears. Most thumb sprains involve your ulnar collateral ligament (UCL), which is located on the inside of your thumb at the first metacarpophalangeal (MCP) joint. Your MCP joint is located at the base of your thumb near your palm, in the webspace. Thumb sprains usually happen when your thumb forcefully stretches too far backward away from your palm or in another awkward direction. Thumb sprains, and other types of sprains, can range from a stretch or small tear in your ligament tissues to a complete tear through your ligament or a detachment from your bone.

What are the different types of thumb sprains?

Healthcare professionals use a grading system to classify the severity of sprains. The three different grades include:

• Grade 1: A grade 1 thumb sprain is a mild sprain. The affected ligament is overstretched but not torn.
• Grade 2: A grade 2 thumb sprain is a moderate sprain. The affected ligament is partially torn.
• Grade 3: A grade 3 thumb sprain is a severe sprain. The affected ligament is completely torn or separated from its attachment to your bone. Severe sprains require medical and/or surgical care.

Is my thumb broken or sprained?

Both a broken (fractured) thumb and a sprained thumb can cause pain, swelling and bruising, but there are some differences to look for. A broken thumb usually causes more intense pain, and your thumb may look deformed or misshapen. A broken thumb can also cause numbness or tingling. If you’re experiencing pain, bruising and swelling in your thumb after an accident such as a fall, be sure to contact your healthcare provider. It can be difficult to tell from the outside if your injured thumb is broken or sprained, so it’s important to get an X-ray and an exam from a knowledgeable healthcare provider to know for sure what the injury is.

Sprained thumb vs. strained thumb: What’s the difference?

A thumb sprain involves overstretched or torn ligaments, which are tissues that connect bones at a joint.

A thumb strain involves an injury to a muscle or a tendon, which is a tissue that connects muscle to bone. Both thumb sprains and thumb strains usually cause pain. If you’re experiencing pain in your thumb, contact your healthcare provider. They’ll evaluate you and may have you undergo an X-ray, musculoskeletal ultrasound or MRI (magnetic resonance imaging) to see if you have a bone break, sprain or strain.

Who is at risk for a sprained thumb?

Anyone can get a sprained thumb at any age, but people who ski or who play sports that involve a ball and using your hands, such as baseball, basketball, volleyball and football, are more likely to get a sprained thumb. People who are at a higher risk of falling are also more likely to get a sprained thumb.

How common is a sprained thumb?

Thumb sprains are a fairly common injury. They’re more common in people who ski or play sports that involve catching, throwing or passing a ball.

What are the symptoms of a sprained thumb?

The symptoms of a thumb sprain depend on how severe the sprain is. There are generally three different grades, or levels, of sprains.

Grade 1 (mild)

Symptoms of a grade 1 (mild) thumb sprain can include:

• Experiencing pain or tenderness around the base of your thumb.
• Experiencing swelling in your thumb or at the base of it.
• Having bruising around the base of your thumb.

In some cases, people who have a mild thumb sprain don’t experience pain at the time of the injury.

Grade 2 (moderate)

Symptoms of a grade 2 (moderate) thumb sprain can include:

• Experiencing limited function and range of motion in your thumb.
• Experiencing pain and tenderness around the base of your thumb.
• Experiencing swelling in your thumb or at the base of it.
• Having bruising around the base of your thumb.

Grade 3 (severe)

Symptoms of a grade 3 (severe) thumb sprain can include:

• Experiencing intense pain and tenderness around the base of your thumb.
• Having a loose or unstable thumb joint.
• Having a difficult time grasping things between your thumb and your pointer finger (index finger).
• Having a lump in your thumb. This can happen if your ulnar collateral ligament (UCL) is completely torn. The end of the ruptured ligament can cause a lump under your skin.
• Experiencing swelling in your thumb or at the base of it.
• Having bruising around the base of your thumb.

What causes a sprained thumb?

A thumb sprain can happen from a sudden, strong force that bends your thumb backward, away from your palm, or in another awkward direction. This often happens from falling on your outstretched hand. A thumb sprain is also a common skiing injury from falling with the ski pole still in your hand, which is why thumb sprains are sometimes called skier’s thumb.

A thumb sprain can also happen over time from activities or sports that involve repetitive grasping or hand twisting. This type of thumb sprain is considered chronic and is known as gamekeeper’s thumb.

How is a sprained thumb diagnosed?

Your healthcare provider will ask you questions about how and when you injured your thumb and about your symptoms. They’ll then perform a physical exam to assess the stability of your thumb joint and where the pain is coming from to determine if the injury is or isn’t a sprain and how severe the injury is. They may also have you undergo imaging tests as mentioned above.

What tests will be done to diagnose a sprained thumb?

After your healthcare provider performs a physical exam on your thumb to check for stability and tenderness, they may have you undergo imaging tests to rule out other possible injuries or to see how severe your thumb sprain is. Imaging tests for diagnosing a sprained thumb can include:

X-rays

• X-rays use radiation to take detailed images of your bones. Your healthcare provider may have you get X-rays of your hand and thumb to make sure your pain and swelling aren’t from a broken or fractured bone. They’ll also want to check if the strain caused an avulsion fracture, which happens when your ligament tears away from the bone it’s attached to and takes a small piece of bone with it.
• Stress X-ray: During this type of X-ray, your healthcare provider will apply tension to your injured thumb while it’s being X-rayed to learn more about the stability of your metacarpophalangeal (MCP) joint. If the pressure causes pain, your healthcare provider may give you an injection of an anesthetic (numbing medication) near your thumb.

MRI

• An MRI (magnetic resonance imaging) takes detailed pictures of the inside of your body without the use of radiation (s-rays). An MRI will show both bony details that may be missed by plain radiographs, as well as soft tissue details indicating the level of a sprain or strain. The information obtained by the MRI may help your healthcare provider better understand how to treat your injury or if surgery/surgical referral may be necessary.

Musculoskeletal ultrasound

• A musculoskeletal ultrasound (sonography) uses sound waves to take images of your body. Your healthcare provider may order an ultrasound to look at the soft tissue surrounding a joint. It can indicate if there are partial tears, tearing or fluid collections. Your healthcare provider may have you get an ultrasound of your thumb to better understand the severity of your injury and the best treatment plan.

How is a sprained thumb treated?

The treatment for a sprained thumb depends on how severe your sprain is.

Mild thumb sprains (grade 1 sprains) can usually be treated from home using a treatment plan known as PRICE (protection, rest, ice, compression and elevation). Treatment for a mild thumb sprain can include:

• Protection: Wear a thumb spica splint for a few days to help immobilize the injured area. You can purchase these over the counter at the drug store or online.
• Resting your hand: Avoid using your affected hand for at least 48 hours after your initial injury. This is easy to do if you’ve immobilized the area. If you don’t have a splint, then do your best to avoid movements and using the hand/thumb causes pain.
• Icing your thumb: Apply ice to your affected thumb and hand as soon as possible after the injury. This can help minimize swelling. An ice massage can target and focus icing directly on the area of discomfort. Use an ice cube and hold with a washcloth, making small circular motions for three to five minutes multiple times per day in the area of concern. Sometimes, an ice bath can be helpful, too — dip your thumb and hand in ice water for three to five minutes — just be careful not to overdo it and cause frostbite.
• Using a compression bandage: Wrap your affected thumb joint with an elastic compression bandage. Some thumb spica splints have an elastic or stretchy quality to them. This can help minimize swelling.
• Elevating your hand: When you’re resting, hold your hand up higher than your heart as much as you can.
• Taking pain relievers: Over-the-counter pain relievers such as aspirin and ibuprofen can help with pain and swelling.

If you’re still experiencing pain and swelling after two days of rest and at-home treatment, see your healthcare professional.

If you have a moderate thumb sprain (grade 2 sprain), treatment can include:

• Wearing a thumb spica splint: Your healthcare provider will likely have you wear a thumb spica cast or splint to immobilize your thumb while it’s healing. Depending on how severe your sprain is, you may have to wear it at all times until your healthcare provider says you can remove it.
• Applying ice to your thumb and hand: Apply ice to your affected thumb and hand as soon as possible after your injury. This can help minimize swelling. An ice massage can target and focus icing directly on the area of discomfort. Use an ice cube and hold with a washcloth, making small circular motions for three to five minutes multiple times per day in the area of concern. Sometimes, an ice bath can be helpful, too — dip your thumb and hand in ice water for three to five minutes — just be careful not to overdo it and cause frostbite.
• Taking pain relievers: Over-the-counter pain relievers such as aspirin and ibuprofen can help with pain and swelling.
• Stretching exercises: Since having your thumb immobilized can cause stiffness, your healthcare provider may have you do certain stretching exercises to help you regain mobility in your thumb. Follow your healthcare provider’s recommendations about when to begin these exercises.

If you have a severe thumb sprain (grade 3 sprain), treatment can include:

• Undergoing surgery: Surgery is often necessary when a ligament completely tears. There are many types of surgery for a thumb sprain, including reconnecting your ligament to your bone and repairing an avulsion fracture with a bone anchor, pin or screw.
• Wearing a thumb spica cast or splint: After surgery, you’ll likely need to wear a cast or a splint for six to 12 weeks so your thumb sprain can heal.
• Participating in occupational/physical therapy: After your thumb sprain has healed from surgery, your healthcare team will have you do certain exercises to regain strength and range of motion in your thumb and hand.

Do I need to go to the hospital for a sprained thumb?

Everyone experiences pain from time to time, but persistent pain isn’t normal. If you injured your thumb and are still experiencing pain after two days of resting and icing it, be sure to contact your healthcare provider. They’ll likely want to do tests to see if you have a more serious injury and/or give you a splint to help stabilize your thumb.

How long does it take for a sprained thumb to heal?

The length of recovery for a sprained thumb depends on the severity of your sprain. A mild sprain usually heals within four to six weeks if you wear a splint or cast to immobilize your thumb and refrain from activities that irritate it.

A more severe thumb sprain, such as a grade 3 sprain, could take several months before it’s fully healed and you’re able to use your thumb like normal again. This is because severe sprains usually require surgery, which then requires you to wear a post-surgery splint or cast and do physical therapy.

How can I take care of myself if I have a sprained thumb?

Follow your healthcare provider’s instructions on how to care for your sprained thumb. Try avoiding activities and sports that involve using your hands for at least a month so your ligament has time to heal.

How can I prevent a thumb sprain?

There are a few things you can do to try to prevent a thumb sprain, including:

• Stretch your hand and finger muscles before you do any exercises or play a sport that requires using your hands.
• Wear safety equipment when you play sports.
• Exercise on flat surfaces to try to prevent falls.
• Wear shoes that fit well and make sure your shoelaces are tied properly so you’re less likely to trip and fall.
• When you’re skiing, be sure to let go of your ski poles if you’re falling instead of holding onto them.
• If you’re at a higher risk for falling, use a walking aid such as a cane or walker.

What is the outlook (prognosis) of a thumb sprain?

If mild (grade 1) and moderate (grade 2) thumb sprains are treated properly with rest and immobilization of your thumb, they usually heal well without long-term complications.

Most studies show that surgeries for severe (grade 3) ulnar collateral ligament (UCL) sprains are usually successful. Grade 3 UCL sprains that aren’t treated with surgery usually lead to chronic (long-term) instability.

Does a sprained thumb cause any complications?

The likelihood of having complications from a thumb sprain depends on how severe it is and which ligament was affected. Complications from a sprained thumb can include:

• Chronic pain in your thumb.
• Arthritis in your thumb joint.
• Instability in your thumb joint.
• Decreased pinch strength.
• Nerve damage from surgery.
• Decreased range of motion in your thumb joint.

When should I see my healthcare provider?

If you’re experiencing symptoms of a thumb sprain such as pain and instability in your thumb joint, reach out to your healthcare provider.

If you have a sprained thumb and are experiencing new or concerning symptoms, contact your healthcare provider.

A note from Cleveland Clinic

As we go about each day doing our normal activities, there’s always a risk of tripping, falling and getting injured. Thumb sprains are a common injury. If you experience a thumb sprain, reach out to your healthcare provider. It’s usually a good idea to make sure it’s only a mild sprain and not a more serious sprain or a different injury. You can also get a treatment plan that will help get your thumb back to normal again.