If you happen to be a skier you may have heard the term, “skier’s thumb” or “gamekeeper’s thumb.” These are actually slightly different injuries, but they do have one thing in common, the UCL, or ulnar collateral ligament.

Skier’s Thumb is considered to be a sudden injury, such as the tearing of the UCL. Gamekeeper’s thumb is a chronic injury, which means that it develops over time. The term, “Gamekeeper’s Thumb”, comes from gamekeepers (likely European farmers) who developed this injury from repeated use. When they would kill their chickens, rabbits, or other small game, they would typically place their thumb and index finger against the head or neck, place it against the ground and apply opposing pressure. This regularly used technique of breaking the neck of an animal would cause damage to the UCL.

The ulnar collateral ligament holds together bones at the base of the thumb. It also helps keep the thumb from going too far in the wrong direction. Injuring the UCL is common among skiers because they often fall on outstretched hands, while still holding the ski pole. The ski pole can play a role in the tearing of this ligament as it can push the thumb away from the hand upon impact.

I have recently had this injury and I can tell you, it is as painful as breaking a bone in the hand (another previous injury I have had). The thumb and the area around the base of the thumb tend to swell up pretty quickly. The best thing you can do for this injury right away is to get yourself down to the bottom of the mountain via the easiest way possible. If you are at a ski area, this may involve side slipping or traversing until you get to an easy groomed run. Or if you feel you are unable to ski down, notify ski patrol and they can take you down the mountain in a toboggan.

Next, you should elevate the hand by bending your arm against the chest. Ideally your hand should be up near your shoulder, the goal is to have it above your heart to help reduce swelling. Then hold an ice pack, or a plastic bag filled with snow on your injury. Try to place a washcloth or light fabric between your bare skin and the ice pack. Both elevating and icing the hand will help relieve pain.

The final step is to have a doctor look at it to determine whether you have a sprain, Skier’s Thumb, or Gamekeepers Thumb. The latter often requires surgery. Now that you know what the UCL or Ulnar Collateral ligament is, take care of yours!