Bowler’s thumb is a medical condition, which is caused due to repeated pressure or compression of the nerve. This compression or friction results in damaging the nerve, which provide sensation to the thumb. The sensory and motor nerves to thumb are median and radial nerve. Bowler’s thumb is an overuse injury that generally occurs because of inappropriate sizing of the thumb hole in the bowling ball.
As the name suggests, Bowler’s thumb is mostly a result of frequent ten-pin bowling, but it can also be seen in other avocations such as martial arts or cherry picking, where chronic repetitive pressure is exerted on one of the three nerves of the hand. Pinch or irritation of radial or median nerve causes pain in thumb as well as irritation of ulnar nerve(1) causes referred pain to base of the thumb and skin over first phalanx.
Causes and Risk Factors of Bowler’s Thumb
Bowler’s thumb is caused due to compression of ulnar nerve on the inside part of thumb because of an extremely tight thumb hole in the bowling ball. This also happens if a player tries to spin the ball a fair bit.
In cases which are longstanding, repeated friction or compression results in fibrous tissue or adhesions being formed about the nerve leading to difficulties even when not playing.
Signs and Symptoms of Bowler’s Thumb
The Symptoms For Bowlers Thumb May Include:
- Pain on the inner side of the thumb.
- Pain in the web between the thumb and index finger.
- Tingling sensation(2) in the distal end of the thumb.
- Feeling of numbness in the thumb.
- Weight at the base of the thumb.
- Pain when using or pinching the thumb.
- Stiffness in joints of first, third and fourth fingers.
- Pain in the joints of first, third and fourth fingers.
How is Bowler’s Thumb Treated?
First step towards treatment is a conservative or nonoperative approach, which generally helps overcome the problem.
Conservative Treatment for Bowler’s Thumb
- Avoid bowling.
- Correction of causative issue like the thumb hole in the ball.
- Using a splint or thumb guard for protection of the thumb.
- Alter the grip on the ball.
Surgery for Bowler’s Thumb
Surgery may be needed only when conservative measures mentioned above fail to give any results. Surgery involves
- Nerve transposition or alteration of the path of the nerve to avoid compression.
- Neurolysis to remove the fibrotic tissue(3) surrounding the nerve to ease compression.
Investigations for Bowler’s Thumb
The Tests May Include:
- MRI in severe cases leading to surgery.