Snowboarding has been an up-and-coming sport over the last two decades. The risk of injury within the lower extremities (below the pelvis) has decreased due to improvements in binding, boots and general ergonomics; however, the risk of injury to the upper extremity is more so (one-half to two-thirds of all injuries).
When common snowboarding injuries are compiled, there is a large proportion of them being bone related such as wrist and elbow fractures, or dislocations.
- Scaphoid or Lunate fracture
- Elbow fracture
- Shoulder dislocation
Wrist injuries account for 22% of injuries experienced during snowboarding, roughly 78% of these will result in fractures, however of the remaining injuries the wrist sprain was the most common diagnosis.
Negating the wrist fracture; the shoulder is implicated more frequently during snowboarding injuries than the wrist. This is due to the protective mechanism employed whilst falling either forward or backwards. Of these, the most common is an acromioclavicular sprain and a rotator cuff strain/impingement.
What is it?
The Acromioclavicular joint is the connection between your Shoulder blade (scapula) and the collarbone (Clavicle).
How does it occur?
During snowboarding, injuries to this joint are most commonly caused by a fall directly onto the tip of the shoulder; this often forces the scapula downwards whilst the clavicle remains in place. It may also occur if you fall and put your hand out in front of you to protect yourself (also known as a FOOSH fall – fall on outstretched hand).
Types of injury
The acromioclavicular joint injuries are classified into six grades:
- 1/ a sprain of the capsule around the joint
- 2/A complete tear of the acromioclavicular ligament and sprain of the coracoclavicular ligament
- 3-6 Displacement of the clavicle into different directions due to complete tearing of the ligaments.
What you will feel
Acromioclavicular joint injuries often result in an ache like pain on the top of the shoulder which turns sharp with overhead movement and across body movement. Initially, the pain may be quite broad, however as the initial pain decreases it will become more specific to the joint itself. You may also experience swelling and/or bruising on the tip of the shoulder, pain with pressure and a feeling of instability. You may also notice a bump develop on the top of your shoulder.
Rehabilitation exercise table for an acromioclavicular sprain (Grades 3-6 may require surgery)
The Rotator Cuff tear
What is it?
The rotator cuff is comprised of four muscles – the Supraspinatus, Infraspinatus, Subscapularis and Teres Minor.
Where does it occur?
The tear happens more frequently to the tendon (where the muscle attaches to the bone) than the muscle belly.
These muscles attach the head of the humerus (upper arm) to the scapula (shoulder blade). Any of these muscles may be torn or damaged; however, it is most commonly the Supraspinatus. The four muscles also work with different movements:
- the Supraspinatus abducts the arm (outwards movement)
- the Infraspinatus externally rotates the Humerus (twist the arm outwards), and assists in extension at the shoulder
- the Teres Minor externally rotate the Humerus (twist the arm outwards)
- the Subscapularis mainly internally rotates the Humerus (twists the arm inwards)
How does this occur?
This injury can occur traumatically during snowboarding – such as by falling onto an outstretched hand to protect yourself (Foosh fall), or a sudden wrenching movement with your arm going upwards/out to the side.
It may also occur gradually over time, with repetitive gentle falls, or repetitive movement leading to a more gradual tear.
What will you feel?
The pain from a rotator cuff tear is often felt at the front and/or the side of the shoulder. Frequently a sharp pain and/or weakness is felt with overhead motion, and taking the arm out to the side. Pain may also be worst after rest, and during the night.
Why does it occur?
Several factors are thought to contribute to a rotator cuff tear; these include a history of repetitive impingement of the muscle, overuse through overhead activity; or degeneration through ageing or poor circulation.
Rehabilitation Exercise table for a rotator cuff tear (most can be treated non-operatively)