2014 Winter Olympics: Freestyle Skiing and Shoulder Dislocations
EVENT: FREESTYLE SKIING
Freestyle skiing is the competition that includes the disciplines of men’s and women’s moguls and aerials. In this Olympics, both men and women will be participating in the discipline of ski cross for the first time as well. Freestyle skiing was a demonstration sport at the 1988 Games in Calgary with the moguls becoming an official event at the 1992 Games in Albertville and the aerials following in the 1994 Games at Lillehammer. Freestyle skiing combines the skills of technical and aerial skiing with varying degrees of acrobatics that makes falls common. This leads to today’s topic of shoulder dislocations.
CONDITION: SHOULDER DISLOCATION
What is it? A shoulder dislocation is where the upper end of the arm bone (humerus) is forced out of its alignment with the shallow socket of the shoulder blade (scapula) in which it sits called the glenoid. Dislocations are often the result falls or collisions with another object or person which forces the shoulder out of alignment. As mentioned, the humerus sits in the shallow glenoid, which is deepened slightly by a cartilage ring called the labrum. Surrounding the joint, and helping to stabilize it, are the four rotator cuff muscles that provide stabilization in all directions, the least of which is the lower front. Often the humerus will dislocate in an anterior or inferior direction due to this imperfection in the anatomy of the shoulder. A subluxation is a partial dislocation of the joint when varying degrees of the surfaces of the bones making up the joint remain in contact.
What are the symptoms? The main symptom of a shoulder dislocation is intense pain localized to the joint. The shoulder may also have a visible deformity depending on whether or not the joint has relocated on its own. Additionally, patients will have great difficulty with movement of the shoulder, especially if the shoulder has not relocated itself. Some patients may also note numbness and or tingling in the shoulder that may radiate down the arm depending on injury severity. Physicians will make the diagnosis by obtaining a quick history of the injury and then performing an exam of the shoulder and the rest of the arm to look any additional injuries including damage to nerves, blood vessels, ligaments or any other soft tissues. X-rays of the shoulder will also be taken to confirm the dislocation and look for any fractures that may have occurred as a result of the trauma.
What is the treatment? Treatment for a shoulder dislocation is relocation of the joint. Higher success rates of relocation are likely if it is attempted relatively soon after the injury. In some instances patients will need a sedative medication to help them relax and lessen the pain. There are various techniques to relocate a dislocated shoulder and may have the patient sitting or lying on their back or stomach based on the technique used. Once a shoulder has been relocated, the physician will obtain x-rays to confirm joint relocation and perform another brief exam to check the blood and nerve supply to the shoulder and arm. Post relocation, patients will also be placed in a sling for support and given oral pain medication if needed. Follow-up in a few days will then be necessary for continued management of the injury.
How can it be prevented? Preventing a shoulder dislocation includes avoiding falls, wearing protective gear when playing contact sports and exercising regularly to maintain shoulder strength and flexibility. Maintaining good shoulder strength after a previous dislocation can minimize re-dislocation. However, once a patient dislocates, the higher the likelihood that they will dislocate again especially if they are younger. For patients that repeatedly dislocate, surgery may be necessary to repair chronic ligament damage that causes instability.
Random useless trivia about Freestyle Skiing: In the 1988 Games in Calgary, Canada and the 1992 Games in Albertville, France, men’s and women’s aerials and ballet were demonstration sports in the Freestyle Skiing program. Since then, aerials have become an official Olympic event whereas ballet has been dropped.