Ski Injuries to the Shoulder

The skiing season is here again, and with it comes the danger of injury when sliding down a mountain on flat objects strapped to your feet. However, skiing may not be as dangerous as you might think. Reported statistics show that ski and snowboarder injuries range from 0.5 to 1.35 per 1000 skier/snowboarder days among individuals who engage in these activities recreationally1-2.

With appropriate precautions and depending upon the amount of risk you take when skiing, many injuries can be avoided. Furthermore, modern skiing equipment and optimised slope preparation is thought to at least be partly responsible for a decreased injury risk on ski slopes.

According to a 2023 research paper published by the National Library of Medicine, 46.8% of injured skiers and snowboarders sustained injuries in their upper extremities. Of these patients, the shoulder had 21.6% presenting with a skiing injury3.

Shoulder injuries that are common for skiers include:

Bone fractures - the most common shoulder injury is a clavicle (collarbone) fracture, usually caused by falling onto your outstretched hand. This is a very painful injury not only in your collarbone, but also in your shoulder and down your arm, and will often bruise and swell. You’ll need to wear a sling to immobilise your shoulder joint. Once the fracture has healed you will probably be advised to have physiotherapy to improve your range of movement.

Other bone fractures - include greater tuberosity, humeral, scapula and glenoid fractures.

Joint dislocations – your shoulder is the easiest joint in your body to dislocate as the shoulder socket is shallower than other sockets. If you endure a significant impact to your shoulder such as a collision or fall with other skiers or trees, your shoulder will dislocate. Acromioclavicular (AC) dislocations are the most frequent type of shoulder dislocation, where your shoulder blade is forced downwards and your collarbone becomes prominent. If you have an AC dislocation you will feel intense pain, that could extend from your shoulder into your back and arms, and some swelling and bruising will appear.

Other shoulder dislocations - include glenohumeral and sternoclavicular joint dislocation, although these are rarer. A doctor will recognise a dislocated shoulder and they will put the ball of your shoulder joint back into it’s socket and immobilise the area with a sling. You won’t be able to ski for a while after a shoulder dislocation as you will have damaged the soft tissue around the shoulder and it will need to be rested. You will most likely be recommended to engage in physiotherapy to strengthen your muscles and improve your range of motion.

Soft tissue injuries - a rotator cuff tear is the most common ski injury and often happens when you attempt jumps. If you have a rotator cuff injury your shoulder will hurt, the pain will be worse when you raise your arms, and your shoulder movement will be restricted. Ice, rest and over the counter pain relief are self-help treatments. Depending upon the extent of your injury, physiotherapy to build strength and movement, or surgery to repair large tears may be recommended. Other soft tissue injuries include: rotator cuff impingement due to overuse, labral injuries, bursitis, and pectoralis major or biceps rupture.

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].

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