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Sports Medicine

, Volume 25, Issue 3, pp 201–211 | Cite as

Shoulder Injuries from Alpine Skiing and Snowboarding

Aetiology, Treatment and Prevention
  • Mininder S. Kocher
  • Michele M. Dupré
  • John A. FeaginJr
Injury Clinic

Summary

There has been a decrease in the overall injury rate and the rate of lower extremity injuries for alpine skiing, with a resultant increase in the ratio of upper extremity to lower extremity injuries. Upper extremity injuries account for 20 to 35% of all injuries during alpine skiing and nearly 50% of all injuries during snowboarding. The most common upper extremity injuries during skiing are sprain of the thumb metacarpal-phalangeal joint ulnar collateral ligament, and the most common in snowboarding is wrist fracture.

Shoulder injuries from skiing and snowboarding have been less well characterised. With the increased ratio of upper to lower extremity injuries during alpine skiing and the boom in popularity of snowboarding, shoulder injuries will be seen with increasing frequency by those who care for alpine sport injuries. Shoulder injuries account for 4 to 11% of all alpine skiing injuries and 22 to 41% of upper extremity injuries. The rate of shoulder injuries during alpine skiing is 0.2 to 0.5 injuries per thousand skier-days. During snowboarding, shoulder injuries account for 8 to 16% of all injuries and 20 to 34% of upper extremity injuries. Falls are the most common mechanism of shoulder injury, in addition to pole planting during skiing and aerial manoeuvres during snowboarding. Common shoulder injuries during skiing and snowboarding are glenohumeral instability, rotator cuff strains, acromioclavicular separations and clavicle fractures. Less common shoulder injuries include greater tuberosity fractures, trapezius strains, proximal humerus fractures, biceps strains, glenoid fractures, scapula fractures, humeral head fractures, sterno-clavicular separations, acromion fractures and biceps tendon dislocation. Prevention of shoulder injuries during skiing and snowboarding may be possible through interventions in education and technique, conditioning and equipment and environment.

Keywords

Rotator Cuff Extremity Injury Proximal Humerus Fracture Clavicle Fracture Shoulder Injury 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Davidson TM, Laliotis AT. Alpine skiing injuries. A nine-year study. West J Med 1996; 164: 310–4Google Scholar
  2. 2.
    Davis MW, Litman T, Drill FE, et al. Ski injuries. J Trauma 1977; 17: 802–8PubMedCrossRefGoogle Scholar
  3. 3.
    Ekeland A, Holtmoen A, Lystad H. Skiing injuries in Alpine recreational skiers. In: Johnson RJ, Mote Jr CD, Binet M-H, editors. Skiing trauma and safety: 7th International Symposium. Philadelphia: American Society for Testing and Materials, 1989: 41–60CrossRefGoogle Scholar
  4. 4.
    Gutman J, Weisbuch J, Wolf M. Ski injuries in 1972-1973: a repeat analysis of a major health problem. JAMA 1974; 230: 1423–5PubMedCrossRefGoogle Scholar
  5. 5.
    Johnson RJ, Ettlinger CF. Alpine ski injuries: changes through the years. Clin Sports Med 1982; 1: 181–97PubMedGoogle Scholar
  6. 6.
    Johnson RJ, Ettlinger CF, Campbell RJ, et al. Trends in skiing injuries: analysis of a 6-year study (1972-1978). Am J Sports Med 1980; 8: 106–13PubMedCrossRefGoogle Scholar
  7. 7.
    Johnson RJ, Ettlinger CF, Shealy JE. Skier injury trends 1972 to 1990. In: Johnson R, Mote C, editors. Skiing trauma and safety: 9th International Symposium. Philadelphia: American Society for Testing and Materials, 1993: 11–22CrossRefGoogle Scholar
  8. 8.
    Johnson RJ, Pope MH. Epidemiology and prevention of skiing injuries. Ann Chir Gynaecol 1991; 80: 110–15PubMedGoogle Scholar
  9. 9.
    Lamont M. Ski injury statistics. What changes? In: Mote C, Johnson R, editors. Skiing trauma and safety. 8th International Symposium. Philadelphia: American Society for Testing and Materials, 1991: 158–63CrossRefGoogle Scholar
  10. 10.
    Lystad H. A five-year study of skiing injuries in Hemsedal Norway. In: Johnson RJ, Mote Jr CD, Binet M-H, editors. Skiing trauma and safety: 7th International Symposium. Philadelphia: American Society for Testing and Materials, 1989: 32–40CrossRefGoogle Scholar
  11. 11.
    Matter P, Ziegler WJ, and Holzach P. Skiing accidents in the past 15 years. J Sports Sci 1987; 5: 319–26PubMedCrossRefGoogle Scholar
  12. 12.
    Oliver B, Allman F. Alpine skiing injuries: an epidemiological study. In: Mote C, Johnson R, editors. Skiing trauma and safety: 8th International Symposium. Philadelphia: American Society for Testing and Materials, 1991, 125–32Google Scholar
  13. 13.
    Requa RK, Toney JM, Garrick JG. Parameters of injury reporting in skiing. Med Sci Sports 1977; 9: 185–90PubMedCrossRefGoogle Scholar
  14. 14.
    Sahlin Y. Alpine skiing injuries. Br J Sports Med 1989; 23: 241–4PubMedCrossRefGoogle Scholar
  15. 15.
    Shealy JE. Comparison of downhill ski injury patterns. In: Johnson R, Mote C, editors: 9th International Symposium. Philadelphia: American Society for Testing and Materials, 1993: 23–32Google Scholar
  16. 16.
    Sherry E. Skiing injuries in Australia. Med J Aust 1984; 140: 530–1PubMedGoogle Scholar
  17. 17.
    Sherry E, Fenelon L. Trends in skiing injury type and rates in Australia: a review of 22,261 injuries over 27 years in the Snowy Mountains. Med J Aust 1991; 155: 513–5PubMedGoogle Scholar
  18. 18.
    Tapper EM. Ski injuries from 1939-1976: the Sun Valley experience. Am J Sports Med 1978: 114–21Google Scholar
  19. 19.
    Warme Jr WJ, Feagin JA, King P, et al. Ski injry statistics 1982-1993; Jackson Hole Ski Resort. Am J Sports Med 1995; 23: 597–600PubMedCrossRefGoogle Scholar
  20. 20.
    Carr D, Johnson RJ, Pope MH. Upper extremity injuries in skiing. Am J Sports Med 1981; 9: 378–83PubMedCrossRefGoogle Scholar
  21. 21.
    Davidson TM, Laliotis AT. Snowboarding injuries: a four-year study with comparison with alpine ski injuries. West J Med 1996; 164: 231–7PubMedGoogle Scholar
  22. 22.
    Ungerholm S, Engkvist O, Gierup J, et al. Skiing injuries in children and adults: a comparative study from an 8-year period. Int J Sports Med 1983; 4: 236–40PubMedCrossRefGoogle Scholar
  23. 23.
    Young L, Lee S. Alpine injury patterns at Waterville Valley: 1989 update. In: Mote C, Johnson R, editors. Skiing trauma and safety: 8th International Symposium. Philadelphia: American Society for Testing and Materials, 1991, 85–97Google Scholar
  24. 24.
    Engkvist O, Balkfors B, Lindsjsš U. Thumb injuries in downhill skiing. Int J Sports Med 1982; 3: 50–5PubMedCrossRefGoogle Scholar
  25. 25.
    Fairclough JA, Mintowt-Czyz WJ. Skier’s thumb: a method of prevention. Injury 1986; 17: 203–4PubMedCrossRefGoogle Scholar
  26. 26.
    Kocher MS, Feagin Jr JA. Shoulder injuries during alpine skiing. Am J Sports Med 1996; 24: 665–9PubMedCrossRefGoogle Scholar
  27. 27.
    Primiano GA. Skier’s thumb injuries associated with flared ski pole handles. Am J Sports Med 1985; 13: 425–7PubMedCrossRefGoogle Scholar
  28. 28.
    Van Dommelen BA, Zvirbulis RA. Upper extremity injuries in snow skiers. Am J Sports Med 1989; 17: 751–3PubMedCrossRefGoogle Scholar
  29. 29.
    Chow TK, Corbett SW, Farstad DJ. Spectrum of injuries from snowboarding. J Trauma 1996; 41: 321–5PubMedCrossRefGoogle Scholar
  30. 30.
    Sutherland AG, Holmes JD, Myers S. Differing injury patterns in snowboarding and alpine skiing. Injury 1996; 27: 423–5PubMedCrossRefGoogle Scholar
  31. 31.
    Kuriyama S, Fujimaki E, Katagiri T, et al. Anterior dislocation of the shoulder joint sustained through skiing: arthrographic findings and prognosis. Am J Sports Med 1984; 12: 339–46PubMedCrossRefGoogle Scholar
  32. 32.
    Weaver JK. Skiing-related injuries to the shoulder. Clin Orthop 1987; 216: 24–8PubMedGoogle Scholar
  33. 33.
    Bladin C, McCrory P. Snowboarding injuries: an overview. Sports Med 1995; 19: 358–64PubMedCrossRefGoogle Scholar
  34. 34.
    Pino EC, Colville MR. Snowboard injuries. Am J Sports Med 1989; 17: 778–81PubMedCrossRefGoogle Scholar
  35. 35.
    Hedges K. Snowboarding injuries. An analysis and comparison with alpine skiing injuries. Can Med Assoc J 1991; 145: 1097–1103Google Scholar
  36. 36.
    Johnson RJ. Skiing and snowboarding injuries: when schussing is a pain. Postgrad Med 1990; 88: 36–51PubMedGoogle Scholar
  37. 37.
    Russell JA, Holmes III EM, Keller DJ, et al. Reduction of acute anterior shoulder dislocations using the Milch technique: a study of ski injuries. J Trauma 1981; 21: 802–4PubMedCrossRefGoogle Scholar
  38. 38.
    Ettlinger CF, Johnson RJ, Shealy JE. A method to help reduce the risk of serious knee sprains incurred in alpine skiing. Am J Sports Med 1995; 23: 531–7PubMedCrossRefGoogle Scholar
  39. 39.
    Knipschild PG, Bouter LM. Risk factors for ski injuries: a crash course of epidemiologic methods with emphasis on comparability in experiments and case-control studies. In: Johnson RJ, Mote Jr CD, Binet M-H, editors. Skiing trauma and safety: 7th International Symposium. Philadelphia: American Society for Testing and Materials, 1989: 9–17CrossRefGoogle Scholar
  40. 40.
    Kok G, Bouter LM. On the importance of planned health education: prevention of ski injury as an example. Am J Sports Med 1990; 18: 600–5PubMedCrossRefGoogle Scholar
  41. 41.
    Ytterstad B. The Harstad injury prevention study: the epidemiology of sports injuries. An 8 year study. Br J Sports Med 1996; 30: 64–8PubMedCrossRefGoogle Scholar
  42. 42.
    Thomas P. Avoiding skiing injuries. Practitioner 1989; 233: 90–4PubMedGoogle Scholar
  43. 43.
    Burns TP, Steadman JR, Rodkey WG. Alpine skiing and the mature athlete. Clin Sports Med 1991; 10: 327–42PubMedGoogle Scholar
  44. 44.
    Bouter LM, Knipschild, Volovics A. Personal and environmental factors in relation to injury risk in downhill skiing. Int J Sports Med 1989; 10: 298–301PubMedCrossRefGoogle Scholar
  45. 45.
    Ettlinger CF, Johnson RJ. The state of the art in preventing equipment-related alpine ski injuries. Clin Sports Med 1982; 1: 199–207PubMedGoogle Scholar
  46. 46.
    Metheny JA. Skiing orthosis for recurrent shoulder dislocation. Am J Sports Med 1984; 12: 82–3PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1998

Authors and Affiliations

  • Mininder S. Kocher
    • 1
    • 2
  • Michele M. Dupré
    • 1
  • John A. FeaginJr
    • 2
    • 3
  1. 1.Department of Orthopaedic Surgery, Massachusetts General HospitalHarvard Medical SchoolBostonUSA
  2. 2.Teton Village Clinic, Jackson Hole Ski ResortJacksonUSA
  3. 3.Division of Orthopaedic SurgeryDuke University Medical CenterDurhamUSA

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