Surfer's Neck

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Surfer's Neck - Clinically Relevant Anatomy[edit | edit source]

Neck Upper Back.png

Surfing is enjoyed by many people around the world. Surfing involves dynamic moves on an unstable surface needing good body strength, coordination and balance.A common problem for surfers is Surfer's neck (and Surfer's Back)

The muscle, facet joints, foramina of vertebrae, nerves and fascia are some of the structures that may be involved in the pain mechanism. Fortunately these niggles can often be rectified with some good manual therapy techniques, correction of surfing technique (if needed) and a good rehabilitation program incorporating stretches, strengthening and co-ordination and postural training.

Mechanism of Injury / Pathological Process[edit | edit source]

Neck Pain is a common niggle for surfers and is often caused by overuse.

Common causes may be attributed to

  • Large amount of time spent in the prone position with neck in extension. Prolonged extension of the cervical facet joints in a closed packed position (whilst paddling) increases the demands on the structures of the upper spine and associated soft tissues.
  • Inadequate extension in the thoracic, increasing the demands of extension on the cervical spine.
  • Turning, cutting, and twisting movements of the spine and neck predispose the neck to overuse injury.
  • Insufficient flexibility and strength of muscles in upper kinetic chain and spine.
  • Surfing Hawaii.jpg
    Poor surfing technique eg with paddling
  • Poor postural alignment predisposing injury
  • Poor breathing technique ie upper chest, neck muscle breathing pattern not diaphragm breathing.

Clinical Presentation[edit | edit source]

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Diagnostic Procedures[edit | edit source]

add text here relating to diagnostic tests for the condition

Outcome Measures[edit | edit source]

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Management / Interventions[edit | edit source]

Exercise treatment appears to be beneficial in patients with neck pain. There is some evidence to support muscle relaxants in acute neck pain associated with muscle spasm, conflicting evidence for epidural corticosteroid injections for radiculopathy, and weak positive evidence for cervical facet joint radiofrequency denervation.[1]

Physiotherapy[edit | edit source]

Differential Diagnosis[edit | edit source]

Surfer's myelopathy, Surfer's myelopathy is a atraumatic thoracic/conus medullaris myelopathy with only a 42% neurological recovery rate, almost uniformly affecting young, healthy, novice surfers who have no pre-existent spinal disease. Symptoms usually start with back pain and rapidly progress to complete or incomplete myelopathy. Emergency physicians must be better informed about surfer's myelopathy. Novice surfers and instructors should be educated on the early signs and symptoms of this condition.[2]

Vertebrae injury or fracture An retrospective analysis of surfer's in Australia found an incidence of .5% and .3% respectively[3] A multitude of different injuries occur in the cervical spine and depend on the position the surfer is in when they strike the sea floor relative to the force vector of the wave. Flexion, extension, axial load, rotation, and a variety of different combinations may result in fractures, dislocations, or spinal cord injuries (predominantly contusions).[4] Make sure to include in subjective examination recent trauma.

Spinal cord injury

Resources

add appropriate resources here

References[edit | edit source]

  1. Cohen SP. Epidemiology, diagnosis, and treatment of neck pain. InMayo Clinic Proceedings 2015 Feb 1 (Vol. 90, No. 2, pp. 284-299). Elsevier. Available from: https://www.mayoclinicproceedings.org/article/S0025-6196(14)00833-7/fulltext (last accessed 18.9.2019)
  2. Freedman BA, Malone DG, Rasmussen PA, Cage JM, Benzel EC. Surfer's myelopathy: a rare form of spinal cord infarction in novice surfers: a systematic review. Neurosurgery. 2015 Oct 30;78(5):602-11.Available from: https://www.ncbi.nlm.nih.gov/pubmed/27082966 (last accessed 18.9.2019)
  3. Meir R et al. An investigation of surf participation and injury prevalence in Australian surfers: a self-reported retrospective analysis. Gosford Australia Southern Cross University ePublications@SCU; 2011 Available from:https://epubs.scu.edu.au/cgi/viewcontent.cgi?article=1901&context=hahs_pubs (last accessed 18.9.2019)
  4. Dimmick S, Sheehan P, Brazier D, Anderson SE. Injuries sustained while surfboard riding. Skeletal radiology. 2013 Apr 1;42(4):463-5. Available from: https://link.springer.com/article/10.1007/s00256-012-1536-9 (last accessed 18.9.2019)