Thumb Sprain

Violent overstretching of one or more ligaments in the joint of the thumb. Sprains involving two or more ligaments cause considerably more disability than single-ligament sprains. When the ligament is overstretched, it becomes tense and gives way at its weakest point, either where it attaches to bone or within the ligament itself. If the ligament pulls loose a fragment of bone, it is called a sprain-fracture. There are 3 types of sprains:

• Mild (Grade I) - Tearing of some ligament fibers. There is no loss of function.
• Moderate (Grade II) - Rupture of a portion of the ligament, resulting in some loss of function.
• Severe (Grade III) - Complete rupture of the ligament or complete separation of ligament from bone. There is total loss of function. A severe sprain requires surgical repair.

Body Parts Involved

• Ligaments that hold the metacarpo-phalangeal joint of the thumb together.
• Tissue surrounding the sprain, including blood vessels, tendons, bone, periosteum (covering of bone) and muscles.

Causes

Stress on a ligament that temporarily forces or pries the thumb out or its­normal location. Thumb sprains occur frequently in baseball players, particularly catchers, but they may occur in other exercise or sports activities.

Signs & Symptoms

• Pain when the thumb is bent backwards.
• Pain in the web of the thumb when it is moved.
• Laxity and instability in the joint.
• Bruising that appears soon after injury.
• Swelling over the joint at the bottom of the thumb.

Treatment

Note:- Follow your doctor's instructions. These instructions are supplemental.

First Aid

Follow directions for R.I.C.E. :

• Rest the injured area as much as possible.
• Ice the injury as recommended.  This reduces blood flow and limits swelling and internal bleeding.
• Compress the injured joint according to your doctor's instructions.
• Elevate your hand to help control swelling.

Continuing Care

If the doctor does not apply a cast, tape or elastic bandage:

• Continue using an ice pack 3 or 4 times a day. Place ice chips or cubes in a plastic bag. Wrap bag in a moist towel, and place it over the injured thumb. Use for 20 minutes at a time.
• After 72 hours, apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot shower, heating pads, or heat liniments or ointments.
• Take whirlpool treatments, if available.
• Massage gently and often to provide comfort to provide comfort and decrease swelling.

Medication

• For minor discomfort, you may use:

Aspirin, acetaminophen or ibuprofen.

Topical liniments and ointments.

• Your doctor may prescribe:

Stronger pain relievers.

Injection of a long-acting local anesthetic to reduce pain.

Injection of a corticosteroid, such as triamcinolone, to reduce inflammation.

Home Diet

During recovery, eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs.

Diagnostic Measures

• Your own observation of symptoms.
• Medical history and exam by a doctor.
• X-rays of the thumb, hand and wrist to rule out fractures.

Prevention Tips

Tape vulnerable joints before practice or competition to prevent reinjury. Immobilization after healing can bo provided by a slip-on protector devised by a brace-maker.