Thumb sprain (skier's thumb) or finger sprain

Synonym for sprain:

• Strain

What is a thumb or finger sprain?

A sprain is a stretch or tear of one or more ligaments in the thumb or finger. When a ligament is stretched or torn, bleeding can occur in the joint, leading to swelling and bruising.

What is a ligament?

A ligament is a tissue that holds bones together. We have hundreds of ligaments in the body between each of our bones to stabilize them.

What is skier's thumb?

Skier's thumb is a sprain of the joint at the base of the thumb that commonly occurs in skiers when falling. The pole strap forces the thumb backward, causing a sprain.

What are the causes of a thumb or finger sprain?

A sprain is always caused by an accident, a blow, or a twist. There must be a clear traumatic event.

Common causes of thumb or finger sprains are:

• Falling on your hand
• Rapid and sudden twisting of the thumb or a finger
• A direct blow to the thumb or finger

Therefore, if the pain appeared slowly and gradually, without any clear incident, it is not a sprain.

Here are some common examples that can cause a sprain to the thumb or finger:

• In skiing, when the pole gets stuck in the snow (skier's thumb)
• In volleyball, when blocking a ball attack
• When slipping and falling on the thumb or finger

What are the symptoms of a thumb or finger sprain?

The main symptoms are:

• Pain in the injured thumb or finger
• Often there is swelling in the thumb or finger
• There may be bruising on the thumb or finger

The pain is increased by:

• Thumb or finger movements
• Putting weight on the hand (for example, to get out of bed)
• Lifting loads (grocery bags, a pot full of water, for example)
• Forcing with the hand (opening a jar or twisting a towel, for example)

How to diagnose a thumb or finger sprain?

Diagnosis is made based on a review of your symptoms and a clinical examination.

If you have experienced trauma to your wrist or hand, to ensure that you do not have a fracture, we recommend that you get an X-ray if you have one or more of the following signs:

• Significant swelling of the thumb or finger
• Visible deformation of the thumb or finger

Did you know that physiotherapists can prescribe X-rays if the injury occurred less than 72 hours ago? If you do not have quick access to a doctor, you can obtain this prescription from a physiotherapist.

A thumb sprain is sometimes confused with a scaphoid fracture, a small bone in the wrist located at the base of the thumb. The wrist is one of the places in the body where, if there is a fracture, it is important to know quickly because the scaphoid does not have good blood circulation. This bone may therefore have difficulty healing properly if the fracture is not diagnosed quickly.

When to consult a physiotherapist for a thumb or finger sprain?

You should consult a physiotherapist if you have symptoms as described above or if your doctor has already ruled out any other cause that may be responsible for your pain.

You do not need to see a doctor before consulting a physiotherapist. If your condition requires you to see a doctor, your physiotherapist will be able to tell you.

What are the physiotherapy treatments for a thumb or finger sprain?

As with all traumatic injuries, we must allow the body to perform its natural healing process.

« Inflammation is a normal and necessary process for proper healing. There is therefore no miracle way to speed up healing. »

However, it is very important to make sure to eliminate any factors that could slow down healing.

Here are some examples of things that could slow down healing:

• Improper dosage of exercises and daily activities
• Poor biomechanics of your movements
• Stiffness in the joints, muscles, and nerves
• Worries or fears related to the injury or pain

« For this reason, your physiotherapist can help you optimize the healing of the injury. They will be able to guide you in the best possible direction to ensure that the injury heals effectively. »

Think of healing from a traumatic injury like taking care of a plant. Pulling on the plant won't make it grow faster. However, you can make sure it gets enough water, sunlight, and fertilizer. We want to put the plant in a good environment to heal. It's the same for a traumatic injury.

Your physiotherapist will perform an assessment to determine your limitations and the severity of the sprain by evaluating the following:

• Your joint mobility
• The gliding of your nerves
• The quality of your movements
• Your strength and stability

Depending on the results of the assessment and the stage of healing of the sprain, your physiotherapist will:

• Will mobilize the joints of the thumb and/or wrist if stiffness has set in.
• Will provide specific exercises to retrain the strength and stabilization of your thumb and entire hand.
• Teach you how to properly manage your daily activities and hobbies to optimize healing
• Will give you advice for your movements.
• The physiotherapist may tape your thumb or finger to reduce pain or limit movement if necessary.

What to do at home for a thumb or finger sprain?

As with any traumatic injury, follow the PEACE and LOVE principles to heal a thumb or finger sprain. Read the blog post on PEACE and LOVE and then read the advice here that applies to the thumb and fingers.

PEACE and LOVE advice specific to the thumb and fingers

(make sure you have read the blog post that explains the PEACE and LOVE steps in detail)

For C = compression:

Use a compressive bandage or tape to surround your thumb or injured finger.

For L = Load:

Start moving the injured finger and using your hand for your daily tasks without significantly increasing the pain. Do the dishes, pick up lighter objects with the injured hand, etc.

For V = Vascularisation:

Light to moderate cardio activity without pain accelerates healing. For a finger sprain, you can:

• Walking
• Use a stationary bike
• Run if you don't have pain
• Swim without pain
• Any other cardio activity that does not increase pain

Sources

• Dubois B, Esculier JF. Soft-tissue injuries simply need PEACE and LOVE.