2014 Winter Olympics: Short Track Speed Skating & Shoulder Separation
EVENT: SHORT TRACK SPEED SKATING
Short Track Speed Skating is essentially the “Roller Derby meets Arena Football” cousin of regular, or long track, speed skating. Multiple skaters (usually between four and six) jockey for position and speed to be the first to cross the finish line while skating around a track with a circumference of around 111 meters. The sport was a demonstration sport at the 1988 Games in Calgary, Canada and became a full Olympic sport in 1992 in Albertville, France. As you can imagine with all of this action in such a tight place, falls are common which leads to our topic today of separated shoulders.
CONDITION: SEPARATED SHOULDER
What is it? A shoulder separation is an injury to the acromioclavicular joint (AC joint) of the shoulder that usually is the result of a direct blow to that area of the shoulder as seen in football or hockey. It can also occur in direct falls on the shoulder or in falls on an outstretched hand. The AC joint is where the end of the shoulder blade (scapula) called the acromion meets the clavicle (collarbone). Severity of separation depends on the amount of disruption of the AC joint and injuries are graded from I-VI with a Grade VI injury involving the most disruption. Grade I injuries involve an injury to the capsule surrounding the AC joint. Grade II and III injuries involve AC capsule injury with tearing of the clavicle-stabilizing coracoclavicular (CC) ligament with a bump being present over the front of the shoulder. A Grade III injury simply represents more disruption than a Grade II one. Grade IV injuries are where the clavicle is pushed behind the AC joint. A Grade V injury is a severe Grade III injury where the clavicle punctures the musculature over the AC joint. Rarely, Grade VI injuries occur where the clavicle is pushed downward and is stuck under the coracoid process of the scapula.
What are the symptoms? Patients will often note intense pain around the front and top of the shoulder when the injury occurs. There will often be swelling and bruising present along with varying degrees of deformity in the appearance of the shoulder. This deformity often presents as an enlarged bump at the end of collarbone. Patients also will often complain of increased pain with shoulder movements that bring the arm above the head or across the body. Some patients may even complain of tingling that extends down into the arm. The diagnosis can usually be made from the description of the event that caused injury and a simple examination. X-rays will also be performed to rule out fractures in and around the shoulder.
What is the treatment? Initial treatment focuses on resting the joint and controlling inflammation and pain. This is usually accomplished by icing the joint and taking anti-inflammatories with or without the use of a sling to support the arm. For less severe injuries (Grade I and II, motion exercises are usually started shortly after the injury and are all that is needed for healing. Surgery is necessary in these cases only when there are problems with non-operative treatment. More severe injuries (Grade IV, V and VI) require surgery. The controversy in treatment arises when dealing with Grade III injuries. Most people do well without having surgeries for this grade of injury. However, some athletes and heavy laborers that have repetitive use of their shoulder, especially in an overhead direction, may benefit from surgery. Unfortunately, no sweeping generalizations can be made and each injury has to be considered on a case-by-case basis.
How can it be prevented? Regular exercise and strength training of the shoulder joint can help prevent separated shoulders. In addition, using the proper protective gear and form that is specific to your sport can also reduce injury.
Random useless trivia about Short Track Speed Skating: Prior to the Sochi Olympics, the male and female skaters with the most medals in Short Track Olympic competition are Apolo Anton Ohno of the United States and Wang Meng and Yang Yang of China.