Thumb subluxation

😳What happens to this thumb?
😲Is it normal or a serious medical condition?
🤯 Should you run to the doctor's office? Undergo surgery? Steroids?💊💉

Or maybe a consultation with a chartered physio? 

Young female patient arrives to my office with a "strange thumb". 😢👍🏻Sporty athlete🤾🏼‍♀️, used to play the piano🎹🎼, recently realised the problem on her left thumb. No direct trauma occurred on her hand.

On the video we can see a carpometacarpal (CMC) joint subluxation with a visible jump😬. Stability at the 1st CMC joint is dependent on static and dynamic forces. However, dislocation of the 1st CMC occur rare, usually a direct trauma needed for this type of injury. Important function of the thumb specially in gripping and grasping makes it a significant problem. (Arch Bone Jt Surg. 2015 Oct; 3(4): 300-303, Farivar Lahiji, MD, Reza Zandi, MD, and Arash Maleki, MD)

But there wasn't any trauma this time🤔

My patient's CMC joint is hypermobile. Hypermobility itself isn't a medical condition and many people don't realise they are hypermobile if it doesn't cause any problems. It might even be an advantage in some sports, playing musical instruments or dance.

🗝 Then what is the key?
PATIENT HISTORY! ASK, TEST, MEASURE, CHECK❗️

Every patients MUST start with a comprehensive full body checkup, that includes taking a detailed patient history. This is how i came to the solution 🙏🏻

💡2 years ago my patient broke her shoulder😖. So I checked her whole left arm, the neck, the upper back and found a very stiff fascial tissue system with shortened muscles in the forearm creating tingling sensation through her arm which she didn't mention as she tought there is no correlation. All muscles and tendons running to the palm was stiff, blocked and the total palmar fascia was affected.