Our last post discussed rotator cuff injuries. Due to the violent nature of skiing and snowboarding related falls, it is also not uncommon for us to see dislocations of the shoulder. A shoulder dislocation is where the head of the humerus (top of the arm bone), moves out of the normal confines of the shoulder joint socket (glenoid). The most common direction of dislocation is anterior (to the front), and the typical mechanism of injury is a combination of outwards rotation wi

We have previously discussed clavicle fractures and injuries to the AC joint. We also commonly see injuries to the rotator occur with skiing and snowboarding.  The rotator cuff is a group of 4 muscles, the tendons of which intertwine with the capsule of the shoulder and help provide stability to the joint. Because they lie close to the joint they are effective as stabilizing muscles, but are quite small in comparison to other muscles in the region, and as such are vulnerable

Lower back pain is the most common complaint we deal with in orthopedic practice, and while it isn’t the most common winter sports injury, it is still possible to injure this area on the slopes.  Lower back pain may come on due to overuse, especially at the start of the season, when we are getting used to an unaccustomed activity again. Or symptoms may start following an acute injury, usually a hard or slightly awkward landing, or a rapid change of direction movement that the

We mentioned in the last post how twisting movements involving ski poles may cause injury to the wrist. Given the positioning of the thumb with these implements, it is also a common area of injury. The most common injury we see in this region is a tear of the ulnar collateral ligament (UCL). So common is this injury that it is colloquially known as “skier’s thumb” (also “gamekeeper’s thumb in hockey). The ligament lies at the articulation between the thumb and the hand, and d

Concussion, also known as a traumatic brain injury (or TBI) is functional disturbance of the brain, typically caused by direct or indirect trauma. As with any injury, concussion needs to be assessed and treated in the correct manner to optimise recovery and avoid long-term disabilities. The acute evaluation involves questioning (using a specific tool such as the sport concussion assessment tool (SCAT)), to ascertain if the person has suffered a concussion. Acute symptoms of a

Another area that may be affected during a fall is the hand and wrist. This is usually the result of a fall onto an outstretched hand, or a falling mechanism involving twisting the hand and wrist around the ski pole. There are a number of different injuries that may occur to this region, but the two most common ones are a fracture of the scaphoid and an injury to the Triangular Fibrocartilage Complex (TFCC). A scaphoid fracture will result in pain on the thumb side of the wri

Musculoskeletal injury is a complicated, multi-faceted process, and the specific cause(s) of injury will be unique to the individual. However, in an effort to decrease the occurrence of injury, there is a general hierarchy of importance in terms of measures that can be taken. Health professionals often observe people over-emphasising some of the less important facets of injury prevention, in the process ignoring the “big rocks” Of primary importance is management of training

Less common than the clavicle fractures and AC joint injuries discussed in the previous posts, a fracture of the upper part of the arm (humerus) may occur with a direct fall onto the side of the arm, as well as with rapid twisting motions involving the shoulder.  These injuries may present similarly to other shoulder injuries such as rotator cuff strains (to be covered in a future post), but the telltale sign is significant bruising on the side of the arm. Any traumatic injur

Clinical guidelines are devised by experts in specific fields, to provide consensus and improve consistency within management protocols. The ankle lateral ligament sprain is one of the most common injuries seen in orthopedic practice, and as such, treatment guidelines need to be frequently updated based on the latest research findings. The 2013 clinical practice guidelines for ankle lateral ligament sprains were updated recently by the Academy of Orthopaedic Physical Therapy

We discussed in the previous post how a fall onto the side of the shoulder may cause damage to the AC joint. The same mechanism of injury may also cause a fracture to the clavicle (collarbone). Clavicle fractures are less commonly caused by a fall onto an outstretched hand or elbow.  The clavicle usually fractures in the middle third, the weakest part of the bone, and this will be indicated by the site of pain. There will often be a visual deformity caused by the fracture. An

Osteoarthritis (OA) is a degenerative condition that affects many, particularly older individuals. The most commonly affected joints are the knees and hips. There is an implied benefit of decreased body mass on the symptoms of OA. And while decreased weight and therefore decreased direct loading to the joint surface may be one proposed mechanism by which weight loss could improve symptoms, reduced body fat levels may also lead to a decrease in the inflammatory states that can

I have written and spoken extensively about the cross-education effect in the past. For a brief synopsis check out Ask 360 episode 11, released on October 1st 2021. The cross-education effect essentially refers to the notion that training one side of the body will result in positive adaptations to the opposite side. The mechanisms responsible for this are thought to be neurally mediated. Several studies now have demonstrated the ability to gain strength and maintain muscle bu

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

Last post we discussed ACL injuries, the granddaddy of knee pain. Equally common are medial collateral ligament (MCL) injuries. The MCL crosses the inside of the knee, and provides stability to prevent valgus stress, the stress that would occur to the knee if you were to push one knee in towards the other from the outside, and also contributes to rotational stability. Forceful movement into valgus or rotation can cause ligament failure, and, unlike the ACL, we have more varie

The 3 letters of doom! ACL injuries are very common in sports, including winter sports. The Anterior Cruciate Ligament (ACL) is one of 4 main ligaments that provide stability in the knee. It runs from the front of the tibia (shin bone) to the back of the femur (thigh bone), and functions to stop the tibia gliding forwards, and also contributes to controlling rotation. The ACL is often injured with a hyperextension (over-straightening) mechanism, or with forceful rotation and

is commonly injured in sports involving twisting, turning, jumping, landing and rapid change of direction. The traditional approach to management of an ACL injury has been to reconstruct the ligament, usually with a donor site from else in the body. In recent times there has been more of a trend towards non-operative management for some patients, with studies demonstrating comparable outcomes from rehabilitation in ACL-deficient knees Over the last few years, there have been