A 12-year-old male jumped approximately 12 feet from a tree and landed on his feet. He complains of pain to his lower back. What injury mechanism is most likely responsible for his back pain?

• A. Direct trauma to the spinal column.
• B. Secondary fall after the initial impact.
• C. Energy transmission to the spine.
• D. Lateral impact to the spine.

Answer: (C)

When a person falls from a height and lands on the feet, the force of the impact travels upward through the legs and pelvis and into the spine. The spine has to absorb this axial load, so the energy is transmitted along the spinal column. This can produce compression or other injuries to the vertebral bodies even without a direct blow to the back. In a 12-year-old, the spine is still developing, but the basic idea remains: the injury mechanism is energy transmission to the spine from the impact through the body, not a direct back strike, a secondary fall, or a lateral hit.