Sprained UCL Ligament of the thumb
While the UCL of the elbow gets the most attention, there is also a ucl on the inner side of the joint at the base of your thumb. This ligament resist the motion of your thumb excessively moving towards your forearm. Injury to this ligament typically occurs when sliding head first into a base with an open hand and catching your thumb on the end of the bag or a catcher receiving a running fastball in the inner part of his mitt.
Typically, after suffering this injury you will experience swelling and redness in the base of the thumb, if you press the joint you may experience some tenderness or pain. A good test to use to rule in/out a ligament rupture of the thumb would be to apply load to the joint in the direction the injury occurred. You can see how the load is applied in the picture below. A positive test will have greater than a 15-degree difference between the unaffected side.
Surgical repair is a likely treatment for a COMPLEtely torn UCL in a COMPETITIVE athlete. conservative options, like physical therapy, are commonly discussed as alternative methods ans should be considered for both prehab and rehab of the injury. This surgery will typically sideline a player for about 6-8 week to allow for proper healing and a sufficient rehab process.
There are a few preventative measures you can take. For baserunners, I love running with batting gloves gripped in your hand. While this may not have any effect on the other fingers, it does require the thumb to stay in a grasped position, therefore not placing it at risk to be exposed to the base in a vulnerable position during a headfirst slide. Another option for both baserunners and catchers alike would be to use a catcher’s thumb guard during both catching and base running. These products typically cost around $25 and are made by companies such as Evoshield. The best part about these products is that they aim to prevent the exact mechanism of injury that causes the sprain.
While thumb sprains are the most common form of hand injury in baseball, injuries to the other fingers also occur while sliding into a base head first. Jammed fingers occur often and can be thought of as a simple dislocation. You may notice a deformity within the first or second joint of the finger that may even be accompanied by visible swelling. After suffering a jammed finger observe the range of motion in all finger joints, if you can still maintain some movement in both directions of the joint the conservative measures can be taken. Lack of motion in a specific direction or a clear inability to correct a deformity may be indicative of a more severe type of injury. These types of injuries include, avulsion fractures, standard fractures, ‘jersey’ finger and other injuries that may require surgery.
Treatment for standard dislocation or ‘jammed’ fingers requires splinting or buddy tape your fingers and return to the game. In a position where fine motor of the fingers plays a greater role, such as a pitcher, you may want to exit the game, perform some rehab, splint the finger, have further workups and evaluations done so that you can be prepared for your next appearance.
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