Jeffrey R. Carlson, MD
As we pass through the summer heat, we start to think about fall outdoor activities to keep ourselves moving. Bicycling through the mountains, viewing the fall colors and enjoying the breeze sounds great. Please be safe!
Even though a lovely bike ride is inviting, researchers at the Harvard Medical School evaluated the patients that they had treated for traumatic spinal cord injuries. The Brigham and Women’s Hospital is a large trauma center in Boston that gets referrals for spinal trauma. They found more than 12,000 cases of traumatic spinal cord injury. This represented 15% of all of their sports-related injuries. Most of the patients were male with an average age of 48. The most frequent activities included cycling (81%), skiing and snowboarding (12%), aquatics (3%) and contact sports (3%).
The spinal cord is very sensitive to compression, which is caused by flexion of the spine. Think of going over the handlebars and landing on your head – your body folds over as the impact forces your shoulders into the ground. The bones or ligaments of the spine can break under the load of your bodyweight, which then would allow the spinal canal to close around the spinal cord. The spinal cord will then be inflamed and in a state of shock. The swelling around the spinal cord will cause the nerves to stop functioning, leading to paralysis. This injury is an emergency, as the need to stabilize the spinal bones and remove any pressure from the spinal cord may help prevent long-term damage.
The best protection from a spinal cord injury is to not fall off of your bike. Unfortunately, accidents do happen, so be mindful of your surroundings and have an emergency plan for any mishaps. Head protection is the most important safety equipment to use to prevent head and cervical spine injuries. There is newly designed protective wear that includes harnesses and spinal protectors, which currently are expensive and cumbersome, but cycling manufacturers are working toward improving the safety of the sport.