His first surfing lesson ended in paralysis: Understanding 'surfer's myelopathy'

Within just a few minutes of falling slightly from his surfboard, a man in his 30s, who had gone out for his first-ever surfing lesson, found himself completely unable to move his legs. This shocking case, revealed in the medical journal 'BMJ Case Reports', led the medical community to investigate a rare and mysterious syndrome known as 'surfer's myelopathy'.

The incident began during the basic learning stages. The patient was standing on the board, tried to turn left to maintain balance, and was subsequently thrown into the water by a wave. He felt sharp pain in his lower back but managed to finish the lesson on his own. The disaster only began to unfold once he left the water: while walking on the beach, he felt numbness in his toe, and within less than half an hour, the loss of sensation spread up his legs, leaving him paralyzed in his lower body, alongside severe impairment of internal system functions.

The medical team at the CUF Tejo Hospital in Lisbon, led by researcher Nuno Ribeiro Pereira, faced a highly complex diagnosis. According to Pereira in an interview with the medical website 'MedPage Today':

'When we see such conditions in the emergency department, we immediately think of something traumatic.'

Despite initial suspicions of an accident or direct physical injury to the spine, such as a collision with the seabed, initial CT scans were completely normal. Only more advanced tests, including vascular catheterization, revealed the frightening truth: central arteries in the spine suffered from severe narrowing and blockages that led to the cessation of blood flow.

After ruling out inflammation and autoimmune diseases, the team reached an accurate diagnosis. Pereira explained the surprising mechanism behind the injury:

'Our hypothesis in the current case is that this position, together with sudden movements of the upper body, can create a small tear in the artery wall.'

According to him, the tiny tear in the artery wall created by the movement and position attracted blood platelets, formed a clot, and completely blocked the blood supply to the nerves. The patient was immediately admitted to intensive care for blood thinners, steroids, and a rigorous neurological rehabilitation program. After about eight weeks of intensive work, some improvement occurred, allowing him to bend his legs, although the road to walking is still long.

The phenomenon of 'surfer's myelopathy' is not widely known to the public, but it is well recognized in medical communities near the coast. It is a rare arterial injury that occurs almost exclusively in beginner surfers. The reason lies in the difference between professionals and beginners: those without experience tend to lie for long hours on their stomachs with their backs arched and heads raised to watch approaching waves—a position that exerts extreme pressure on the spine and the blood vessels that nourish it.

Following this case, experts are issuing an unequivocal call to surfing schools around the world: to immediately change training procedures, require trainees to sit upright on the surfboard while waiting for a wave, and stop the prolonged arched lying position—a step that may prevent the next disaster at sea.