Medically reviewed by John C. Redfern, MD
Many people love ski season in Colorado, but for some skiers and riders, it also brings the first hard fall of the year. I ski myself, so I know how disappointing it is to lose part of a season to an injury. Skiing and snowboarding shoulder injuries range from a bruise that settles on its own to a dislocation or fracture that needs a careful plan. Whether it was a ski fall or a snowboard injury on your first run of the day, knowing the difference helps you make a good decision before you head back up the lift.
Key Takeaways
- Many skiing and snowboarding shoulder injuries happen in a fall, when the arm reaches out to catch the body or the shoulder hits the snow directly.
- A shoulder that looks deformed, or a hand that goes numb, cold or pale, needs emergency care right away.
- Plenty of these injuries heal without surgery, and the right plan depends on which part of the shoulder was hurt and how you use it.
How Shoulders Get Hurt on the Mountain
Shoulder injuries, including dislocations and sprains, are common on the slopes, largely because skiers put their arms out to break a fall. A snowboard injury often follows a similar pattern. With both feet locked to one board, a rider can’t step out to catch themselves. Falls tend to come fast and land on an outstretched hand or the point of the shoulder.
Fatigue plays a part, too. A good share of injuries happen late in the day, when legs are tired and reactions slow down. Here in the Pikes Peak region, falls, cycling and skiing accidents, and sports collisions account for most of the shoulder fractures I treat.
The Most Common Skiing and Snowboarding Shoulder Injuries
The shoulder is built for motion, not stability, so the same fall can hurt bone, ligament or tendon. These are the injuries that usually come off the mountain:
- Shoulder dislocation: The ball of the joint comes fully out of the socket, in most cases toward the front. It generally needs to be put back in place by a medical professional.
- Collarbone (clavicle) fracture: This is the most common shoulder fracture, usually from landing on the shoulder or an outstretched hand. A simple sling is enough for a lot of them.
- Separated shoulder: An injury to the ligaments where the collarbone meets the shoulder blade (the AC joint). It isn’t a dislocation of the ball-and-socket joint, and most are treated without surgery.
- Rotator cuff tear: A hard fall can tear one of the tendons that lift and rotate the arm. A sudden tear from an injury behaves differently from the gradual wear that comes with age.
Older skiers with thinner bone are also more likely to break the top of the upper arm bone (the proximal humerus) in a fall. Treatment for that fracture depends on how the pieces line up.
What to Do Right After a Fall
Stop skiing or riding. Hold the injured arm against your body in whatever position hurts least, and let ski patrol help you down. Don’t let a friend pull on the arm to put a shoulder back in. I’d rather you wait for trained hands than add a second injury to the first.
Go to an emergency room right away for an obvious deformity, an open wound, numbness, or a cold or pale hand. For a painful shoulder after a fall without those warning signs, call my office so we can see you promptly. Bring any X-rays from the resort clinic or urgent care with you.
What I See in My Patients After a Fall
Some of my patients come in the same week as the fall. Others ski through the rest of the season on a sore shoulder and come in once the snow melts. Either way, the history matters as much as the X-ray. How you fell, where the arm was, and whether the shoulder has slipped before all point me toward the structure that failed.
After a fall, I want to know which part gave way: the bone, the labrum and ligaments that keep the ball centered in the socket, or the rotator cuff tendons that move the arm.
Age changes the picture, too. Younger patients who dislocate once commonly dislocate again, since a torn labrum may not heal back in position.
My Approach to Treatment
I start with a careful exam and X-rays. When I suspect a torn tendon or labrum, an MRI, and sometimes an MRI arthrogram or CT scan, shows the soft tissue and any bone loss from the socket. Many patients don’t need surgery.
For a stable fracture, a sling, early gentle motion of the elbow and hand, and follow-up X-rays are frequently enough. A first-time dislocation usually starts with a short period in a sling, then physical therapy to strengthen the rotator cuff and shoulder-blade muscles. Shoulder instability that keeps returning, a significantly displaced collarbone fracture, or a sudden rotator cuff tear in an active patient may call for surgery. In those cases, I talk through the options and the risks so the decision is made with you, not for you.
I completed a sports medicine fellowship at the University of Utah, and I try to plan recovery around getting an active skier or rider back to the mountain, not just back to daily life.
Getting Back on the Slopes
Timelines may vary between patients, but recovery follows a gradual progression. The milestones depend on the injury:
- Fractures: Bone healing generally takes six to twelve weeks, and motion and strength keep returning over several months. Stiffness is the most common problem after a shoulder fracture, so early, guided motion matters.
- Labral repair after dislocation: The sling stays on for roughly four weeks, followed by protected motion and strengthening by about three months. Athletes in demanding sports tend to return around five to six months, once strength and control allow it.
- Rotator cuff repair: The sling is worn for roughly four to six weeks, and a return to heavy or overhead activity can take four to six months.
Prevention is worth the effort, too. Lessons help newer skiers and riders learn to fall more safely. Going into the season in good physical condition and calling it a day when you’re tired or sore can cut down on late-afternoon falls.
Summary
Skiing and snowboarding shoulder injuries tend to come from falls onto an outstretched arm or straight onto the shoulder. Dislocations, collarbone fractures, separated shoulders and rotator cuff tears lead the list. Warning signs such as deformity or a numb, pale hand mean the emergency room, while other painful shoulders deserve a prompt orthopedic exam. These injuries frequently heal with a sling and therapy, and surgery may be recommended when the shoulder keeps giving way or the injury won’t heal in a functional position.
If a fall on the mountain has left your shoulder painful, weak or unstable, request an appointment at my Briargate or Quail Lake office, and bring any imaging from the resort clinic or emergency room.
Frequently Asked Questions
Should I go to the emergency room after a shoulder injury on the slopes?
Go right away if you see an obvious deformity or an open wound, or if your hand feels numb, cold or pale. A shoulder that’s painful without those signs can typically be seen in my office, so call promptly for an evaluation.
Do I need surgery for a broken collarbone from skiing?
Most people don’t. A simple sling works about as well as a figure-of-eight brace and is more comfortable. Surgery may be considered when the fracture is significantly displaced or shortened, broken into several pieces, pressing on the skin, or in an active patient who needs reliable early function.
Can I keep skiing on a shoulder that dislocated?
I would not recommend it until it has been evaluated. The chance of the shoulder coming out again depends on your age at the first dislocation and how you use the arm. Teens and contact or overhead athletes carry the highest risk, and repeat episodes can damage the labrum and the bone of the socket.