With skiing and snowboarding, inevitably there is falling! The next few posts will discuss injuries that may occur during a fall. One common falling position is a onto the side of the shoulder. This mechanism will often cause damage to the Acromioclavicular (AC) joint; the joint between the collarbone and the tip of the shoulder blade. Injuries to this area will usually cause isolated pain on the tip of the shoulder, but many report pain down the side of the neck and the side of the arm as well. There may be local swelling. Patients will initially report difficulty raising the arm. As pain and local inflammation settle the pain will usually be worse in the higher degrees of elevation.
AC joint injuries can be graded depending on the number of ligaments damaged and the severity of the damage. Grade 1 injuries won’t result in any visible change to the area but grades 2 and above will present as differing degrees of visual deformity. An x-ray will help identify the degree of displacement and therefore the degree of sprain. Initial management involves the use of a sling, as well as the application of taping to offload the injured ligaments and promote healing. Soft tissue work to the surrounding muscles may be useful for pain relief. A rehab program should be commenced as soon as possible, and as these aren’t usually accompanied by muscle or tendon injury, some aspects of the rehab can be pushed quite hard. The muscles around the scapula (shoulder blade) are of key importance, as the altered position and impaired stability of the joint may affect the mechanics of the shoulder.
Grade 1-2 injuries are managed non-operatively, while the management of grade 3 injuries depends on the degree of functionality and the goals of the patient, with some individuals opting for surgery. Grade 4-6 injuries are rarer and are managed surgically. A grade 1 injury may settle in a couple of weeks, while a grade 2 might mean a 6-8 week return to sport, still making an in-season return a possibility. If you have suffered a shoulder injury on the slopes then contact us now and let us help guide you on the path to recovery.
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