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Ulnar Collateral Ligament – Boxers Thumb

Ulnar collateral ligament tear is damage to the (UCL) ligament that supports the thumb. Typically, the injury results from the ligaments being over stretched beyond their limits. The UCL ligament is normally damaged when the thumb is bent backwards away from the palm of the hand. This often happens after falling onto an outstretched hand. In most injuries to the thumb the UCL is the ligament damaged, this can make your thumb and index finger feel unstable and difficult to move. It may affect your ability to complete day to day activities such as grasping objects between your finger and thumb.


Symptoms of this injury will depend on the severity of the damage to that ligament. Pain may or may not be present at the time of injury, a although you will most likely have pain around the base of the thumb close to the palm.

  • If you have damage your symptoms may include:
  • Inability to move the thumb through full range of motion pain free
  • Pain at the base of the thumb
  • Swelling around the base of the thumb
  • Feeling of instability in the thumb and index finger
  • Difficulty grasping objects between the finger and thumb

Grading of thumb sprains

Sprains are graded in relation to the damage to the ligament.

  • Grade 1 (Mild) – Ligament has been overstretched, a small percentage of the fibres are damaged but is not completely torn.
  • Grade 2 (Moderate) – An increased percentage of the fibres are damaged; ligament is partially torn. This grading is normally associated with partial loss of function.
  • Grade 3 (Severe) – The ligament has been completely ruptured or has been torn off of its attachment to the bone. This level of sprain will require medical attention and potentially surgery. If the ligament does lose its bony attachment this classed as an avulsion fracture.


Depending on the severity of the injury here are some treatment approaches. Following the RICE protocol will help your recovery process.

Home care

Mild thumb sprains can be treated well with home treatment that will help to decrease your pain and improve symptoms.

  • Rest – try to rest the injured area and avoid any movements that provoke your symptoms.
  • Ice – you should try to ice the injury immediately to keep the swelling down. You can use ice packs for fifteen minutes maximum several times per day. Do not apply the ice directly to the skin.
  • Compression – if possible, wrap the area in an elastic bandage to apply compression to the area. This will help to keep the swelling as low as possible.
  • Elevation – As often as possible, try when resting to keep the area elevated above the height of your heart.

When diagnosed and treated correctly most thumb injuries will heal well with no complications. However, if ignored it can lead to complications further down the line in recovery. If you suspect you may have a sprain you should visit a health professional as soon as possible.

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