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Most Common Spinal Injuries in Skiers and Snowboarders

Published December 1, 2020
| Written By SpineNation Editorial Staff  
Skiing and snowboarding are two of the most popular winter sports in the United States, at least in those parts of the country with access to fresh powder. While both activities are great forms of exercise and a way to get outside during the colder months, injuries occur. Some research has found that the most common type of skiing or snowboarding injury is traumatic brain injury, followed by spinal injuries. Many people injured on the slopes have two or more injuries. In this study, snowboarders were more likely than skiers to suffer injuries. In addition, people over 40 years old were more likely to sustain injured than younger adults. To get a sense of the most common types of spinal injuries in skiers and snowboarders, we talked to Dr. Ernest Braxton, a neurosurgeon at Vail-Summit Orthopaedics and Neurosurgery. Research, in Colorado.

Common skiing and snowboarding spinal injuries

Braxton says traumatic spinal injuries among skiers and snowboarders fall into three categories, based on the three parts of the spine.

Cervical spine, or neck

“I see a lot of cervical lateral mass fractures and facet dislocations,” says Braxton. “Those injuries generally occur when there’s an acute deceleration and either hyperextension or hyperflexion of the neck.”

Lateral mass fractures. The spine is made up of bones known as vertebrae that are stacked one on top of the other. The topmost vertebrae in the spine is known as the atlas. It supports the head. The bulky parts on the sides of the atlas are known as the lateral masses. When a skier stops suddenly, such as by running into another skier or a stationary object, the neck can bend too far backward (hyperextension) or too far forward (hyperflexion). Similar to the whiplash that occurs during a car accident, this can cause a fracture in the lateral masses. It destabilizes the spine and can damage the spinal cord or nerves.

Facet dislocation. On the back of each vertebra is a bony projection called the spinous process. Part of the spinous process forms what’s known as a facet (fa·suht) joint with the adjacent vertebra above and below. These joints provide stability to the spine. There are two facet joints between each pair of vertebrae. Stopping suddenly while skiing or snowboarding can also cause the facet joints to fracture or dislocate. During dislocation, one part of the joint moves further forward than the other part. This will destabilize the spine and may also damage the spinal nerves.

Thoracic spine, or upper and mid-back

Chance fracture. “With the thoracic spine we see a lot of chance fractures,” says Braxton. “That usually occurs when you hit a fixed object at a high rate of speed. The classic one is when you fall out of the window and land on a tree branch.”This compression can occur if you hit something like a tree branch while skiing. It can also be caused by other sudden movements in the spine. “I saw a chance fracture with a snowboarder when he did what’s called a scorpion, where he flipped his legs behind his head while falling,” says Braxton. This high impact can cause a chance fracture at the junction where the thoracic spine meets the lumbar spine or lower back. The fracture extends from the front part of the vertebra to the back part and can also include the spinous processes. People with this injury may not have any nerve-related symptoms, but abdominal injuries often occur because of the impact.

Lumbar spine, or lower back

Burst fracture. “Probably the most common type of injury we see in the lumbar spine is what’s called a burst fracture,” says Braxton. “This occurs when you land on your feet or the buttocks, and the force is transmitted up your spine, causing a kind of starburst pattern fracture in a vertebra.”Burst fractures are more severe than compression fractures, which can also occur when you land hard on your feet or bottom while skiing or snowboarding. Braxton says it generally occurs in a single vertebra. If the fracture is severe enough, it can damage the spinal cord and cause paralysis or nerve injury.
Chronic injuries among skiers and snowboarders

Not all injuries experienced by skiers and snowboarders are traumatic. Some can develop slowly over years, what’s known as a chronic or degenerative condition. Many of these are more likely to occur in older skiers and snowboarders. These conditions can also increase the risk of traumatic injuries during falls or collisions. Braxton says some of the most common chronic spine conditions that he sees in skiers and snowboarders include:

  • Degenerative disc diseaseIn between each pair of vertebrae is a spinal disc that provides cushioning and helps the vertebrae move smoothly. As you age, the discs become less flexible and wear down. This doesn’t always cause symptoms, but some people may experience pain around the weakened disc or other symptoms.
  • Spondylolisthesis. With this condition, a vertebra slips out of place. This can happen because of a stress fracture, but it can also be because of a degenerative condition. As you age, the discs in between the vertebrae can become thinner, which makes it easier for a vertebra to slip out of place. This can cause lower back pain or numbness, tingling, or weakness in the legs.
  • Lumbar disc herniationIf the outer part of a spinal disc becomes weaker, the softer inner part can bulge or push out. This can compress the spinal nerves and cause symptoms such as numbness, tingling, or weakness in the legs.

Treatment and prevention of spinal injuries

Braxton says the treatment for a spinal injury depends on the condition and the symptoms. “We would treat a dislocated facet differently than we would treat a burst fracture,” he says. “However, a lot of the traumatic injuries of the spine respond to spine stabilization, such as fusion.”Degenerative conditions would also be treated differently, he says, but the goal is still the same — stabilize the spine and maintain as much of a person’s functioning as possible.You can’t always prevent traumatic injuries that occur during skiing or snowboarding, but Braxton says strengthening your core muscles in the off-season can help reduce your risk of these kinds of injuries. “You have to engage your core muscles a lot to be a good skier,” he says. “If they’re weaker, you’re more likely to fall and have a trauma, or develop a chronic degenerative condition.”Other ways to prevent injuries on the slopes include:

  • Take skiing or snowboarding lessons if you’re new to the sport or want to improve your skills.
  • Wear protective gear, such as a helmet and knee braces.
  • Warm up beforehand, which will reduce your risk of injuring a muscle.
  • Eat and hydrate appropriately.
  • Don’t ski or snowboard beyond your abilities.
  • Don’t hit the slopes while impaired

Summary

Skiing and snowboarding are both great forms of exercise during the winter, but injuries can occur. This includes traumatic spinal injuries such as fractured or dislocated vertebrae, as well as chronic conditions like a herniated disc or degenerative disc disease. Treatment for these depends on the type of injury or condition. While not every injury can be prevented, skiers and snowboarders can take steps to reduce their risk of injury while on the slopes. One of the most important ways to stay safe is to strengthen your core during the off-season.
Updated: November 20, 2020
Disclaimer

Information provided within this article is for educational purposes and is not a substitute for medical advice. Those seeking specific medical advice should consult his or her doctor or surgeon. If you need to consult with a specialist, you may be able find a health care provider in our Specialist Finder. SpineNation does not endorse treatments, procedures, products or physicians.


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