any doctors, opinions please

Hi All,
Two weeks ago while playing basketball, my right thumb got hit with the basketball while i was attempting to block a pass. My thumb quickly became swollen and i couldn’t move it. I thought initially that the ball may have caught the end of my nail and lifted it or else that it just bent back the last joint of my thumb.

I just figured that it had been sprained so i didn’t do anything with it, thinking that it would fix itself up in a week or so. Well, two weeks on, i don’t have any pain and most of the swelling has gone down, but I still haven’t regained full movement and i can only exert weak pressure with my thumb before it becomes painful.

So I’ve decided to go and see a doctor…

But i’d like to know what it could be and if it might be serious.

The symptoms are.

Swelling around the last joint of the thumb. The joint near the web between thumb and first finger appears to be fine. Some blood/bruising under the skin behind the nail and on the front pad of the thumb. Limited movement of the last joint of the thumb. Unable to exert much pressure in a pinch motion.

Thanks for any info and don’t worry i’m going to get it seen to anyway.


Disclaimer: See your doctor. But you knew that already.

It sounds as if you sustained a mild to moderate sprain of the ligaments in your thumb’s interphalangeal joint. It’s excellent that the pain has dissipated, but full range of motion needs to be restored before you will regain full use of the thumb and full strength. My recommendation would be to very gently manipulate the joint using the other hand as follows:

This joint essentially has only one plane of motion, in which it moves in two directions (flexion and extension). Grasping the tip of the thumb, slowly bend the affected joint forward (flexion) until either it moves no further or you begin to feel pain. If you begin to feel pain, stop–back off that position just a hair–and hold it there for 20-30 seconds. Don’t hold it in a position of pain, but hold it just shy of that position. Then very gently and slowly go the other way. Expect it to twinge a little here or feel a bit achey as you go the other direction. That’s OK. Extend the joint back as far as it will go, or until it starts to hurt. Then back off, hold that position for 20-30 seconds and repeat. Do about five or six reps in each direction, then rest it for half an hour or so. Don’t push it. If it hurts after a session, ice it for 20 minutes.

Every time you think about it, bend your thumb like this. Keep it moving. The important thing is the holding for 30 seconds in the extreme positions. This takes advantage of a property of tissue known as “creep” and gradually stretches the ligaments to their proper length. It also helps to minimize scar tissue, which can contract as it heals and leave you with permanent loss of motion. Once you can do this exercise to the end of the range of motion in both directions with no pain, you’re well on the way to full recovery. Do some grasping and lifting exercises to strenthen the hand muscles; a soft, squeezable rubber ball works well for this purpose too. They are readily available for just a few dollars. You can take some OTC anti-inflammatory meds if you like–ibuprofen works well for most people.

Good luck

This could be serious and does need to be checked out.

Pain in the distal phalanx of the thumb could well be an interphalangeal ligament strain. It would be important, however, to rule out ulnar collateral ligament strain – a serious condition that requires up to six weeks of immobilization in a scaphoid cast to heal properly. The pain from this injury is usually in the first joint of your thumb near the curved fold of skin betwen your thumb and index finger. This pain might be worse if you move your thumb away from your index finger in the same plane as all your fingers.