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Skiers thumb recovery

Original Post
Mark E Dixon · · Possunt, nec posse videntur · Joined Nov 2007 · Points: 974

So like an idiot I tore the ulnar collateral ligament of my R thumb yesterday making a death slide type descent of Big Chute at Crested Butte. Anyone willing to share personal experiences of how soon they were able to resume climbing, skiing, hangboard, campusing, etc after surgical repair? Any insights appreciated!

MikeSLC · · Unknown Hometown · Joined Jul 2007 · Points: 20

A season of slab climbing may be in your future.

Mark E Dixon · · Possunt, nec posse videntur · Joined Nov 2007 · Points: 974
MikeSLC wrote:A season of slab climbing may be in your future.
Not if I can help it!

"A chance to cut is a chance to cure"
Cor · · Sandbagging since 1989 · Joined Mar 2006 · Points: 1,445

Could be as little as a month to come back.. (From my old experiences.)
See if you have good improvement in a week or so, and then decide if
you need to take any further action (knife??)
Mostly it will be the pinching grip thingy. Crimp on flat edges should be ok..

Good luck though, as those always suck!

C

Ryan Huetter · · Mammoth Lakes, CA · Joined Apr 2006 · Points: 395

Have you already established that it is a full or partial tear, and that you are a surgery candidate?
I had a partial tear last January and with a combination of a thumb brace and 8 weeks of PT (as well as all the exercises done at home), I was at 80% or so. Took a couple more months to regain full mobility and strength.

Skiing should't be a problem- while BC skiing/skinning I just put one pole away so I wouldn't be tempted. When your PT makes your brace for you you can hold a pole in the hand so that you get the grip position you would like.

Climbing- no! It is all the little things that you wouldn't think about that are really stressful on the UCL (it took a specific strength exercise that me and my PT came up with to work on clipping a rope into a biner with the hand in question.)
Same with hang boarding- your UCL gets pulled on even when hanging on fingers.

The things that really suck though are the simplest things- zippers, and zip lock bags were super painful!

Good luck.

Mark E Dixon · · Possunt, nec posse videntur · Joined Nov 2007 · Points: 974

Thanks for the info.

I have a complete tear and am getting surgery this afternoon.

When I picked myself up at the bottom of the run, I was thinking, "man my thumb hurts, must have sprained it" So I pull off my glove and it's sticking out sideways. Before I reflected further, I thought "hope this goes back in easily" grabbed the thumb and reduced it. I have zero stability, could easily pull it back out if I wanted to, but honestly it makes me too queasy! My big regret is that I didn't get a photo first. But my reaction was pure reflex.

Taylor-B. · · Valdez, AK · Joined Oct 2009 · Points: 3,186

Check out this procedure thesteadmanclinic.com/bone-…
And this Doc thesteadmanclinic.com/dr-ra…

Tom Lausch · · Madison WI · Joined Apr 2012 · Points: 170

I tore mine last year transitioning off a rail skiing. Got an MRI and they put a cast on it. 6 weeks later they took it off and I started PT. After following my PTs advice to a T for the next 3 weeks. Now I am just as strong as I was before. Dont push it is my advice. You have the rest of your life to go climbing. Dont ruin it by tring to push it.

Take this with a grain of salt as I am now suffering from a torn MCl as a result of another skiing wipeout.

JEFFisNOTfunny · · Unknown Hometown · Joined Apr 2012 · Points: 40

A few years ago... I had the same injury. Is it a clean ligament tare? or did it rip a piece of the bone with it?

Mine was the latter, I did it while riding dirt jumps on my mountain bike... nasty fall combined with the handlebars ripping my thumb back... etc.

It was probably 3 weeks after my injury before I had my surgery (which is a long time, because the ligament starts to retract towards the base of the thumb). Additionally, I wasn't climbing at that point either, but I can relate how long it took to get back on a downhill or dirtjump bike.

At approximately 3 weeks after the injury I had my surgery. It was apparently a success (according to my doctor). I had a month in hard casts. Each appointment, they cut it off to check motion and wound healing.

As soon as I was out of the hard cast I began occupational therapy. I went three days a week and did all the home exercises. The home training is probably just as important as what you do in therapy. The home therapy included stretching and strengthening with puddy.

It took some time, but I think it was around 2 months after the injury that I began to ride again (with a substantial brace). The limiting factor at that point was hand strength. Riding downhill runs, my hand was beyond pumped.

The risk in pushing two hard is you can re-injure the ligament or rip the pin holding the ligament out of the bone.

All said and done... approx 2.5-4 months after surgery to begin riding for me... almost a year before I felt full strength. The scars will give you motion issues and cold issues for longer.

Good luck... don't give up hope. You will get better.

Mark E Dixon · · Possunt, nec posse videntur · Joined Nov 2007 · Points: 974

An update if anyone is interested.

I never had an MRI, just xrays. Went to surgery 2 days post-injury (props to Orthopedic Center of the Rockies, McKee Medical Center and Dr Chamberlain.) My surgeon found I had a complete tear of the UCL with a Stener lesion (so it would never have healed without surgery.) Didn't use a pin, anchored the tendon to a groove cut into the bone.

Was in a plaster splint for a week post-op then switched to a fiberglass cast.
Got the OK for hangboarding and "easy climbing." Had to do one arm hangboard hangs as the initial cast made it difficult to orient my hands properly for two handed hangs. I extended my wrist when the cast was placed, thinking this would make it easier to climb. That was a mistake as the part of the cast over the heel of my hand pushed me away from holds. The area over the thumb was also pretty bulky (probably knew what I was going to be up to!) which made this effect even worse. Finally, the cast went all the way to the base of my fingers, which especially pinched my little and ring fingers.

After two weeks I had abused the original cast enough to justify a change, and the new one was cut lower across the palm, wrist in neutral position and less of a bump over the thumb.

A few days later I went skiing for the first time. (17 days post-op) It was hard to find gloves and clothes that fit over the cast, ended up with some wool mitts under an OR overmitt. Tried VERY HARD not to fall! I had a pair of poles that clipped to a harness secured over my glove/mitt and that let me keep using poles.

The new cast was much better for climbing. I inched up the grades, finding the cast made slopers interesting to say the least. Clipping was often challenging, since I didn't have any real use of my right thumb. But way better than not climbing!

Somewhere about 8-9 weeks post-op I was switched to a flexible, removable cast. I was surprised to find my wrist was quite stiff and painful. I started OT at this point, mildly disappointed that it was only minimally painful.

My thumb was very stiff. This has gradually improved over the last month, but I still don't have full range of movement. If you imagine putting your hand flat on a table and moving your thumb out to the side, I can only get my thumb out to about 75% as opposed to 100% on the other side. I also ended up with my injured thumb at about 2/3s the strength of the good left thumb, when it should have been stronger (since I'm right handed.)

I finished out the ski season still using the flexible cast, but I've been climbing cast free for a couple of weeks now. Feels great although I've lost some grip width so big pinches are hard/impossible. My training season suffered some, but I was able to focus on mental training which I probably need even more than strength training.

Having a surgeon who understood my need to stay active was incredibly helpful.
Not back to full strength but getting close after 13 weeks. Not sure if I'll ever get full range of motion, but planning to stick with the exercises as long as I can.

YMMV, but I do suggest limiting anyone's number of ski slope death slides!

Andy Gaines · · Denver, CO · Joined Apr 2018 · Points: 0

On July 4th I had a ski accident and have had UCL pain ever since. I narrowed it down to being a UCL injury/skier's thumb. Had some minimal swelling but not really any discoloration/bruising.

For other that have had this injury, but actually tore the ligament, did you have major pain, bruising, and large swelling?

At this point I'm thinking it's just a sprain and taking care of it on my own. Have some big climbing trips coming up in Sept/Oct tat I'm hoping I can recover before. 

Mark E Dixon · · Possunt, nec posse videntur · Joined Nov 2007 · Points: 974

Still regret missing that image.

Anyway, the key is whether your thumb is stable if you push it radially. Does it have a firm endpoint similar to the other thumb?
If so, partial tear at worst. Non-operative.

Might still be worth seeing a hand specialist and getting PT if you can afford it.

An update on my injury- full strength in R thumb, still can't open that hand as wide as the left, that's not going to fully recover. But close.

Andy Eiter · · Madison, WI · Joined Jul 2014 · Points: 276
Andy G wrote: On July 4th I had a ski accident and have had UCL pain ever since. I narrowed it down to being a UCL injury/skier's thumb. Had some minimal swelling but not really any discoloration/bruising.

For other that have had this injury, but actually tore the ligament, did you have major pain, bruising, and large swelling?

At this point I'm thinking it's just a sprain and taking care of it on my own. Have some big climbing trips coming up in Sept/Oct tat I'm hoping I can recover before. 

I'm currently recovering from Skier's Thumb (injury occurred June 5th). My experience sounds a lot like yours. I'd get it checked out.

I didn't notice any discoloration, bruising, or swelling. I thought I just jammed it or something, and didn't get it checked out for a couple weeks until a couple OT friends convinced me to go to an ortho clinic. They did an X-ray, which showed an avulsion fracture. They concluded the tear was partial without an MRI.

It's been four weeks with a brace (at all times for the first couple weeks; now only when doing active stuff). The specialist said nothing about PT at my last visit, but I am going to see him again this week. I feel just about far enough in the recovery to start working it a little (today is the first time I've noticed I can hold a full mug of tea without pain). I've got a trip planned for September, but I am not confident the thumb will be ready.

Good luck; hopefully your recovery is swifter than mine.
Guideline #1: Don't be a jerk.

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