SHOULDER INJURIES FROM ALPINE SKIING AND SNOWBOARDING - ETIOLOGY, TREATMENT AND PREVENTION

There has been a decrease in the overall injury rate and the rate of l ower extremity injuries for alpine skiing, with a resultant increase i n the ratio of upper extremity to lower extremity injuries. Upper extr emity injuries account for 20 to 35% of all injuries during alpine ski ing and nearly 50% of all injuries during snowboarding. The most commo n upper extremity injuries during skiing are, sprain of the thumb meta carpal-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 rat io of upper to lower extremity injuries during alpine skiing and the b oom in popularity of snowboarding, shoulder injuries will be seen with increasing frequency by those who care for alpine sport injuries. Sho ulder injuries account for 4 to 11% of all alpine skiing injuries and 22 to 41% of upper extremity injuries. The rate of shoulder injuries d uring alpine skiing is 0.2 to 0.5 injuries per thousand skier-days. Du ring snowboarding, shoulder injuries account for 8 to 16% of all injur ies and 20 to 34% of upper extremity injuries. Falls are the most comm on mechanism of shoulder injury, in addition to pole planting during s kiing and aerial manoeuvres during snowboarding. Common shoulder injur ies during skiing and snowboarding are glenohumeral instability, rotat or cuff strains, acromioclavicular separations and clavicle fractures. Less common shoulder injuries include greater tuberosity fractures, t rapezius strains, proximal humerus fractures, biceps strains, glenoid fractures, scapula fractures, humeral head fractures, sterno-clavicula r separations, acromion fractures and biceps tendon dislocation. Preve ntion of shoulder injuries during skiing and snowboarding may be possi ble through interventions in education and technique, conditioning and equipment and environment.