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Traumatic injuries suffered from skiing accidents grab the headlines, however the majority of injuries result from overuse. Skiing technique and style correlate with the type of problem in most patients. Alvarado Hospital’s orthopedic surgeon and spine specialist, Dr. Ramin Raiszadeh discusses how to protect your back during ski season.

There are two common types of back injuries in skiers. The first type results from sustained flexion loading on the spine. In the tuck position, the spine is flexed forward causing increased pressure in the vertebral bone and discs. Degenerative disc disease can result from the wear and tear sustained by the discs from years of performing in this position. Acutely, a flexion and rotation injury can cause a disc herniation because of the increased load.

The second common type of injury due to overuse syndrome is a stress fracture. Skiers who stand in an erect position cause extension loading in the posterior elements of the spine. The incidence of stress fractures is often increased in slalom skiers who perform jet turns to increase acceleration through the gate. The constant loading of the spine in the erect position can cause impaction of the posterior facet joints and result in a stress fracture, a condition called spondylolysis.

“Preventing back pain on the slopes can be avoided when skiers and snowboarders are armed with the proper information on form, routine stretches and exercises,” said Dr. Raiszadeh.

Snowboarders may sustain either of the two injury types described above. By constantly shifted weight from flexion to extension and vice versa, snowboarders are at risk of either injury pattern.

The mainstay of treatment and prevention for both of these injuries is the same: a trunk stabilization program. The coordinated core program starts with the spine in a neutral, pain-free position. The athlete may progress to more advance exercises that involve balance and coordination, but only after mastering the basic neutral position. The trunk muscles are trained to remain locked in a balanced, neutral position thereby minimizing stress transferred to the spinal discs and joints.

The key is not the amount of exercise the athlete performs, but the quality of the exercise. The core spine muscles must be trained in the neutral, pain-free position.

Several basic exercises from the coordinated core program are demonstrated to help the skier build strength and coordination of the trunk muscles to help prevent injury. If an athlete has back pain, they should consult with their physician before undergoing any activity. A physical therapist can be extremely helpful to ensure the athlete is performing trunk stabilization exercises properly.