Q. I was skiing last week and injured my right shoulder when I fell. I might have felt a pop and it definitely hurt a lot. I was able to keep skiing but I have noticed pain when I try to lift my arm overhead. I tried to maintain my motion but it does not seem to be getting better. I saw my primary care doctor who took X-rays. They did not show anything broken and he gave me some ibuprofen but it does not seem to help. What is my next step?
A. I recommend that you see an orthopedic surgeon for evaluation of your shoulder. Common injuries related to skiing are injuries to the rotator cuff tendon or labral cartilage. There are four muscles that make up the rotator cuff tendon, which can be injured during a fall.
The patient will complain of pain particularly at night, weakness and pain on the extremes of motion. X-rays are usually negative unless an associated fracture is present; an MRI scan is usually helpful in establishing the correct diagnosis. If a rotator cuff tendon tear occurs particularly in a relatively young athletic individual, it usually requires arthroscopic surgery to fix the tear and restore as normal function as possible.
Labral cartilage tears are also common injuries from falls while skiing. The labrum helps to stabilize the ball part of the shoulder within the socket. If torn, this can result in instability and also may require surgical intervention. An MRI scan is also helpful in establishing labral cartilage injuries of the shoulder. Though we live in a warm weather environment, the number of skiers and snowboarders in South Florida is huge. Unfortunately, many individuals who are only vacationing for short periods of time will continue to ski or snowboard while fatigued or in less than optimal conditions, thus resulting in a higher percentage of injuries.
Dr. Harlan Selesnick is team physician of the Miami Heat and director of Miami Sports Medicine Fellowship, Doctors Hospital. Send questions to HarlanS@baptisthealth.net.