Thumb UCL — Non-Operative — Conservative Treatment

UW Health Orthopedic Surgery; UnityPoint Health - Meriter Rehabilitation

Weight-Bearing

No surgical restrictions; no WB involved UE; hand-based thumb spica all times except hygiene

Key Restrictions

No lifting/pushing/pulling >5 lbs involved UE; no WB involved UE; no aggressive pinching/gripping

Timeline & Phases

Phase I (initial–3-5 days): hand-based thumb spica (IP free, MP protected from RU deviation) full time except hygiene; AROM wrist, fingers, thumb IP; no thumb MCPJ ROM; fabricate at initial visit, follow up at 3 weeks | Phase II (3 wks): initiate gentle thumb MCPJ AROM ≤35°; orthosis all time except hygiene/exercises; if painful, 1 additional week immobilization and/or refer to physician | Phase III (4 wks): progress thumb MCPJ AROM to 50°; orthosis all time except hygiene/exercises | Phase IV (6 wks): light to moderate activities without orthosis; PROM avoiding lateral stress to MPJ; pain-free isometric strengthening; orthosis all time except exercises/bathing/light-moderate activities | Phase V (8 wks): pain-free concentric 2-point strengthening, grip and pinch; D/C orthosis except high-risk activities | Phase VI (10–12 wks): resume all activities; no restrictions; work/leisure strengthening as needed

Notes

Non-operative management for Grade 1–2 UCL injury without Stener lesion; goal: stable pain-free thumb MP ROM; progression per pain tolerance; developed collaboratively by UW Health and UnityPoint Health - Meriter Rehabilitation