Surfer's Back: Difference between revisions

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[[File:Surfing.jpg|right|frameless]]
== Introduction ==
Surfing is popular with participants on coastlines throughout the world. At some stage most surfers experience some degree of lower back pain or stiffness. A 2014 Australian study reporting it as the highest ranking of surfing injuries at 23.3%.<ref name=":0">Furness, James & Hing, Wayne & Abbott, Allan & Walsh, Joe & Sheppard, Jeremy & Climstein, Mike. (2014). [https://www.researchgate.net/publication/321739698_Retrospective_Analysis_of_Chronic_Injuries_in_Recreational_and_Competitive_Surfers_Injury_Location_Type_and_Mechanism/citation/download Retrospective Analysis of Chronic Injuries in Recreational and Competitive Surfers: Injury Location, Type, and Mechanism.] International Journal of Aquatic Research and Education. 8. 10.25035/ijare.08.03.06. Available from: https://www.researchgate.net/publication/321739698_Retrospective_Analysis_of_Chronic_Injuries_in_Recreational_and_Competitive_Surfers_Injury_Location_Type_and_Mechanism/citation/download</ref>[[File:Surfing.jpg|right|frameless]]The most common form of lower back pain when surfing is characterised by tight muscles and a constant dull ache, and is most often caused by an over-arching low back and very stiff upper back. Unfortunately, many surfers are also plagued by back pain that hinders or terminates their participation in the sport.<ref>Hammer RL, Loubert PV. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953347/ Alternative pop-up for surfers with low back pain.] North American journal of sports physical therapy: NAJSPT. 2010 Feb;5(1):15. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953347/ (last accessed 15.9.2019)</ref>


== Introduction ==
The older surfers (age higher than 40) and more experienced surfers (more than 20 years of surfing) have higher relative risks of injuries, with the 35-55 age bracket being the most affected by lower back pain.<ref>Bazanella, N.V., Garrett, J.G.Z.D.A., Gomes, A.R.S., Novack, L.F., Osiecki, R. and Korelo, R.I.G., 2016. [http://www.scielo.br/scielo.php?pid=S1809-29502016000400394&script=sci_arttext&tlng=en#B3 Association between low back pain and functional/kinetic aspects of surfers: disability, function, flexibility, range of motion and angle of the thoracic and lumbar spine.] ''Fisioterapia e Pesquisa'', ''23''(4), pp.394-401. Available from: http://www.scielo.br/scielo.php?pid=S1809-29502016000400394&script=sci_arttext&tlng=en#B3 (last accessed 16.9.2019)</ref>
Surfing is popular with participants on coastlines throughout the world. At some stage most surfers experience some degree of lower back pain or stiffness. A 2014 Australian study reporting it as the highest ranking of surfing injuries at 23.3%.<ref name=":0">Furness, James & Hing, Wayne & Abbott, Allan & Walsh, Joe & Sheppard, Jeremy & Climstein, Mike. (2014). [https://www.researchgate.net/publication/321739698_Retrospective_Analysis_of_Chronic_Injuries_in_Recreational_and_Competitive_Surfers_Injury_Location_Type_and_Mechanism/citation/download Retrospective Analysis of Chronic Injuries in Recreational and Competitive Surfers: Injury Location, Type, and Mechanism.] International Journal of Aquatic Research and Education. 8. 10.25035/ijare.08.03.06. Available from: https://www.researchgate.net/publication/321739698_Retrospective_Analysis_of_Chronic_Injuries_in_Recreational_and_Competitive_Surfers_Injury_Location_Type_and_Mechanism/citation/download</ref>  


The most common form of lower back pain when surfing is characterised by tight, spasmy muscles and a constant dull ache, and is most often caused by an over-arching low back and very stiff upper back. Unfortunately, many surfers are also plagued by back pain that hinders or terminates their participation in the sport.<ref>Hammer RL, Loubert PV. [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953347/ Alternative pop-up for surfers with low back pain.] North American journal of sports physical therapy: NAJSPT. 2010 Feb;5(1):15. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953347/ (last accessed 15.9.2019)</ref>
NB - This page describes and evaluates the common forms of surfers back. If assessment reveals any eg.[[The Flag System|red flags]], [[Spinal Masqueraders|spinal masqueraders]], suspected [[Lumbar Spine Fracture|spinal fracture]] be sure to liaise with appropriate medics and investigate as needed.
[[File:Surfer.jpg|right|frameless]]
[[File:Surfer.jpg|right|frameless]]


== Common Causes of Back Pain in Surfers ==
== Common Causes of Back Pain in Surfers ==
1.Large amount of time spent in the prone position. A recent study finding that 38.5% of the mechanisms of chronic lower back injury were attributed to both prolonged paddling and lying on the surf board, both of which involve lying prone.
The most common reasons for low back in surfers is due to one or or of the following
 
1.Large amount of time spent in the prone position. A recent study finding that 38.5% chronic lower back injury were attributed to both prolonged paddling and lying on the surf board, both of which involve lying prone.<ref name=":0" />
 
2.Prolonged extension of the lumbar thus facet joints in a closed pact position. Adding paddling to this hyperextended position for extended periods of time and again increases the demands on the low back and may predisposes it to chronic injury.
 
3.Inadequate extension in the thoracic and cervical spine increasing the  demands of extension on the low back<ref name=":0" /> (The low back forced to do more extension than it would normally do).
 
4.Explosive turning, cutting, and twisting movements often combining the trunk movements of flexion and rotation combined predispose the lower back to chronic injury<ref name=":0" />
 
5.Insufficient core stability (an integral part of surfing). The core is required to perform manoeuvres and to protect the body, especially the spine, from injury by stabilisation. Also an important function is to stabilise the trunk to enable precise movement of the extremities (needed in the completion of surfing manoeuvres).<ref>Liisa Airaksinen [https://www.theseus.fi/bitstream/handle/10024/63501/Airaksinen_Liisa.pdf?sequence=1&isAllowed=y THE ROLE OF CORE STABILITY IN]
 
[https://www.theseus.fi/bitstream/handle/10024/63501/Airaksinen_Liisa.pdf?sequence=1&isAllowed=y SURFING] Melbourne, Australia. Bachelor Degree Program in Physiotherapy May 2013 Available from: https://www.theseus.fi/bitstream/handle/10024/63501/Airaksinen_Liisa.pdf?sequence=1&isAllowed=y (last accessed 16.9.2019)
</ref>
 
6. Insufficient flexibility and strength of muscles in lower kinetic chain and spine.
 
== Subjective Assessment  ==
Questions to ask include:
 
Past back problems?
 
Any accidents falling off board?
 
Check for any red flags i.e recent malignancy, unremitting pain, weight loss etc.
 
Is it chronic, sub-acute or acute?


2.Prolonged extension of the lumbar causing the  facet joints to be in a closed pact position. Paddling in the prone, hyperextended position for extended periods of time puts increased demands on the low back and predisposes it to chronic injury.
Recent changes in surfing regime


3.Inadequate extension in the thoracic and cervical spine increases the  demands of extension on the low back<ref name=":0" />
What type of work do they do, as this may predispose to back pain


4.Explosive turning, cutting, and twisting movements often combining the trunk movements of flexion and rotation combined may predispose the lower back to chronic injury<ref name=":0" />
How long does it take for pain to come on?


== Sub Heading 3 ==
Is it only with certain movements or manoeuvers?


== Resources  ==
== Objective Assessment ==
*bulleted list
Include at a minimum the following
*x
* Surfing position and "pop up" technique - look out for: hyperextension back, stiff segments back, poor flexibility/strength with "pop up"(All these can contribute to a potential cause of the problem).
or
* Check movement in spine looking for :stiff or hyper mobile joints; scoliosis; kyphosis; excessive lordosis etc
* Muscle lengths and strength should be assessed in the major muscles involved in surfing.These include: core muscles as involved in stabilising/supporting pelvis; hip flexors; thigh muscles; quadratus lumborum; erector spinae
* Neurodynamic tests: LLTT's


#numbered list
== Physiotherapy Treatment  ==
#x


== References  ==
== References  ==

Revision as of 07:47, 16 September 2019

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Top Contributors - Lucinda hampton, Wanda van Niekerk, Kim Jackson, Shaimaa Eldib and Tony Lowe  

Introduction[edit | edit source]

Surfing is popular with participants on coastlines throughout the world. At some stage most surfers experience some degree of lower back pain or stiffness. A 2014 Australian study reporting it as the highest ranking of surfing injuries at 23.3%.[1]

Surfing.jpg

The most common form of lower back pain when surfing is characterised by tight muscles and a constant dull ache, and is most often caused by an over-arching low back and very stiff upper back. Unfortunately, many surfers are also plagued by back pain that hinders or terminates their participation in the sport.[2]

The older surfers (age higher than 40) and more experienced surfers (more than 20 years of surfing) have higher relative risks of injuries, with the 35-55 age bracket being the most affected by lower back pain.[3]

NB - This page describes and evaluates the common forms of surfers back. If assessment reveals any eg.red flags, spinal masqueraders, suspected spinal fracture be sure to liaise with appropriate medics and investigate as needed.

Surfer.jpg

Common Causes of Back Pain in Surfers[edit | edit source]

The most common reasons for low back in surfers is due to one or or of the following

1.Large amount of time spent in the prone position. A recent study finding that 38.5% chronic lower back injury were attributed to both prolonged paddling and lying on the surf board, both of which involve lying prone.[1]

2.Prolonged extension of the lumbar thus facet joints in a closed pact position. Adding paddling to this hyperextended position for extended periods of time and again increases the demands on the low back and may predisposes it to chronic injury.

3.Inadequate extension in the thoracic and cervical spine increasing the demands of extension on the low back[1] (The low back forced to do more extension than it would normally do).

4.Explosive turning, cutting, and twisting movements often combining the trunk movements of flexion and rotation combined predispose the lower back to chronic injury[1]

5.Insufficient core stability (an integral part of surfing). The core is required to perform manoeuvres and to protect the body, especially the spine, from injury by stabilisation. Also an important function is to stabilise the trunk to enable precise movement of the extremities (needed in the completion of surfing manoeuvres).[4]

6. Insufficient flexibility and strength of muscles in lower kinetic chain and spine.

Subjective Assessment[edit | edit source]

Questions to ask include:

Past back problems?

Any accidents falling off board?

Check for any red flags i.e recent malignancy, unremitting pain, weight loss etc.

Is it chronic, sub-acute or acute?

Recent changes in surfing regime

What type of work do they do, as this may predispose to back pain

How long does it take for pain to come on?

Is it only with certain movements or manoeuvers?

Objective Assessment[edit | edit source]

Include at a minimum the following

  • Surfing position and "pop up" technique - look out for: hyperextension back, stiff segments back, poor flexibility/strength with "pop up"(All these can contribute to a potential cause of the problem).
  • Check movement in spine looking for :stiff or hyper mobile joints; scoliosis; kyphosis; excessive lordosis etc
  • Muscle lengths and strength should be assessed in the major muscles involved in surfing.These include: core muscles as involved in stabilising/supporting pelvis; hip flexors; thigh muscles; quadratus lumborum; erector spinae
  • Neurodynamic tests: LLTT's

Physiotherapy Treatment[edit | edit source]

References[edit | edit source]

  1. 1.0 1.1 1.2 1.3 Furness, James & Hing, Wayne & Abbott, Allan & Walsh, Joe & Sheppard, Jeremy & Climstein, Mike. (2014). Retrospective Analysis of Chronic Injuries in Recreational and Competitive Surfers: Injury Location, Type, and Mechanism. International Journal of Aquatic Research and Education. 8. 10.25035/ijare.08.03.06. Available from: https://www.researchgate.net/publication/321739698_Retrospective_Analysis_of_Chronic_Injuries_in_Recreational_and_Competitive_Surfers_Injury_Location_Type_and_Mechanism/citation/download
  2. Hammer RL, Loubert PV. Alternative pop-up for surfers with low back pain. North American journal of sports physical therapy: NAJSPT. 2010 Feb;5(1):15. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2953347/ (last accessed 15.9.2019)
  3. Bazanella, N.V., Garrett, J.G.Z.D.A., Gomes, A.R.S., Novack, L.F., Osiecki, R. and Korelo, R.I.G., 2016. Association between low back pain and functional/kinetic aspects of surfers: disability, function, flexibility, range of motion and angle of the thoracic and lumbar spine. Fisioterapia e Pesquisa23(4), pp.394-401. Available from: http://www.scielo.br/scielo.php?pid=S1809-29502016000400394&script=sci_arttext&tlng=en#B3 (last accessed 16.9.2019)
  4. Liisa Airaksinen THE ROLE OF CORE STABILITY IN SURFING Melbourne, Australia. Bachelor Degree Program in Physiotherapy May 2013 Available from: https://www.theseus.fi/bitstream/handle/10024/63501/Airaksinen_Liisa.pdf?sequence=1&isAllowed=y (last accessed 16.9.2019)