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2014 Winter Olympics: Nordic Combined and Skiers Thumb

Date: February 17, 2014 Category: Uncategorized

EVENT: NORDIC COMBINED

Nordic Combined is an Olympic sport that combines two sports that we have already discussed on the blog-cross-country skiing and ski jumping.  This sport was a part of the first Winter Olympics at the 1924 Games in Chamonix, France.  Each of the two events has a number of injuries that are common, of which a tear of the ulnar collateral ligament of the thumb, also known as Skier’s Thumb, is one.  This injury can occur in the cross-country portion of the competition due to the use of ski poles and the potential for falls while holding them.

CONDITION: SKIER’S THUMB

What is it?  Skier’s Thumb is an acute tearing of the ulnar collateral ligament (UCL) of the thumb that acts as a stabilizer of the metacarpophalangeal (MCP) joint at the base of the thumb.  It most commonly occurs when skiers fall on an outstretched hand while holding a ski pole which bends the thumb away from the hand and stresses the UCL leading to its tearing.  Gamekeeper’s Thumb is a similar condition that involves stretching of this ligament without tearing that results in increased laxity and instability in the thumb.   

What are the symptoms?   Symptoms of Skier’s Thumb can include pain at the base of the thumb that can often be localized to the side closest to your index finger.  Swelling, discoloration and wrist pain can also be present.  Patients will often complain of pain that is worse with movement of the thumb along with weakness or inability to grasp things with their thumb and index finger.  A physician can make the diagnosis by testing the stability of the UCL compared to your unaffected thumb. In addition, they will check for any damage to your hand nerves and for any associated injuries in your wrist, elbow and shoulder.  X-rays will also be taken of your hand to rule out any fractures.

What is the treatment?  In the acute phase immediately after the injury, care should be taken to ice the injured area and prevent excessive movement by not using the thumb or by using a commercially available wrist brace with thumb support.  Follow-up with a physician should then be pursued for definitive treatment.  If a partial injury to the UCL is present without severe instability, the thumb can usually be immobilized for several weeks as treatment.  Complete rupture or tearing of the ligament usually requires surgery. 

How can it be prevented? The easiest way to prevent Skier’s Thumb is to have the awareness to throw off your ski poles when falling.  By not having a ski pole in your hand when falling, the chances of sustaining an injury are reduced.  Additionally, avoiding grips with restraining devices such as wrist straps or closed grips can help to prevent injury.

Random useless trivia about Nordic Combined: Prior to the 2010 Games, Nordic combined was one of two Winter Olympic sports that the United States had never won a medal in.  Biathlon was the other.  This drought ended when Johnny Spillane took the Silver medal in the Individual Normal Hill/10km event. 

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