Each year thousands of families flock to the beaches during the summer months to enjoy the cool ocean temperatures. A knowledge of the common mechanism of spinal cord injury along with a healthy respect for the power of the ocean waves may prevent spinal cord injuries.
Basic Cervical Spine Anatomy
The cervical spine consists of 7 cervical vertebrae closely linked by facet joints (above and below each vertebrae), intervertebral discs, and multiple ligaments. The intervertebral discs distribute compressive loads from vertebrae to vertebrae while the ligaments restrict the range of motion of each motion segment (vertebrae, disc, vertebrae).
Located within the center of each vertebrae is a vertebral foramen (hole in the center of the vertebrae) which houses the spinal cord. As the spinal cord descends down through the vertebrae, spinal nerves branch out to either side.
The normal motions of the cervical spine include flexion (chin to chest), extension (chin away from chest), lateral flexion (ear to shoulder), and rotation (chin to shoulder). Any movement beyond a normal range can cause serious injury to the motion segment resulting in a possible injury to the spinal cord.
Mechanism of Cervical Spine Injuries
According to Project Wipeout (Hoag Presbyterian Hospital, 1979), there are four primary mechanisms for ocean-related cervical spine injuries. These include the following:
- Hyperflexion – the head is pushed forward until the chin is forced against the chest.
- Hyperextension – the head is forced backwards further than it can normally extend.
- Rotational – the head and body rotate in opposite directions.
- Vertical compression – the head is forced down directly onto the spine.
Project Wipeout is an educational program for children and young adults for the purpose of saving lives and preventing ocean-related injuries. The program was started during the summer of 1979 by Hoag Hospital medical staff after admitting five young people into their intensive care unit with severe spinal cord injuries.
Spinal injuries in adults have also been documented in research studies. A retrospective analysis of 100 patients was undertaken at the University of Hawaii reviewing the water sports spinal cord injuries sustained between 1993-1997 (Change, S.K., Tominaga, G.T., Wong, J.H., Wedone, E.J., & Kaan, K.T., 2006).
Patients were treated for fracture, subluxation, and/or dislocation (29 patients) with an average age of 48. A majority of those treated were males (89%) and had large builds (75%). Of those injured, 65% had pre-existing cervical spine abnormalities (spinal stenosis or degenerative spondylosis).
Dr. Luis Robles, M.D. reviewed the injuries sustained by 16 patients treated between January 1999 to May 2005 (Journal of Neurosurgery, May 2006). The findings concurred with the above research in that high risk patients were older people with preexisting cervical spondylosis.
Dr. Robles concluded that cervical spine injuries were linked to inexperienced swimmers along with patients who underestimated the danger of the waves. The most common mechanism of injury in this study was hyperextension.
Preventing Spinal Cord Injuries at the Beach
Activities such as bodysurfing, diving through waves, and jumping off of piers and rock jetties can lead to serious spinal cord injuries. Because spinal cord injury can last a lifetime, children as well as adults need to be taught how to properly protect their head and neck while in the ocean.
Safety information can be obtained through Hoag Hospital’s Project Wipeout website. Educational information can be downloaded including an activity book, coloring book, and educational brochure. Teaching packets can also be obtained along with an educational video by contacting the Project Wipeout Director.
Terry Zeigler - Educating through writing with over twenty-five years of experience as a Kinesiology Professor and Certified Athletic Trainer.
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