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Skiing is a high-intensity sport that combines speed, technique, and physical endurance. While it provides numerous health benefits and thrilling experiences, it also comes with a significant risk of injury.
Among these, shoulder injuries are particularly prevalent due to the physical demands of the sport and the frequency of falls. Understanding the common shoulder injuries sustained during skiing accidents is crucial for effective prevention and management.
This article explores the most common shoulder injuries associated with skiing accidents: shoulder dislocations, rotator cuff injuries, clavicle (collar bone) fractures, and AC (acromioclavicular) joint injuries.
Xray of Shoulder Dislocation
A shoulder dislocation occurs when the head of the humerus is forcibly displaced from the glenoid cavity of the scapula(shoulder blade). This injury is most commonly anterior in nature and often results from high-impact falls where the arm is extended outward. Skiers frequently sustain this injury during sudden crashes or when attempting to break a fall with an outstretched arm.
The signs and symptoms of a shoulder dislocation include intense pain, visible deformity, swelling, and the inability to move the arm. Immediate management involves reduction of the dislocation by a trained professional, followed by immobilisation of the joint with a sling to allow for healing. Rehabilitation typically includes physiotherapy to restore strength and range of motion. If the shoulder continues to be unstable or further dislocates, then arthroscopic stabilisation may well be required.
Prevention strategies focus on strengthening the rotator cuff muscles, which stabilize the shoulder joint. Skiers can also benefit from improving their balance and technique to reduce the likelihood of high-impact falls.
The rotator cuff is a group of four tendons that stabilize the shoulder and facilitate movement. A rotator cuff injury occurs when one or more of these tendons is damaged, often due to the sudden trauma of a fall or an abrupt pole planting manoeuvre. This injury is particularly common in skiing, where quick, unexpected motions can strain the shoulder, and if severe enough cause a rotator cuff tear.
Symptoms of a rotator cuff tear include pain during movement, weakness in lifting the arm, and a clicking or popping sensation in the shoulder. Treatment options range from conservative approaches such as physical therapy and anti-inflammatory medications to surgical repair for severe tears.
Preventative measures include preseason strengthening exercises for the rotator cuff and proper skiing technique. Skiers should also focus on controlled, deliberate movements to reduce stress on the shoulder during abrupt manoeuvre.
Clavicle fractures, or broken collarbones, are another common shoulder injury among skiers. These fractures typically result from direct impact or falls onto an outstretched hand, transferring the force to the collarbone.
Symptoms include visible deformity, swelling, bruising, and severe pain localized to the clavicle. Treatment generally involves immobilisation with a sling, though surgical intervention may be necessary in cases where the fracture is complex or significantly displaced.
To prevent clavicle fractures, skiers should wear appropriate protective gear and practice controlled fall techniques. Proper training and conditioning can also enhance a skier’s ability to react to sudden changes in terrain or balance.
The AC joint connects the clavicle to the scapula (shoulder blade) and is often injured during direct impacts to the shoulder. Such impacts can occur when a skier collides with an obstacle or falls onto the tip of their shoulder. AC joint injuries range from mild sprains to complete separations, depending on the severity of ligament damage.
Symptoms include pain at the top of the shoulder, limited range of motion, and in severe cases, visible deformity. Treatment varies based on the injury’s severity, with mild cases requiring rest, ice, and physical therapy, while severe cases may necessitate surgical intervention.
Preventing AC joint injuries involves strengthening the stabilising muscles around the shoulder and learning how to fall safely. Skiers can also minimise risk by maintaining situational awareness and avoiding high-risk behaviour on the slopes.
Several factors contribute to the high incidence of shoulder injuries in skiing. Biomechanically, the shoulder joint is particularly vulnerable during high-speed falls or abrupt stops. The intense forces generated during skiing can easily overwhelm the joint’s natural stabilisers.
Environmental factors, such as icy or uneven terrain, increase the likelihood of falls, while improperly adjusted ski bindings can prevent timely release, exacerbating the risk of injury. Human factors also play a significant role, with beginner skiers often being more susceptible due to their limited technique and balance.
Unfortunately, if you do suffer a shoulder injury when skiing , then seeking medical attention, and prompt and accurate diagnosis is essential to determine the best course of treatment.
As well as Clinical Examination, imaging studies such as X-rays and MRI scans are often used to assess the type of injury and its extent. This can help to determine whether conservative measures , such as sling and physiotherapy will be sufficient, or whether surgical intervention may be required.
Rehabilitation plays an essential part in recovery, helping to restore range of motion, strength and power, and function. It also reduces the risks of stiffness and ongoing pain. We work closely with our experienced Shoulder Physiotherapists to maximise your recovery.
Skiing is an exhilarating sport, but it comes with inherent risks, including shoulder injuries. The four most common injuries — shoulder dislocations, rotator cuff tears, clavicle fractures, and AC joint injuries — can have significant implications for a skier’s health and performance. However, these injuries can often be prevented through physical conditioning, proper technique, and the use of protective equipment. By understanding the mechanisms, symptoms, and treatment of these injuries, skiers can better prepare themselves to enjoy the slopes safely. Increased awareness and improved safety measures are essential to reducing the prevalence of shoulder injuries.
If you are suffering from any shoulder pain or think you have sustained any of the injuries described then don’t delay seeking advice from one of our expert shoulder specialists to ensure timely diagnosis and treatment.
The aim will be to optimise your recovery from injury but also allow a full return to this exciting winter sport.
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Author Joydeep Sinha
Specialist shoulder and upper limb surgeon at London Bridge Orthopaedics
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