As winter draws near and snow begins to blanket the ground, many winter sports enthusiasts are gearing up for activities like skiing, snowboarding, and ice hockey. Alongside this excitement, it’s important to stay mindful of shoulder injuries. One of the most common shoulder injuries we see are shoulder separations, formally known as acromioclavicular (AC) joint injuries.
These injuries typically occur when a person falls or receives a direct impact to their arm when it’s close to their body. They are especially prevalent among young men aged 18 to 30 and are commonly observed in sports like football, skiing, snowboarding, and ice hockey. Notably, AC joint injuries are the most frequently encountered upper extremity injury among ice hockey players1. Moreover, AC joint injuries in one study conducted at a ski mountain accounted for 6.7% of all emergency room visits, with snowboarders particularly at risk, making up over 62% of these cases2.
The AC joint, a small structure at the end of the collarbone, is critical for maintaining the shoulder’s connection to the rest of the thorax. In cases of severe injury, surgical repair typically focuses on the coracoclavicular ligaments, which provide essential vertical support to the joint. Recently, however, there has been increasing recognition of the AC joint capsule ligaments, which contribute horizontal stability in the front to back direction.
Fortunately, most AC joint injuries do not require surgery. Typical treatment includes using a sling to support the arm, taking anti-inflammatory medications, and undergoing physical therapy. This regimen aims to restore the shoulder’s full range of motion, correct scapular movement, and relieve pain. Athletes may return to their sports once they achieve full, pain-free shoulder mobility and strength, with most recovering within 6 to 12 weeks, depending on injury severity. When surgery is necessary, the primary objectives are to realign the AC joint and achieve secure fixation in both the vertical and horizontal planes often through suture fixation and tendon grafts.
Preventing AC joint injuries while skiing entails a warm-up prior to activity using light dynamic exercises like arm circles and shoulder rotations, which help improve flexibility and increase blood flow to the shoulder, preparing it for the varied movements of skiing and reducing strain across shoulder muscles. Practicing proper skiing technique, including a balanced stance, strong core, and forward arm position, also helps minimize shoulder stress. Skiers should be cautious about terrain and weather, as icy or uneven slopes can increase fall risks. Additionally, rest and recovery, including hydration and regular breaks, support overall condition and help reduce fatigue-related injuries. With these precautions, here’s to a safe and enjoyable winter season in 2024!
References:
- White CA, O’Connor SJ, Sestak TR, Fox ES, Cagle PJ. Shoulder injuries in ice hockey players: Prevalence, common management, and return to play. J Orthop. 2023;35:145-149
- Kelley N, Pierpoint L, Spittler J, Khodaee M. Acromioclavicular joint injuries at a Colorado ski resort. Phys Sportsmed. 2023 Feb;51(1):33-39.