The number of skiing and snowboarding injuries has fallen approximately 50 percent since the mid-1970s and there are now an estimated two injuries per 1,000 skier visits. While there is no doubt that improvements in technology — in both gear and mountain operations — has helped bring the ski injury statistic down, researchers at Johns Hopkins estimated that 600,000 skiers and riders are injured annually in the US.
Even though lower limb injuries are the most common on the slopes — particularly ACL from skiing accidents — upper-extremity injuries happen more than you may think.
According to a study published in the British Journal of Sports Medicine, shoulder injuries occur in 4 to 11 percent of all alpine skiing injuries and 22 to 41 percent of upper-extremity skiing injuries. Shoulder injuries make up eight to 16 percent of all snowboarding injuries and, paradoxically, only 20 to 34 percent of upper-extremity injuries.
Most Common Types of Shoulder Injuries from Falling while Skiing & Snowboarding
Rotator Cuff Tears
The rotator cuff is a group of muscles in the shoulder that come together to form one large tendon. This tendon stabilizes the shoulder joint by compressing the head of the humerus against the cavity of the joint while allowing for a wide range of motion. The four muscles of the rotator cuff (the subscapularis, infraspinatus, supraspinatus and teres minor) contract during arm movements to keep the head of the humerus secure and in the shoulder socket.
Rotator cuff tears from skiing and snowboarding are most often a result of a trauma — such as a fall or an impact with a tree, tower or another person. Such accidents can put pressure on the shoulder joint, causing it to twist which can result in a rotator cuff tear. Rotator cuff pain is the most common torn rotator cuff symptom.
As the body’s most mobile joint, the shoulder can move in a variety of ways and directions. Unfortunately, the blunt trauma of a ski or snowboard accident can push the shoulder joints’ flexibility to its limit — and cause a dislocation. A partial dislocation (called a subluxation) occurs when the head of the humerus (the upper arm bone) is partially out of the shoulder socket (the glenoid). A complete dislocation means the humerus is completely out of the glenoid.
There are three different kinds of shoulder dislocations. An anterior shoulder dislocation is when the shoulder slips forward, a posterior shoulder dislocation is when the shoulder is displaced backward and an inferior dislocation is when the humerus dislocated downward. In most cases, an orthopedic shoulder specialist will treat a partial or complete dislocated shoulder by manually pushing the humerus back into the joint socket.
AC Joint Separations
Commonly referred to as a separated shoulder, this shoulder injury actually involves the acromioclavicular joint (AC joint), not the shoulder joint. Located at the top of the shoulder, the AC joint is where the collarbone (clavicle) connects to the highest point of the shoulder blade. There are three “grades” of AC joint separations.
Grade 1 AC Separation
A grade 1 AC separation is a mild separation where the AC ligament is sprained. These mild separations do not move the collarbone and the joint appears normal on X-rays.
Grade 2 AC Separation
In a grade 2 AC separation, the AC ligament is torn and the coracoclavicular (CC) ligament is sprained or slightly torn. These tears allow the collarbone to move out of alignment and result in a small bump.
Grade 3 AC Separation
A grade 3 AC separation is the most severe, in which the injury involves complete tears of the AC and CC ligaments. With a complete separation, the AC joint is noticeably out of place and causes a large bump on the shoulder.
AC joint separations occur in both skiers and snowboarders, however, snowboarders are more prone to AC separations due to the nature of a snowboarder’s stance while riding.
There are three main types of shoulder fractures: a clavicle fracture, a humerus fracture and a scapula fracture.
The clavicle, better known as the collarbone, is a long, thin bone that stretches from the base of the neck to the shoulder, and connects to the shoulder via the AC joint. A clavicle fracture results from a direct impact to the collarbone and is an extremely common injury for snowboarders.
Humerus Head Fracture
The head of the humerus (upper arm bone) is the “ball” of the shoulder ball-and-socket joint. A proximal humeral fracture occurs when the head of the humerus is fractured. There are two other types of humerus fractures — shaft and distal fractures — though these types of injuries don’t affect the shoulder as much as a proximal humeral fracture.
Colloquially called the shoulder blade, the scapula is a flat, triangle-shaped bone in the upper back that is the primary connection between the chest and arm. Unlike clavicle fractures, scapula fractures are extremely rare, making up less than 1 percent of all broken bones.