Injury Prevention in Nordic Skiing: Elbow & Shoulder Pain

Due to the repetitive stress from poling, Nordic skiers can develop overuse injuries of both the elbow and/or the shoulder. The most common of these are medial epicondylitis and shoulder impingement syndrome.   The underlying cause of the development of these injuries is multi-factorial: poling technique, pole length, and poor strength and conditioning.


Shoulder impingement syndrome is caused by underlying weakness of the rotator cuff and muscles around the shoulder blade.  This underlying weakness causes impingement or pinching of the rotator cuff between the humerus and glenoid (ball and socket of the shoulder joint), which can be further exacerbated by poor poling technique.  Therefore to prevent developing shoulder pain during your Nordic ski season, make sure you incorporate strength and conditioning of your rotator cuff and periscapular musculature.

Medial epicondylitis is an irritation of the tendon of the wrist flexors and presents as pain on the inside of the elbow.  This irritation is caused by repetitive stress to the tendon mainly from poor poling technique, but also from underlying weakness of the wrist flexor muscles.   Thus prevention of medial epicondylitis can be achieved through working on your poling technique and ensuring you have proper forearm strength.

See More Injury Prevention in Nordic Skiing: Knee Pain

See More Injury Prevention in Nordic Skiing: Lower Back Pain

See More Injury Prevention in Nordic Skiing: Technique


Jason Lunden, DPT, SCS specializes in the rehabilitation and prevention of sports-related injuries, with a particular interest in the biomechanics of sporting activities – running, cycling, skiing, snowboarding and overhead athletics. He has published on the topic of shoulder biomechanics and the rehabilitation of knee injuries and has a strong commitment to educating others. Jason serves as a physical therapist for the US Snowboarding and US Freeskiing teams and is a frequent, well-received local and national presenter on the topics of sports rehabilitation and injury prevention. If you have specific questions about how to strengthen, restore, and get back on the slopes and trails, contact us at Excel Physical Therapy, 406.556.0562 in Bozeman, Montana or 406.284.4262 in Manhattan, Montana. #excelptmt