Breaking Down Nick Young’s Thumb Injury: What is a Radial Collateral Ligament?

• Post By: Jeff Stotts
• Date: October 4, 2014
• Category: Break Down, NBA

The last two seasons have been disastrous for the Los Angeles Lakers and poor health has been one of the primary factors contributing to the team’s struggles. Last season was particularly bad as the Lakers finished last in the number of games lost to injury with 320. The injuries, particularly Kobe Bryant’s recovery from Achilles surgery and his subsequent leg fracture, had even bigger financial impact, as the team lost over $44 million to injuries.

With Bryant and veteran point guard Steve Nash being active participants in training camp, a sense of optimism was beginning to build in Los Angeles. Unfortunately it took one injury to bring that to a crashing halt as guard Nick Young suffered a thumb injury during a recent practice session.

The injury has been diagnosed as a complete tear of the radial collateral ligament (RCL) of Young’s right thumb and will require surgery. The thumb is comprised of three bones, the proximal and distal phalanxes and the first metacarpal. The proximal phalanx attached to the metacarpal bone to form the metacarpophalangeal (MCP) joint. At the base of the proximal phalanx are two ligaments, the ulnar collateral ligament (UCL) and the RCL. The UCL serves as the primary stabilizer for the MCP joint and is located on the inside of the thumb, near the webbing of the thumb and pointer finger. The RCL attaches on the outside aspect of the thumb and helps prevent excessive side-to-side bending of the joint. Together the collateral ligaments provide stability when pinching or gripping an object.

The UCL is commonly injured in sports most often when a player gets hung up on a something like a base in baseball or an opponent’s jersey. However RCL injuries are relatively rare and occur less frequently than their counterpart, primary because the force need to place stress on the ligament is less likely to occur.

Young’s suffered a Grade III or complete tear of the ligament, an injury best treated with surgery. In the procedure, the surgeon will suture the torn ligament back together. If a reconstruction is necessary, a surgical graft is harvested from the tendon of a little-used muscle in the wrist known as the palmaris longus. The graft is anchored to the bone and placed in the same position as the torn RCL. In some cases a wire is placed through the bone to add stability to the joint and provide a better environment for healing. The surgery has a high long-term success rate.

As previously mentioned RCL sprains are fairly uncommon. The InStreetClothes.com Injury database has just one confirmed diagnosis of a RCL tear. During the 2002-03 season, Suns guard Penny Hardaway missed nearly two months and 24 games recovering from surgery to repair a torn RCL. Former Red Sox third baseman Mike Lowell suffered a RCL injury during the 2009 season and underwent surgery in the offseason. The injury nixed a trade to the Texas Rangers but Lowell was back by spring training and able to complete one last season with Boston before retiring.

Young will spend at least the next four weeks in a cast or splint. Once it is removed he can begin his progressive rehab designed to reestablish range of motion and strength in the joint. Upon completion, Young will begin sports-specific drills, including passing, shooting, and catching a basketball. Extra time may be needed since the injury occurred to Young’s shooting hand. Furthermore expect to see Swaggy P wearing a protective thumb splint upon his return. Young will be able to participate in conditioning drills under the watchful eye of the Lakers medical staff.

The Lakers have estimated his return at somewhere between six to eight weeks. Surgery is slated for Monday and more accurate timeline should be provided following the procedure. Still it seems likely his recovery spills over into the regular season and is a considerable setback fora Lakers team hoping to move past their last two injury-riddled campaigns.