THE SKIER & SNOWBOARDER MAGAZINE, MARCH 2001


FROM an orthopaedic and sports medicine point of view the most useful thing a skier can do post season is to maintain fitness and treat any injuries.


Most of us who go skiing sustain minor injuries in various tumbles while on holiday and expect the residual discomfort/bruising/swelling to resolve itself. Fortunately, it does so in the vast majority of cases with most skiers treating themselves with a degree of neglect, rest, ice and anti-inflammatories.


This is probably entirely appropriate for the most part. However, there are a few common, persistent or nagging injuries that are best not ignored.


A common injury among skiers and snowboarders alike is a fall on to the shoulder or a fall involving the shoulder. This can produce a common condition of subacromial impingement syndrome (painful arc syndrome). This is a condition manifested by people experiencing pain when their arm is utilized up at around shoulder height or once they take their arm right up into full elevation the pain either disappears or subsides.


The pathology with this condition is of an injury to a tendon in the shoulder called the rotator cuff which becomes either partly torn or simply inflamed. In either case it swells and this swollen enlarged tendon gets caught as it runs through a bony ligamentous tunnel in the shoulder. The condition becomes a bit of a vicious circle in that the more the tendon is swollen the more it rubs and so on and so forth.


Fortunately, the condition is easy to treat either with a programme of physiotherapy and/or a course of up to three injections. If the condition is allowed to persist it usually deteriorates steadily and can lead to a complete tear in the tendon.


The second most common complaint you are wise not to ignore is that of ongoing symptoms of pain, swelling, clicking or giving way following a minor knee injury If you had sustained a major ligament injury to your knee while skiing you would certainly have known all about it and would probably have to be blood wagoned down and possibly flown home.


It is, however, possible to sustain relatively minor cartilage tears in the knee which can grumble on for months with symptoms as I have described above. If you have such knee symptoms after a minor skiing injury then I would recommend referral to a local orthopaedic surgeon with an interest in sports medicine. He or she is likely to investigate with an MRI scan to confirm the diagnosis and can either put your mind at rest by saying that there is no evidence of any cartilage injury and that your symptoms will settle, or that the scan may confirm the diagnosis, in which case arthroscopic surgery will cure you quite quickly


If you leave such meniscal tears without treatment the tears can extend and lead to secondary degenerative change.


In summary, therefore, any symptoms from minor injuries sustained while skiing that persist for more than six weeks should be taken seriously.