Although snowboarders are more protected from knee twisting injures upper limb and ankle injuries are more common. Beginners who are particularly susceptible to catching an edge and falling a lot are especially vulnerable to injuring their shoulder, with one of the most common injuries being a clavicle fracture.
1.Clavicle fracture
Symptoms:
Tenderness, bruising, swelling
Bony deformity
Pain
Inability to lift arm
Treatment
A figure of eight bandage is the ideal choice for helping to immobilize the clavicle as unlike a sling alone it is designed to prevent foreshortening of the bone as it heals (when the ends overlap)
If is a severe fracture or if it fails to heal surgery may be required
Healing times
Usually around 4-6 weeks
A fracture at the end of the clavicle near the shoulder is more prone to delayed union
Rehabilitation exercises when pain allows
Assisted forward shoulder flexion (lifting your arm up using the other arm to help) to 90 degrees should be performed to prevent stiffness.
Elbow bending and straightening
Tennis ball squeezes
Wrist and hand movements e.g. bending and straightening
Once the pain has reduced you should try to use your shoulder normally to prevent stiffness and tightness of the muscles around your shoulder
Use ice regularly to help reduce swelling
5. Try to maintain your overall fitness in these weeks as well
Rehabilitation- from 4 weeks+ once the x-ray shows the clavicle is in a good position and healing- aim to perform these 3x a day
Regaining the full range of movement:
1. Pendulum exercises
- Hold onto a table with your with your un injured arm and let your injured arm hang over it pointing downwards towards the floor
- Let your arm hang loose and perform small circles side to side and forwards and backwards for around 2 minutes
2. Assisted exercises
- Holding a broom use your good arm to help your lift your arm to the side and also above your head
- Wall crawl- walk your hands up a wall
3. You may need to see a physiotherapist at this time to help you regain the full movement of your shoulder
Begin isometric strengthening exercises (when the muscles contracts but does not cause movement) try to hold each exercise for 3 seconds each time and repeat 15 x
Rotator cuff muscles
Stand in front of a door or door frame with your elbow bent to 90 degrees, push against the door with your hand:
Internal rotation- place your palm side of your hand on the door and push inwards
External rotation- place your back side of your hand on the door and push outwards
Scapula (shoulder blade) squeezes- squeeze your scapula together
Triceps- place your elbow onto the table at 90 degrees and push downwards
Deltoid (main muscle which gives shoulder shape)
With your arm straight push your hand against a wall sideways, in front of you and behind you
Around 6 weeks+ progress strengthening exercises
- Start with 10 of each exercise and as you find these easy aim to build up to 15 repetitions x 3 sets
1. Rowing with Theraband
- Tie a Theraband around a door handle, hold onto this with both hands and pull the band directly back, squeezing your shoulder blades together. Hold this for 3 seconds. Your elbows should stay tucked in.
2. Add resistance to rotator cuff exercises- Tie a Theraband around a door handle and keep your elbow tucked in to your side and at 90 degrees:
Internal rotation - pull the band towards your tummy and slowly bring this back to the starting position
External rotation- pull the band outwards and slowly bring this back to the starting position
3. Wall push-ups
- Do push ups against the wall, as you get stronger you can lower the surface e.g. of a table- floor
4. Add resistance to deltoid exercises
Place a Theraband under your foot and with your arm straight
1. Slowly lift your arm straight up
2. Slowly lift you arm straight up to the side
You should be guided by a physiotherapist to perform the exercises above.
