BACK IN MOTION

From surfers to weekend athletes, spinal surgeon and Assistant Professor Mario Zotti is redefining recovery — one vertebra at a time.

It often starts with something small — a twinge after paddling out, a stiff twist pulling on a wetsuit, or, more dramatically, a dump onto sandbanks. On the Gold Coast and Northern Rivers, where movement is woven into daily life, back or neck pain can feel like the end of freedom. Few understand that better than orthopaedic and spinal surgeon Dr Mario Zotti, whose own journey from sports injury to spinal expertise has shaped both his empathy and his practice.

At just twenty, Zotti was a medical student and keen AFL player when a seemingly minor collision during a tournament left him unable to move. The pain was so severe that his housemates had to carry him home. Though the immediate agony subsided, years of recurring flare-ups followed. “Year after year, I’d try to return to sport, but within days my back would tighten and lock up,” he recalls. These recurring episodes created a cycle of hope and frustration, and they significantly influenced his understanding of back pain.

Years later, during orthopaedic training, another injury struck while he was renovating the decking with a sledgehammer. This time, the pain radiated down his leg, accompanied by weakness and numbness — signs of nerve compression. A scan revealed a large, extruded disc and early degeneration far beyond what was typical. “I remember the radiologist’s comment — that my spine looked ‘worse than it should for my age.’ That kind of language can stay with you,” he says. “It taught me how powerful words are when patients are vulnerable. People often arrive scared because of what they’ve been told that their spine is ‘degenerate’ or ‘worn out’, and they worry that they will no longer be able to do what they love and are often afraid of spinal procedures from hearing things like this” he notes. “But scans don’t tell the full story. You can build strength, stability and control — even with a so-called ‘bad’ back.”

After struggling on for months in trepidation, an injection brought instant relief, sparing him from surgery. “That experience was transformative,” he says. “To go from being in agony and anxious about an intervention to up and walking pain-free — it changed the way I understood spinal care. Rather than just treating a spine, it was about restoring life for that person.”

That experience became the foundation of his professional ethos. “It gave me a deep respect for what patients go through,” he says. “I know what it’s like to be told to rest, to lose confidence in your body. It’s not just physical — it’s emotional.” Asst/Professor Zotti’s connection to sport has never faded. He and his wife, Violetta — the clinic’s founder, director and practice manager who herself had spinal surgery 6 years ago — both know firsthand what it’s like to rebuild after spinal interventions. These days, they play social soccer together multiple times a week, something that once seemed impossible. “Five years ago, I thought I’d be lucky to finish two training sessions without painkillers,” he says. “Now, I can sprint, lift weights, and play a 90-minute match pain-free.”

That recovery, he explains, came from an understanding of the muscles that stabilise the spine — particularly the multifidus, the small but powerful muscle group that acts like the body’s built-in brace. “The spine itself is inherently unstable,” he explains. “It’s the stability given by the muscles around it — that corset of strength — that lets us surf, paddle and move explosively without pain.”

Zotti’s personal journey inspired years of research into how muscle conditioning, core strength and flexibility prevent injury and improve surgical outcomes.

Through his work on multifidus function, alongside trusted rehabilitation teams, he’s helped countless patients — particularly surfers and athletes — regain strength, balance and confidence. And, after decades of managing his own spinal condition, he’s now stronger than ever. “My scans might look worse than twenty years ago and worse than most of the patients,” he admits, “but functionally and muscle-wise, I’m better than I was 10-15 years ago.”  Last year, he even represented Australia in an international medical soccer tournament, a milestone that once felt impossible. “That’s the joy of movement restored.”

“Surfers, like most athletes, demand significant movement and balance in their back and neck — and that’s the goal,” he says. “We analyse the cause and start small. We’re no longer talking about rigid fusions unless absolutely necessary. We want to keep people moving.”

Today, as Assistant Professor at Bond University and Surgeon at Back/Neck Clinic, Dr Zotti combines surgical innovation with genuine human care.

Minimally invasive techniques, he explains, are game changers for patients. “These innovations have completely changed return to activities,” he says.

“Traditional open spine surgery involves significant muscle disruption and need for wound healing. With minimally invasive endoscopic approaches, we can access the spine through tiny keyhole incisions, reduce pain and muscle damage, and get people moving faster. Many of my patients go home within 24 hours and return to activity twice as quickly as before. Activities like surfing wouldn’t have been permitted until 8-10 weeks with traditional surgeries are now possible after 2-3 weeks provided one paces themselves and can demonstrate readiness.”

Zotti was also the first surgeon in Queensland to perform basivertebral nerve ablation (BVNA), a minimally invasive procedure that targets back pain at its source around the disc — offering results without fusion or large incisions. “We’re moving beyond the old hammer-and-nail approach of just fusing or replacing discs,” he explains. “The goal is to restore natural movement and reduce pain in a way that is sustainable with studies showing durability of effect in 80% of patients at 5 years.”

For Dr Zotti, the coast’s active lifestyle isn’t just a backdrop — it’s the motivation for him and his patients to resume activities and thrive again. Whether it’s a surfer wanting to get back in the water, a tradie returning to work, or a parent chasing their kids on the beach, his mission remains the same: to help people move without fear.

“The spine isn’t fragile — it’s resilient,” he says. “With the right care, advice and conditioning, you can live — and move again — and possibly better than before.”