“Increasingly crowded resort ski slopes, higher speeds, and enthusiasts’ attempts at more technically difficult maneuvers made popular by the Olympics and other televised competitions have upped the risk for collisions and falls and resulted in more serious injuries, especially to the spine,” states Yalamanchili.
Scientists agree. In a 2019 study published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine, authors write that, while the overall trauma rate among skiers and snowboarders has declined somewhat, the number of spinal injuries “has either plateaued or increased slightly,” with the most likely trauma being vertebral fractures.
Meanwhile, the incidence of overall alpine-related injuries continues to rise as an ever-growing number of enthusiasts take to the slopes. In a 2017 study published in the Journal of Orthopaedic Surgery and Research, investigators estimate the number of active skiers and snowboarders worldwide at 270 million.
Among the more common spinal injuries on the slopes, Yalamanchili says, are:
· Cervical fractures or dislocations, particularly those involving the vertebrae at the very top of the spine. They occur when a fall or collision causes the head and neck to severely hyperextend (move too far backwards) or hyperflex (move too far forward) – much like whiplash in a car crash.
· Chance fractures of the thoracic spine or mid- and upper-back, which can result from a high-impact injury (like hitting a tree branch while skiing) or overly quick movements affecting the spine, as might happen during a high-speed fall. Chance fractures, which happen when the spine forcefully flexes and extends, can affect spinal ligaments, bone, and spinal discs, usually at the juncture of the thoracic and lumbar spine columns.
· Lumbar (lower) back injuries, the more likely being compression fractures or burst fractures when a person lands hard on the buttocks or feet. The resulting force is transmitted to the spine, pushing bones on top of each other or causing starburst-like vertebral fractures.
Scientists writing in a November 2019 issue of Current Sports Medicine Reports indicate spinal injuries account for as much as 17 percent of all traumas on the slopes, with the lumbar spine being the most commonly involved among skiers and snowboarders alike. However, “the majority of severe spinal injuries occur in skiers, while spinal injuries in snowboarders tend to be more stable…Injuries in skiing are more often due to high-speed collisions leading to distraction and rotation injuries, whereas injuries in snowboarding are more often due to jumps and falls,” the authors note.
Of course, as is the case with a variety of other sports, long years of skiing may eventually lead to various forms of chronic spinal degeneration, Keeping as fit as possible can sometimes delay the effects of time on the spine and allow one to continue enjoyable sports activities well into the senior years.”
Experts contend spinal injuries as a result of skiing or snowboarding are relatively uncommon, but when they do occur, they can be life-altering and even life-threatening, says Yalamanchili. The authors of the Scandinavian journal article indicate that, within the population they studied, less than 1 percent of skiers or snowboarders with spinal injuries were fully recovered at the time of hospital discharge. “One might surmise that a portion of these individuals could go on to experience long-term or chronic morbidities as a result of their spinal trauma,” Yalamanchili says.
“The back is a complicated structure of tendons, muscles, overlapping ligaments holding spinal vertebrae in place, and an array of nerves emanating from the spinal column. Anything that disrupts the ways in which all these parts work together – strains, muscle and tendon pulls, spinal disc failure, nerve compression, injuries to bone or soft tissues – can create significant and painful repercussions,” Yalamanchili explains.
Although some researchers note that much of the focus to date has been on minimizing injury risk to the head and upper and lower extremities in alpine sports rather than protecting the spine. Yalamanchili advises the following steps to help improve one’s overall chances for a carefree winter of sports:
· Wear the proper gear, including a back protector that can help reduce the potential for sustaining a severe spinal injury while skiing or snowboarding.
· Warm up muscles and hydrate before heading out to the slopes.
· “Buddy up.” Avoid skiing or snowboarding alone.
· Do not engage in alpine activities when tired or impaired by medications, alcohol, or other drugs.
· Be aware of all safety rules and issues for the slopes you are about to use.
· Slow down
“And, most importantly, take lessons from alpine sports professionals. Skiing and snowboarding are not do-it-yourself activities that you can learn by simply watching YouTube,” Yalamanchili concludes.
Sridhar Yalamanchili, PT, MSPT Cert.MDT treats a variety of spinal and upper and lower body musculoskeletal disorders as lead clinician in outpatient physical therapy at the Atlantic Spine Center. www.painandrehab.com