Elbow Room with Dr. George

Elbows

“My elbow accident happened a few years ago while I was training in the halfpipe. I still remember that day as if it were yesterday! I met Reto Lamm and a couple of friends by the parking area at the Stelvio Glacier Resort. The Iceripper Camp was just over, and we were free for a full day of training. It was a beautiful, sunny day on the Stelvio Glacier, and the pipe was perfectly shaped.

“As every respectable freestyler does, we got to the top of the pipe quite late and the snow was already wet and soft. We rode all day–what was left of the day–and didn't even stop for lunch. We started to try some new tricks on a single hit, but by this time the pipe was in really bad condition. On my third try at a McTwist, my edge got stuck in an ice chunk and I catapulted face down into the pipe, swimming like hell while falling. My right arm whacked the coping, and I knew something very bad had happened. I remember incredible pain in my elbow, and I think I passed out for a while. Fortunately, my friends quickly called the rescue team, who ended up taking too long because it was lunchtime. I waited for them for half an hour and then decided to go down by myself. My elbow looked kind of strange, and my arm was already so swollen I wasn't even able to get my sweater off.

“I arrived at the hospital four hours later–like a zombie! They told me my elbow was dislocated. It didn't take them long to put it back into place. Meanwhile, I was flying high on some weird injections that took quite a long time to land from–and it took me even longer to get back on my board.”–Max Perotti

The outstretched arm often functions as a “third” limb if you lose your balance during a trick or just while riding. Therefore, more than half of all injuries are associated with the arm. Force, multiplied by your body weight and applied to your arm, is transmitted to the wrist, the elbow, the shoulder, or to all of them.

How does an elbow dislocation occur?

An elbow dislocation is most commonly related to direct high impact to the outstretched arm while the elbow is flexed around 90 degrees. The bones of the arm (radius, ulna, and humerus) transmit the impact to the elbow joint, which is less stable in a bent position. As described by Max, elbow injuries often occur during a fall on your arm in an upside-down position.

Even though elbow dislocations are less frequent than wrist or shoulder injuries, they are still considered among the most serious injuries in snowboarding. Elbow dislocations are very painful, and like shoulder injuries they can easily lead to dangerous situations in mountain areas.

How can I avoid them?

Like most high-velocity injuries, an elbow injury can be avoided by not overestimating your riding capabilities, especially during hard tricks in a slushy pipe! In case of an elbow dislocation, never do any radical treatments such as trying to reposition it yourself; get medical assistance because this injury can cause serious damage to the articulation (ways that the joint interrelate), vessels, and nerves. Immobilize your arm by wrapping it to your chest; this helps to reduce pain. An X-ray is a must.

An elbow dislocation without additional arm injuries or lesions is treated, in most cases, with a cast and physiotherapy, and as Max can attest, with good results.

 

Dr. George Ahlbäumer is known as one of Europe's top orthopedic surgeons specializing in snowboard injuries, based at the Clinic Gut in the Center of Bone and Joint Surgery in the Swiss Alps at St. Moritz.