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Ulnar Collateral Ligament Injury

The ulnar collateral ligament (UCL) of the thumb is a tough band of tissue that connects the bones at the base of the thumb. This ligament prevents the thumb from abducting too far from the other fingers of the hand. Injuries to the UCL are similar to gamekeeper’s thumb (a chronic injury) or skier’s thumb (an acute injury) and are usually the result of injuries that occur during sports activities.

Ulnar Collateral Ligament Injury

Ulnar Collateral Ligament Symptoms

Individuals suffering from an acute tear to the UCL usually have swelling and discomfort or pain at the site of the injury. Oftentimes, the injured patient will find it difficult to grasp objects, feeling a sharp pain in their arm when they attempt to hold an object firmly in their grasp.

Treatment of UCL injuries usually involves the RICE protocol:

• Rest
• Ice-to alleviate pain and swelling
• Compression-wrist brace or splint to compress and immobilize the wrist
• Elevation-above the heart

Partial tears of the UCL typically heal without the need for surgery. Protocol calls for restricting the motion of the injured joint for four to six weeks with a thumb spica type cast. After cast removal range of motion and strengthening exercises begin. Individuals that have a complete tear, require surgery to repair the damage, followed by a cast and a wrist support with thumb control. The wrist brace is usually recommend for two weeks, longer depending on the severity of the injury, health of the patient, and the day to day activities an individual engages in.


The proper use of a wrist brace with forearm support and a thumb spica (thumb brace) are essential in the healing process. A thumb spica, or thumb splint, is essential in keeping the entire length of the UCL stable and supported, as the thumb connects to the hand and wrist by the injured ligament. Many wrist braces offer a thumb spica to fully support the arm and thumb while the patient is healing.