Friday, December 20, 2013

Snowboarding Can Be a Pain in the Rear...


Some time ago, I thought it would be great fun to learn how to snowboard. And it was...until the third day, when I was gathering speed linking my self-proclaimed awesome S turns (instead of my falling leaf) and I had to stop suddenly for a youngster that cut across my path and BOOM- I slammed right down on my rear. When the stars faded from my vision, the throbbing in the seat of my pants had my full, undivided attention- I had fractured my tailbone. For the next several months, my days were filled with apologies to our patients for appearing rude by not sitting as I listened to their concerns...but I could only sit on an inflatable "donut" that I was too vain to bring into each exam room.

Tailbone (coccyx) injuries are some of the most common snowboard injuries, although certainly they occur in other situations. Whether it is a bruise, dislocation or fracture, these injuries are caused by self-induced trauma such as falling hard on your rear end, a direct blow (your friend smashing in to you on their skis, or perhaps a contact sport like football), childbirth, or repetitive strain (such as bicycling). A bruise may or may not be visible, and the pain is typically worse when sitting or if you press on the affected area (either topically or via a bowel movement or intercourse.) X-rays can be tricky to interpret, often requiring both sitting and standing views for best accuracy.

Treatment is largely avoidance of pressure on the area, as obviously casting is not practical! Avoid prolonged sitting, and use an inflatable cushion if possible (the donut). Avoid constipation so you don't get additional pain from a hard bowel movement (so eat high fiber and drink lots of water!) Anti-inflammatory medications such as ibuprofen can help reduce pain, and using ice packs for 10-20 minutes several times per day the first few days will also help. If your pain is not controlled by these methods, it's time to head to see a doctor. They will not have a miracle cure, but can offer further diagnostics (to be sure you don't have a displaced fracture) and possibly stronger pain medications.

BOTTOM LINE: Protect YOUR "bottom line" by using padding if you are learning to snowboard and exercise caution by wearing "gripping" shoes on icy surfaces to avoid falling, and again, remember to protect your HEAD with a HELMET!

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