Recently I heard of a case of a condition called Surfer’s Myelopathy (SM) took place in Taiwan to a lady who was taking a beginners lesson. The injury left the woman with severe spinal injuries that took years to recover from. I was shocked, as while I have suffered and witnessed plenty of injuries and accidents in my 25 years of surfing (mostly caused by people hitting the reef) I have never heard of someone being left unable to walk after a simple surfing lesson. I have done a little research to try to understand the condition a little better to make sure that we can minimise the risk for our students. Below I set out a litle about what I found out on the rare condition, and also my own thoughts on how to lower the risk of such an injury or any other injury for that matter while in the water.
What is Surfer’s Myleopathy?
Surfer's myelopathy (SM) is a rare nontraumati paraplegia. It is a spinal cord injury caused by hyperextension of the back. When the back is hyperextended, a blood vessel leading to the spine can become kinked, depriving the spinal cord of oxygen. For this reason, it is sometimes referred to as "a stroke of the spinal cord. To simplify, it is a rare injury, not caused by a trauma (such as a fall) which damages the spinal cord and can leave a person potentialy paralised from the waist down. It is considered the cause is from over extending the back, or from having the back over extended (over arched) from the surfing posture.
Who is at risk?
Learners: The key risk factor seems to be inexperience as almost all persons afflicted were first-time surfers. A secondary risk factor seems to be fitness, in that people who are more sedentary with less developed muscles are more at risk as is dehydration (not drinking enough water).
What are the risks
Putting the danger in perspective, as the ASM website acknowledges, you have more risk of being attacked by a shark in the water than from getting SM. However, the risk while small is real, so if you are a first time surfer its worth to look at the tips below to minimise the risk of any injury.
Avoiding SM
The ASM website sets out the following Tips for First Time Surfers to avoid SM:
S – Sit on your board while waiting for the waves.
P – Pace your time in the water. Limit it to 30 minutes.
I – Insist on a knowledgable surfing instructor.
N – Notice signs of pain and discomfort in your back.
E – Exit the water and seek immediate medical attention if you experience pain or weakness.
I would add to this the following simple observations:
Walking out to the waves is better than paddling out and sitting on your board:
For first time surfers, in my opinion there is no need to paddle out or be in water at a depth where you can’t touch the ground. Why? The reason is simple, don’t waste your energy, and catch more waves. The goal in the first stage of surfing is to master the art of the paddle and the “pop up”, which is the action in which surfers use one motion to stand up on their surfboard. The key to mastering both of these quicker is simple – catch more waves. Big, small, white water, its all the same at this point. The way we run lessons is students walk with their own boards into the water out to the point where they are comfortable, then they turn their boards around and jump on and start paddling in to catch a wave. Thus there is no need to spend a prolonged time on your board at this stage lying down with your back arched in the paddling position. Its better to use your leg muscles to get your self out back, and then save your back for paddling in to catch waves. Otherwise you waste too much time and too much energy trying to paddle out back and lying in water that’s too deep. This technique will decrease the potential for SM as well as any other more normal strains from putting too much strain on the back. As you get better and more experienced and master the pop up, then you can start to paddle out and catch waves further out back. By that time your body and muscles will be more used to surfing and you are out of the SM high risk group.
Pay attention to your technique
I think this is under emphasised and consider that as almost all the sufferers of SM were first time surfers perhaps poor technique led to them putting an increased level of strain on their lower spines. Surf coaches should spend time and energy trying to install good technique into their students and not just to stand up faster but also to avoid injury.
The pop up requires a surfer to synchronise the movements of a jump forward (using the lower body) and a push up (using the upper body). It is crucial for injury avoidnce that these two motions are done together, however the difficulty for many first time surfers is that as it’s a new movement they lack the muscle memory to combine the actions together at the start. As a result I see a lot of first time students first extending their arms to push themselves up and then jumping forward, basically breaking down the one motion pop up into two separate movements. Some surf schools even teach this as its easier to get students standing this way and it feels safer to some students than the winner takes all pop up at once movement.
The danger is that breaking down the pop up into separate movements puts a great deal more strain on the lower back and spine than synchronising the movements. When you do the pop up movements together correctly it’s your shoulder, upper back muscles and feet that provide you with your upward and forward momentum together. The lower back and spine are basically neutral movers except for your hip twist when in the air. Thus no strain is put on your spine. However, if you first extend your arms, then jump forward, inorder to recreate the same momentum your initial push up would have given you to get your body jumping forward most students over extend their lower back using their hips and lower spine to create that second burst of forward momentum. This action places quite a lot of strain on the lower back and spine and increases the risk of straining or injuring the back. So when you are in the water, make sure you work hard to keep good technique. If you are getting muscle fatigue, take a rest on the beach for bit rather than risk injury through forcing it with poor technique.
Listen to and be patient with your body.
Often the most simple advise is the most effective – that is be realistic and patient with your body and to listen to it. We should all keep in mind the single and only important goal of surfing – fun. There is no need for anyone to push themselves past the point their body condition is in at that moment. So as I tell my students, relax and remember, its not important whether you stand up or not, but only that you have fun. If you have never surfed before and don’t do regular exercise, take it easy. Perhaps the first lesson just learning to paddle and surfing the waves lying down is enough. Its still super fun, and way more fun than straining your back or worse. If you need to take a break, have one, drink plenty of water and don’t pin your own progress to what others do, or your own expectations. If you enjoy what you are doing and progress as fast as your body is comfortable then you will certainly get there in the end. And most importantly you will enjoy the ride along the way which as every surfer knows is the end goal of surfing itself.
So, have fun, listen to your body and stay safe. See you in the ocean.
BTW, for anyone that is interested in reading more about SM please see the resources set out on the surfer’s myleopathy foundation wbsite at http://www.smawareness.org/
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