Soft Tissue Injury: Thumb

  • Reference Number: HEY-256/2014
  • Departments: Orthopaedics


This leaflet has been produced to give you general information about your injury.  Most of your questions should be answered by this leaflet.  It is not intended to replace the discussion between you and your doctor, but may act as a starting point for discussion.  If after reading it you have any concerns or require further explanation, please discuss this with a member of the healthcare team caring for you.

What is a soft tissue injury?

The term soft tissue refers to muscles, ligaments and tendons that surround and support our joints. Injuries to the soft tissue surrounding the thumb are usually caused by a forceful stretch when landing awkwardly on the hand or direct blow for example when playing ball sports.

What are the symptoms?

A soft tissue injury to the thumb may result in:

  • Pain.
  • Heat, redness or bruising.
  • Swelling.
  • Stiffness and loss of function.

Pain relief

The most important initial treatment is aimed at controlling the pain and swelling by following the principles of RICE:

R – Rest

Complete rest is not advisable but it is important that you prevent putting the thumb under strain in the early stages of healing. Ensure you continue to move the fingers and wrist as normal as it is common to quickly become stiff in these joints.

I – Ice

There are many different ways in which ice can be applied. However, whichever method you choose it is important that you wrap it in a damp towel to prevent burning the skin. Ice should be applied for 20 to 30 minutes every two hours.

Please Note:

Only use an ice pack on areas that have normal skin sensation i.e. where you can feel hot and cold.
Do not apply over an open wound.
Do not apply an ice pack to an area that has poor circulation.
During ice application check the skin every five minutes and discontinue its use if:

  • the area becomes white, blue or blotchy.
  • the area becomes excessively painful, numb or tingles.

C – Compression

If you have been a compression type splint to wear it is important this is removed if you develop any signs of poor circulation, pins and needles or numbness.

E – Elevation

If you have swelling in your wrist or hand sit on a chair and place your elbow on cushions so that it is level or slightly higher than your shoulder. In this position point your hand towards the ceiling then open and close your hand as this will help to reduce any swelling further.

Consuming alcohol, massaging the injured area and applying heat can all be detrimental in the early stages of healing and therefore should be avoided.

Rehabilitation and recovery

If you follow this basic advice your injury should take around six weeks to heal. However, everyone recovers from injuries at different rates and it is dependant on the severity of the injury and the presence of any other medical problems. It is possible you may suffer symptoms for up to three months.

After 72 hours it is very important you try to start using your hand normally again especially when doing everyday tasks like washing, dressing and eating. The exercises below will help you to regain full function, flexibility and strength and you should try to practice them 10 times each, 4 times per day.

1. Hold your thumb with your other hand so that all you can move is the end joint.

Rehabilitation and recovery - Step 1

Bend the end joint of your thumb as far as you can and feel it stretching.

Hold this for 10 seconds.

2. Touch your thumb to the tip of the index finger on the same hand.

Rehabilitation and recovery - Step 2

Now slide your thumb down this finger as far as possible until you feel it stretching. Hold 10 seconds.

Repeat the same exercise as described above while touching your thumb to your middle finger, then your ring finger and finally your little finger. Each time hold the stretch 10 seconds.

3. Place your hand, on its side onto a table, with your little finger touching the table.

Rehabilitation and recovery - Step 3A

Lift your thumb upwards as far as you can and feel it stretching.

Hold this for 10 seconds.

Rehabilitation and recovery - Step 3B

Next take your thumb out as wide as you can and feel it stretching.

Hold the stretch for 10 seconds.

4. Now put your hand flat on the table palm downwards and lift your thumb upwards so that it lifts off the table. Hold for 10 seconds and relax.

You may experience more discomfort when you start the exercises however this is normal and does not mean you should stop. If your symptoms remain worse for more than two hours after the exercises then you should decrease the number of each exercise that you do and build up again slowly.

When can I return to normal activities?

If your job involves activities using your hand and thumb regularly you must ensure that you practice similar tasks so that you build your strength and function up gradually.

If you participate in an active hobby then it is advised that you do not return to this until you have full range of movement, strength and you can use your hand normally without experiencing pain or swelling.

If you play a sport involving use of your hand and thumb, practice sports specific activities like gripping a tennis racquet or a cricket bat to prepare yourself. Build this up gradually before returning to full training sessions and competition.

When to seek further help

If 10 days following your injury you are unable to use the thumb and it remains painful and swollen, despite following the above advice, please contact the physiotherapy team.

Should you require further advice on the issues contained in this leaflet, please do not hesitate to contact: Physiotherapy team: (01482) 608939.

If there is no answer please clearly state your full name, address and telephone number and we will get back to you as soon as possible.

General Advice and Consent

Most of your questions should have been answered by this leaflet, but remember that this is only a starting point for discussion with the healthcare team.

Consent to treatment

Before any doctor, nurse or therapist examines or treats you, they must seek your consent or permission. In order to make a decision, you need to have information from health professionals about the treatment or investigation which is being offered to you. You should always ask them more questions if you do not understand or if you want more information.

The information you receive should be about your condition, the alternatives available to you, and whether it carries risks as well as the benefits. What is important is that your consent is genuine or valid. That means:

  • you must be able to give your consent
  • you must be given enough information to enable you to make a decision
  • you must be acting under your own free will and not under the strong influence of another person

Information about you

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We may pass on relevant information to other health organisations that provide you with care. All information is treated as strictly confidential and is not given to anyone who does not need it. If you have any concerns please ask your doctor, or the person caring for you.

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