 Dr.
D’s take.
What has
been suggested is that when the spinal cord is in extension
(arching to look over your back at a wave
or just good positioning
on the board while looking forward) it creates a stressful
situation for blood flow.
The blood vessels in the spine run along the front and back
of the spinal cord. The spinal cord is the soft part of the
spine
comprised of nerves that run through the spinal canal. The spinal
canal is made up of a tunnel thru the bone in your spinal column
(the bony part of your back.
So
what is thought to happen is that from the arching of the back
it is just enough to decrease the flow of blood or kink off
the tiny blood vessels much like kinking off a hose. To the
unconditioned
back that is not used to arching in such a matter this can
result in just enough “tissue ischemia” or lack of oxygen
to the spinal cord tissue. Our brain and our spinal cord get very
upset when the don’t get sugar or oxygen. Just the same as
when you stop breathing from a heart attack it doesn’t take
much time to cause damage. Now in 80% of the reported cases these
symptoms are temporary. The spinal cord goes into a state of shock
most likely from swollen nerve cells deprived of oxygen that calm
down and return to normal function.
 The
image at left shows an actual
cut into the tissue covering your spinal cord. This is if you
were looking at the back of someone’s neck. See all
the fine small blood vessels? Wouldn’t take much to pinch
them huh?
So who is
at risk?
These cases
presented in beginning surfers. In most cases the ones spending
too much time in the water the first
time out.
Certain
people with bony anatomy may be more prone as well but from
the published studies the patients have ranged from skinny
to big
and bulky. Those with other conditions that cause damage
to their blood
vessels and limit blood circulation in the small arteries
like diabetics (sugar damages small blood vessels) and smokers
(chemicals
in cigarette smoke causes damage to the walls of small blood
vessels and decrease the level of oxygen in your blood when
you are smoking)
may be more at risk.
The image
below right
is looking as if you were facing a person looking at their
chest,
no chest is seen here of course. See how small the space is
where the blood vessels are barely fitting between the bone.
Wouldn’t take much to pinch that area closed.  How do I
prevent it?
Just like
everything else, moderation and take it slow. Don’t
go out and surf for 4 hours the first time because your
buddy without a job is doing it everyday.
• Don’t
spend more than 45 minutes in the water. When you are not paddling
sit up and arch your body forward to
stretch your back.
• Don’t
lay on your board like a wet tuna straining your head and neck
to see the waves coming because
you are afraid
of loosing
balance if you sit up.
• Stay
well hydrated-the more dehydrated you are the less efficient
you
are at pumping blood
around and
your joint
spaces in your
back are more narrow when you are dehydrated.
• Make
sure you are physically fit by seeing a doctor before you
partake in any new sport.
• And
last but not least don’t
give into the “I gotta
learn it yesterday and be good” attitude
that everyone has these days. Surfing is as
difficult as any other sport, the surroundings
and feeling you get in the water is the high
you should be appreciating when starting out.
See you next
time with more cool pics and medical verbiage (at least one
gross-you-out-pic guaranteed
every time).
Sincerely,
Dr. Derek Lodico
Lieutenant, US Navy | 