May I snowboard?

I always explain that my job is to teach people how to use their body well. I am well aware that this sounds very abstract at first, so let us see a practical example.

One of my patients recently asked whether he may snowboard during his holidays, despite his bad back (he has seriously damaged lumbar disks, with chronic radiating pain). What are the risks inherent to snowboarding, and the potential damage to his back in view of his condition? [...]

 There are 3 main risks linked to snowboarding:

• falls and shocks (e.g., when jumping), which will compress the lumbar spine,
• loosing balance backwards, which will contract the back muscles and put strain on the intervertebral joints,
• prolonged rotations in the lower back, due to the different orientation of the chest vs. the feet, which are a cause of disk overuse.

The first two can be managed by "taking it easy": we call them functional risks. They depend a lot on you. The third one is a structural risk: it's inherent to the activity. In theory, it should be avoided by this patient due to his lumbar condition.

Now, one should also recognize that activities he loves are good for his psyche, hence his body. Therefore, my final advice was

• to prevent risks 1 and 2: take it easy: no black slopes,
• due to the inherent risk (nr. 3), start by snowboarding 2 x 1hr on days 1 and 2, with a lunch break and relaxing exercises inbetween (here is an example). If things go fine, 2 x 2hr on day 3. Rest on day 4. If everything goes fine: increase to 2 x 2hr every day, always taking a day of break after 3-4 days of snowboarding, and always relaxing very regularly. 

The message could hence be: nothing is forbiden, it's just a matter of how you carry out the activities, (i.e. for how long and in which posture) and how you relax afterwards. My job is help you find your way. Of course, we also work together on your motivation: which support do you need from me and others to consolidate the new behaviour? For example, how can your family switch from (sometimes) being a stressor to being supportive? But this is another topic...