Ruptured UCL / Torn RCL - Ouch!

You may recall from my last post that I took a spill off of my mountain bike at my last Adventure Race in Perdenales Falls State Park. Yes I bent my thumb back and it hurt like hell but I didn't think anything of it other than it being a bad sprain. Sure there was some pain and swelling but my range of motion was still 95% and it was getting a little better everyday.

Enter my old friend Hoss who happens to be a physical therapist. Hoss saw my update and called me up. In some fairly colorful language told me I needed to go have it looked at. I quote: "An opposable thumb is what separates us from lower life forms....you don't want to f*** around with your thumb." Got it. So a couple of days later when it didn't feel like my thumb was really improving I made the call to have it looked at.

A few X-rays later Dr. Saenz said it was questionable enough to get an MRI done on it. Ok...better safe than sorry. I had an MRI done last year on my elbow and it was no big deal but the machine they used to do my thumb was super powerful compared to the one from my elbow. I could literally feel the magnetism of the machine pulsing through my body. Pretty weird. Anyway, I left with the films in hand to go see the hand specialist. I'm fairly good with pictures so I pulled them out to see what I could make out on them but with 100 or so images I could only narrow down the scans to the page that had the ligaments on it. From there is wasn't sure if the orientation of my hand would show a ligament in one image and not the other.

Oh well. Better to let the experts do this I suppose. Fortunately I was lucky enough to get a referral to Dr. Rust at the Hand Center here in San Antonio. The Hand Center is the facility that treats all of the NBA players and other professional athletes in the area. If you mess your hand up, this is where you want to be sent.

After the initial exam, Dr. Rust order up a couple of more X-rays of the thumb and pulled out the MRI films I had given her. With the new X-rays and the MRI film in hand she put them up on the light board and explained what we were looking at.

Here's how it went. If you hold up your right thumb in the "Thumbs Up" position and go to the big knuckle at the bottom of the V between your thumb and index finger, there are ligaments on each side of that knuckle that extend just over the joint of the bone in the pad of your thumb to the next bone in your thumb (towards the tip of your thumb). Looking at your own thumb, the ligament on the right is the Ulnar Collateral Ligament and the one on the left (toward the pad/palm of your thumb) is the Radial Collateral Ligament. These ligaments give your thumb lateral stability which prevents that joint from moving excessively from side to side. My RCL is torn on the lower end and should heal on it's own. However, my UCL is ruptured (torn completely away from the bone) and has to be surgically repaired. She actually pointed at the MRI and said, "See this ligament over here....there should be one on the other side just like it. Yours is now down here just flopping around. We've got to go in and fix that."



Well crap. She went on to explain that if I don't repair it now it'll just get worse and she'll have to use a cadaver ligament later on to reconstruct it. That would suck. I prefer to keep my own body parts and not add some stranger's to the mix. Or, I could also do nothing and have a floppy thumb for the rest of my life which some people opt to do. The problem there is that if you try to pick up anything heavy (imaging picking up a really heavy water bottle or something that requires your hand to be in that same position) the downward weight of the object will pull your thumb down (no lateral stability) as you try to grip it and over time you eventually won't be able to hold anything normally. That's not good no matter how you look at it. As you've probably guessed, I've opted to get this thing fixed by the hand specialist.

I told my AR Teammates that if there were any good news it's that I'll be forced to work on my running since I won't be able to ride my bike for a while! I've guess I've got to look at the positive side of this because I'll basically be giving everyone the "Thumbs Up" for weeks whether I'm in a great mood or not. Cut me off in traffic? Take this "thumbs up" buddy. Don't like the way I drive? "Thumbs up" to you too!

Anyhow, surgery's scheduled for Tuesday. I'm hoping to have pictures and post updates as I work through this little set back so stay tuned for that. And just to entertain myself while I'm healing, I'm thinking of mixing up the answers whenever someone asks me what I did to my thumb. You know...I was spear fishing on the Great Barrier Reef and was bitten by a shark.... fun stuff like that!