SETTING THE SCENE

It was December 28th 2019, a Saturday. It was only my third time up on the mountain this year so far and I was looking forward to taking full advantage of my season pass (never had one before). I had gone up with my sister-in-law and met up with a groups of friends at the mountain. It was just a normal day, the weather was decent, but the mountain was still very bare in some spots as the snowfall so far had been poor. Today was supposed to be another easy day, to get comfortable on the mountain again.

THE INCIDENT

The group and I were on a blue square run (moderate difficulty). They were ahead of me on a small cat-track that lead into the more open face. I ended up passing them at the entrance to the open face. I looked back at them to make sure they saw me enter and weren't waiting anymore. Unfortunately, when I did this my board started to drift and I ended up with my board in a "regular" position (I ride "goofy"). This was coupled with a skier above me speeding down the mountain, quickly approaching my position. Afraid I was going to collide with the skier I tried to get out of the way. Now, if you aren't a boarder one thing you have to understand is that it can be incredibly difficult to control your board when riding downhill in the opposite position. Imagine being a right-hand dominant individual trying to throw a baseball left handed. So my attempt to get out of the way amounted to little more than me throwing myself to the left and falling to the ground. At the time I felt a minor twinge in my neck, but I shrugged it off. I had taken much more intense falls in the past without any significant injury.

THE AFTERMATH

Despite the fall, I was able to keep boarding for several hours. Looking back I did start to notice a slowly increasing discomfort in my neck. However, it wasn't enough to affect my ability to snowboard.

At the end of the day, as my sister-in-law and I were walking back to the car the discomfort really started to kick in. When she asked if I could drive home so she could take a nap I joked back, "Sure! As long as you look left for me." During the 1.5 hour drive home things kept getting worse and worse. I didn't realize how bad things were until we got back to their house and upon seeing me my brother paused in his track and asked "What the heck did you do to your neck?!"

The first thing I did when I got home was go lie down on the couch to rest. After an acute injury like this that is progressing, it is okay to rest. The key is to make sure it is only temporary, and you have plans to get your issue addressed quickly.

After a few hours of binge watching Netflix I got started on trying to self-treat my neck. When trying to move my neck I felt a "block" for lack of a better word around the mid-level of my neck. However, I struggled to make any progress.

Luckily, my neck did not prevent me from getting a good night's sleep. Unfortunately, when I woke up in the morning I still could not get my head upright. My self-treatments were still not working and I was still lying on the couch, avoiding extended time in an upright posture to reduce strain on my neck.

That is when the fear started to set in. Yes, even a physical therapist can experience fear related to an injury. My fear was anchored in a sense of uncertainty and inappropiately superimposing my experience with previous patients also experiencing neck pain. I had never experienced such immobility, which led me down a dark path of worrying if I did some serious damage to my neck such as a spinal fracture, or ligament tear. I started focusing on my previous experience with patients who were suffering from severe neck pain. None of whom ever came into the clinic unable to achieve a neutral spine position, even my patient who had a cervical fracture at C1 leading to instability could at least achieve a neutral neck posture!

Luckily, I was able to interrupt these thoughts by going through the same mental checklist I do with all my patients. My pain did not prevent nor wake me up from sleep, I had no numbness/tingling or weakness in my arms, no issues with eating, speaking, or other red flag items that would be cause for concern.

After calming down I re-evaluated my situation, using the principles of the Selective Functional Movement Assessment (SFMA). Using these principles I started assessing my upper cervical spine and realized this region was not moving well. I started seeing immediate results treating my upper cervical spine. Soon I was able to get my neck into a neutral position! SUCCESS!!

MY FIRST DAY OF WORK

By Monday my neck was finally straight (but I still have very limited rotation to the left) and I was able to go to work treating patients all day. I was cautious with certain activities and used my hands to support my neck getting on and off the ground when demonstrating exercises. However, my neck did not impair my ability to perform my job duties. Although, by the end of the day I had an intense burning sensation between my shoulder blades.

THREE WEEKS AFTER INJURY

With continued self-manual therapy treatments and specific motor control exercises I continued to build on my success. Within three weeks I was able to perform all of my activities as a physical therapist including getting onto/off the floor, demonstrating various neck exercises, performing manual therapy without having to be concerned about my neck.

By week three I was ready to hit the slopes once again!

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