Among many sports-related injuries, skiing is in the top five causes of shoulder injuries. It's estimated that over 1.5 million Brits (skiers and snowboarders) go on a snow-sport holiday every year worldwide. About 10,000 Brits get injured each snow season, which is about 1 in 300. That’s much better odds than for most sports! One is more likely to be injured playing football or tennis than skiing. The overall risk of injury combining all the snow sports is about 0.2% to 0.4%. Injury rates on the slopes, however, have been decreasing over the years, mainly due to the development of safer equipment.
Causes of Injury
Falls represent the most common mechanism of shoulder injury. Around 10% ofaccidents result from a collision with another person or object, 5% are lift related,and 5% occur as the result of equipment failure.
Symptoms
The most common symptoms of shoulder injuries are pain, swelling around theshoulder joint, restricted movement, muscle weakness, or instability in the shoulder. Severe pain, marked deformity, significant swelling, and an inability to move the shoulder, require immediate medical attention.
Shoulder Injuries in Skiing/Snowboarding
The most common shoulder injuries are rotator cuff strains/tears (24%), shoulderjoint dislocations (22%), acromioclavicular joint dislocations (20%), and claviclefractures (11%). Less common shoulder injuries are greater tuberosity fractures(7%), proximal humeral fractures (3.3%), biceps tendon strains or dislocation (2.6%).
Rotator Cuff tendon Injuries
The rotator cuff is formed by four muscles and their tendons that lift and rotate the shoulder. Tears or strains, can result from overuse or acute trauma. A rotator cuff strain often results from repetitive motions or a sudden force during skiing.
➢ Shoulder BursitisIt happens when the bursa under the acromion(shoulder blade) is inflamed.Bursitis is often associated with repetitive shoulder use and presents withlocalized swelling and tenderness over the shoulder.
➢ Shoulder ImpingementImpingement of the rotator cuff tendons between the acromion and humeralhead, is characterized by pain during specific shoulder movements, especiallylifting the arm overhead, and is diagnosed through clinical examination and MRIimaging.
➢ Rotator cuff tendon tearsThey present with pain during specific arm movements, such as lifting or reachingoverhead, with dull ache deep in the shoulder, difficulty sleeping on the affectedside and arm weakness. An MRI scan can confirm the diagnosis. A complete tear may result in significant loss of function and require surgical intervention.
Shoulder Joint Dislocation
The upper arm bone pops out of the shoulder socket after a fall or a sudden,forceful impact. A dislocated shoulder typically causes a visible out-of-placeshoulder joint and immediate, intense pain. X-rays are used to confirm thedislocation.
Acromioclavicular Joint Injuries (sprains or dislocation)
Injuries to the acromioclavicular joint which connects the collarbone to theshoulder blade, can result from falls or direct blows to the shoulder. This injuryis common and may require surgery if there is a severe ligamentous tear.
Fractures
Fractures of the clavicle (collar bone) are common skiing shoulder injuries andcan occur during accidents involving collisions or high-impact falls.
Superior Labral antero-posterior tear (SLAP lesion)
The labrum is a ring of cartilage that attaches to the rim of the shoulder socket,helping to hold the ball in the socket. A SLAP lesion involves a tear in thelabrum and may cause clicking or catching sensations, locking, popping, orgrinding sensations within the shoulder. It may cause pain with specificmovements or symptoms of Shoulder instability. MRI and joint arthroscopy candiagnose this condition. It commonly results from a fall onto an outstretchedhand or a direct blow to the shoulder during skiing.
Biceps tendon tear or dislocation
Biceps tendon tear or dislocation at the upper end of the biceps tendon areusually linked to rotator cuff damage. The tear presents with a characteristicPopeye deformity of the upper arm. The dislocation causes pain with rotationof the arm.
Frozen / Stiff Shoulder
Frozen shoulder develops gradually and is characterized by stiffness and asignificant decrease in shoulder movement. It is more common in individualswho have had previous shoulder injuries or immobilization.
The shoulder injuries are complex. Consulting with shoulder specialists can provide an accurate diagnosis and appropriate treatment plan.
At Ramsay Health Care, we provide a wide range of orthopaedic treatments that target shoulder pain or injuries. If you would like to book an appointment with Mr Anestis Iossifidis, see his profile.
References¹
1 Injury patterns in a large-scale ski resort in the host city of 2022 Winter Olympic Games: a retrospective cross-sectional study. Chen N, Yang Y, Jiang Y, Ao Y. BMJ Open. 2020; 10:0. [PMC free article] [PubMed] [Google Scholar]
2 Current incidence of accidents on Austrian ski slopes [Article in German] Ruedl G, Philippe M, Sommersacher R, Dünnwald T, Kopp M, Burtscher M. Sportverletz Sportschaden. 2014; 28:183–187. [PubMed] [Google Scholar]
3 Recreational Skiing- and Snowboarding-Related Extremity Injuries: A Five-Year Tertiary Trauma Center Cohort. İzzet Özay Subaşı et Volkan Gür. National Library of Medicine v.15(7); 2023 Jul. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10464917/ [Accessed 28 November 2023].