Thumb sprains are common injuries where a ligament stretches or tears within your thumb joint. In severe thumb sprains, your ligament can be partially or completely torn, which often needs surgery. Treatment for thumb sprains often involves rest, using a splint and physical therapy.
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.
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Healthcare professionals use a grading system to classify the severity of sprains. The three different grades include:
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.
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.
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.
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.
The symptoms of a thumb sprain depend on how severe the sprain is. There are generally three different grades, or levels, of sprains.
Symptoms of a grade 1 (mild) thumb sprain can include:
In some cases, people who have a mild thumb sprain don’t experience pain at the time of the injury.
Symptoms of a grade 2 (moderate) thumb sprain can include:
Symptoms of a grade 3 (severe) thumb sprain can include:
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.
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.
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:
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:
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:
If you have a severe thumb sprain (grade 3 sprain), treatment can include:
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.
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.
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.
There are a few things you can do to try to prevent a thumb sprain, including:
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.
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:
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.
Last reviewed by a Cleveland Clinic medical professional on 12/23/2021.
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