Surfer’s myelopathy is a non-traumatic injury to the spinal cord that can result in paralysis. This condition is not caused by a direct impact, but by a specific posture held for an extended time. While most associated with surfing, particularly among beginners, the injury stems from the mechanical stress placed on the spine. It is a rare neurological event that can develop suddenly.
The Onset and Symptoms
The initial sign of surfer’s myelopathy is the abrupt onset of sharp pain in the mid-to-lower back. This pain often begins while the individual is still paddling on their board or immediately after exiting the water. It is quickly followed by neurological symptoms, which start as tingling sensations or numbness in the legs.
This sensory disturbance can rapidly progress to muscle weakness and, in severe cases, complete paralysis of the lower body (paraplegia). The progression from mild sensory issues to significant motor deficits can be very fast. Loss of bladder and bowel control is another sign of serious nerve function disruption.
Physiological Causes
The underlying cause of surfer’s myelopathy is a disruption of blood flow to the spinal cord, a condition known as ischemia. This occurs when the spine is held in a prolonged state of hyperextension, such as the arched-back position used when paddling on a surfboard. This posture can put pressure on the blood vessels that supply the spinal cord.
This sustained arching can lead to the kinking or compression of a blood vessel like the anterior spinal artery, which delivers oxygenated blood to the front portion of the spinal cord. Much like a bent garden hose, this constriction chokes off the blood supply. Without sufficient oxygen, the nerve tissue of the spinal cord begins to suffer damage, leading to the neurological symptoms that characterize the condition.
At-Risk Individuals and Activities
Surfer’s myelopathy predominantly affects first-time or novice surfers. This is often due to underdeveloped core and back muscles that are not conditioned for the strain of prolonged paddling. Beginners also tend to use improper technique and spend long periods lying on the board without taking breaks.
While the name links it to surfing, the condition can arise from any activity that involves sustained spinal hyperextension. This includes certain yoga postures, gymnastics movements, or intense Pilates exercises where the back is arched for an extended duration.
Medical Response and Recovery
The appearance of symptoms like back pain followed by leg weakness or numbness requires immediate medical attention. An urgent evaluation is necessary to assess the situation. The diagnostic process involves a detailed neurological exam to gauge nerve damage, followed by an emergency Magnetic Resonance Imaging (MRI) scan of the spine. The MRI is used to visualize the spinal cord and confirm the injury.
Treatment involves supportive care and may include the use of steroids to help reduce swelling in the spinal cord. The path to recovery is highly variable and depends on the initial severity of the neurological deficit. Some individuals may experience a full recovery, while others are left with permanent paralysis or long-term weakness. Extensive physical and occupational therapy is a main part of the rehabilitation process.
Prevention Techniques
Practical steps before and during surfing can help prevent this injury. A proper warm-up is an important first step. Beginners should limit the duration of initial sessions and take frequent breaks from the prone paddling position. Sitting up on the board while waiting for waves relieves the hyperextension of the back.
Additional preventive measures include:
- Maintaining adequate hydration, as dehydration can be a contributing risk factor.
- Building core and paravertebral muscle strength over the long term to help support the spine.
- Learning a proper paddling technique that minimizes excessive back arching.
- Stopping immediately if back pain occurs during any activity involving spinal hyperextension.