Orthopedics-Online

Overstretched thumb

When do we speak of an overstretched thumb?

The thumb is the only finger that consists of only two phalanges.
For this, the base joint of the thumb is particularly flexible. The individual thumb joints are stabilized by ligament structures.
The ligaments are located on the inside and outside of the joints.

Sports accidents in particular can overstretch these ligaments. This happens when the thumb is pushed too much in a direction in which it cannot actually move due to strong force.
However, if the thumb is overstretched, one of the tendons or muscles of the thumb may also be overstretched.
These are located on the top and bottom of the thumb.

Your complaints are not only related to your thumb?

Find out more about the topic in general: Overstretched finger

causes

The cause of an overstretched thumb is usually a sports accident.
This results in excessive forces being exerted on the thumb.

Often sports are involved in which the hands are needed to hold something. This can be, for example, balls (volleyball, handball, basketball, soccer as a goalkeeper) or things such as ski sticks.
The clinical picture of the ski thumb describes, for example, the overstretching or injury of the inner ligament of the thumb.
This occurs when the ski pole gets caught and your thumb gets stuck in the loop.
More rarely, an overstretched thumb can also occur in other accidents.

Do you suffer from a skier's thumb?

Find out more about the treatment options at: Ski thumb therapy

Symptoms

An overstretched thumb is primarily expressed in pain. These typically occur after an accident with an overuse of the thumb.
If the thumb is held still and not used, pain does not necessarily have to be present. However, the discomfort occurs when using the thumb.

Most of the time, the thumb swells up after a sports accident.

Bleeding in the form of a bruise may also occur less frequently.
This so-called hematoma occurs when a structure with blood vessels is damaged.

Usually the mobility and functionality of the thumb are severely restricted after overstretching. On the one hand, this is due to the pain, on the other hand, the thumb can also feel unstable.
The joint is less protected due to the injury to the stabilizing ligaments. The injury traps fluid in the affected thumb joint. This can also limit mobility.

Pain with an overstretched thumb

The pain with an overstretched thumb is usually due to the injury to the joint structures. The stabilizing ligaments do not tear when overstretched, but small tears in individual fibers of the ligaments can occur.

In addition, other structures can also be affected.
For example, small blood vessels can burst, and fluid accumulates, which presses on the surrounding structures and thus activates the nerve fibers that conduct pain.
Typically, the pain occurs primarily when the thumb is strained and used.

diagnosis

The diagnosis of the overstretched thumb is initially suspected on the basis of the so-called anamnesis.
During this initial questioning of the person concerned by the doctor, a trauma or accident should be remembered, otherwise the probability of an overstretched thumb is rather low.

Then the thumb should be examined and there is pain on pressure and movement.
The affected joint is usually swollen, and occasionally a bruise occurs.

Imaging is also required to diagnose overextension. This is mainly used to rule out serious injuries. So neither bones nor other structures should be seriously broken or torn.
If the patient is overstretched, no defects can be seen in the X-ray; an MRI examination could provide indications of water retention.
However, no serious injuries should be seen there either.

Learn more about imaging:

MRI procedure,
MRI for claustrophobia - what options are there?

How does an overstretched thumb differ from a collateral ligament tear on the thumb?

Overstretching is a preliminary stage of the collateral ligament tear.
Both injuries are caused by the same mechanism.
However, more force must be exerted on the thumb to tear the collateral ligament than if it is overstretched.

When overstretched, the individual fibers of the lateral ligament are drawn in length, some of the fibers can also tear, but these cracks are microscopic and cannot be seen with the naked eye.
On imaging, the tape appears stable as a whole.

In the case of a collateral ligament tear, on the other hand, so many fibers are torn that the tear can be seen on an MRI image.
Often the two torn ends of the side ligament no longer have any contact with one another.
The treatment is correspondingly more complicated, and a collateral ligament tear on the thumb takes longer to heal than an overstretched thumb.

Find out more about the collateral ligament tear at:

Torn ligament on the thumb

therapy

Overstretched thumb therapy is usually not complicated.
If no structures are severely injured, immobilization of the thumb using a splint is sufficient.
After a few weeks, the thumb can be used again for light activities.

The thumb can then be strengthened again through additional physiotherapeutic exercise.
In most cases, no further treatment is necessary.

Taping the thumb

Taping the thumb after an overstretching can initially be used to immobilize it.
A rather stiff tape is required for this.

Once the immobilization phase is over, the thumb can be used again. Usually some complaints arise when returning to sport.
The overstretched ligament can be supported in its stability by taping the thumb.
Depending on the type of load, a firm or elastic tape can be used.

Do you suspect that your ligament is not only overstretched, but actually torn?

Find out about that Taping a torn ligament

Healing time

An overstretched thumb usually takes a few weeks to heal.

First of all, the affected tape should be spared.
For this you should plan around two to six weeks, depending on the severity of the injury.

The thumb can then be used functionally again. During this time, physical therapy can improve the flexibility and strength of the thumb again.
Depending on which tasks you need the thumb for, this can also take a few weeks.
When exactly the healing is complete should be decided individually and is best to discuss with the attending physicians and physiotherapists.

forecast

An overstretched thumb is not a serious injury.
Although microscopic damage occurs in the collateral ligament, this is usually quickly healed by the body.

If there are no additional injuries, the prognosis is excellent.
Occasionally, even after a few months, symptoms can still arise when the affected thumb is heavily strained.