The torn ligament ends are unable to reapproximate, and residual instability results. This injury can occur when the skier falls directly on the shoulder. On physical examination, pain is present directly over the acromioclavicular joint, and deformity is seen in grade 2 and 3 sprains. Such injuries can include compression fractures of the body of the lumbar vertebrae or fracture of the coccyx resulting from falls. The increasing popularity of skate-skiing may increase the rate of such injuries.
Patellofemoral syndrome is also common.
Overuse injuries most often result from training errors or errors in technique. Poor weight transfer, however, prolongs the time the ankle is in a pronated position, with the ski remaining on edge rather than gliding flat. A flat ski is faster, and it reduces stresses on the hip and lower extremity. Additional instruction in technique may resolve persistent patellofemoral or medial tibial stress symptoms. Treatment of overuse injuries is individualized, but in general, relative rest, stretching and strengthening exercises, and gradual return to skiing are involved.