Contact sports such as football carry a significant risk of injury to the spine. Neck and back sprains and strains are common place, but more serious injuries are possible as well. There are a number of injuries that are peculiar to contact sports and there are guidelines to follow to try and avoid these injuries. The cervical spine is particularly prone to serious injury in contact sports and deserves special attention.
Sports related spine injuries can fall into a few different categories: those that result in symptoms without structural damage, those that result in structural damage without symptoms, and those that result in both. A thorough evaluation of an injury is crucial to preserving the safety of the athletes. Athletes should not return to competition if there is a neurological deficit, a radiographic abnormality, certain pre-existing conditions, or repetitive injury without proper evaluation. Also, there are precautions that can be taken to try to minimize the risk of injury.
Conditions that generally preclude an athlete from participating in a contact sport include congenital spinal abnormalities such as narrowing of the spinal canal and other conditions that may decrease the stability or integrity of the spine. Previous spinal cord injury, untreated disc herniations, or certain fusion procedures may preclude competition in contact sports, as well. A spine specialist is trained to evaluate for these conditions and make recommendations accordingly.
On the field, there are rules in place to protect the safety of players; however, injuries can and still do occur. Knees to the head, hyperextension injuries of the back, or hitting another player helmet first are high risk moves and may be hard to avoid. The best advice is to play by the rules, respect your opponents by trying not to destroy them, to wear proper padding including neck rolls to prevent whiplash, and proper core strengthening and stretching to prepare physically for competition.
When injuries do occur, trained medical personnel should be on-hand to properly evaluate and care for the athlete. With suspected neck injuries, the helmet should be left on the player and the player should be immobilized with a backboard and neck brace prior to transporting to a medical facility. Possible injuries include sprains, fractures, spinal cord neuropraxia, and “stingers”. Spinal cord neuropraxia may result from a high velocity hit or over-extension/flexion of the neck. It may cause numbness, tingling or burning, or weakness that typically resolves within 15 minutes but may last up to 48 hours. Athletes with narrowing of their canal are more susceptible to this type of injury and therefore athletes should be evaluated with an MRI before returning to competition. Stingers are usually a result of a nerve stretch injury that results in temporary burning pain or weakness in one arm and may require MRI evaluation if it fails to get better quickly.
For athletes with spine injuries, it is important for all symptoms to resolve before returning to competition. When an injury occurs, evaluation by a spine specialist can help ensure safety and decrease the risk or repeated injury.
Michael Musacchio, Jr., M.D., is a neurosurgeon specializing in minimally invasive spine surgery.
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