EPIDEMIOLOGY OF ATHLETIC NECK INJURY

https://doi.org/10.1016/S0278-5919(05)70063-6Get rights and content

Section snippets

DECISION-MAKING IN SPORTS

Any attempt to reduce the complexities of valid and reliable reporting of injuries in sports to meet the demands of epidemiologic surveillance of athletic injuries has many hurdles to overcome,7 but when overcome, it reasonably provides knowledge for the decision-makers in sports where voids are filled with opinion.10 As a result, most professional sharings on athletic injuries have concerned their clinical nature and significance according to the author's experience, often accompanied by case

Sport Versus Nonsport

From 1973 to 1981, the United States had a central repository for all spinal cord injuries supported principally by the Department of Education, Rehabilitation Services Administration. Reports were submitted by regional spinal cord injury centers to the National Spinal Cord Injury Data Research Center (National Center) and there compiled for viewing internal patterns of frequency until its closure from cessation of federal funds.

It was acknowledged that what was received were a minority of

Historical Perspective

In the National Spinal Cord Injury Data Research Center report, 32 of the 50 gymnastic cases reported during those 9 years came from trampoline accidents. It is not known whether these arose from home use, physical education, or competition. National attention was brought to the risks of this apparatus for serious neck injuries in 1960 by Ellis with a report of five cases, three of which resulted in quadriplegia, all but one identified with an incorrectly attempted somersault, and involving

Historic Perspective

The article by Clarke elsewhere in this issue describes how the advent of the modern helmet led to a significant rise in the frequency of catastrophic head injuries until (1) helmet standards began to be addressed, and, later, (2) rules changed that minimized the helmeted head receiving the brunt of the initial impact. With such a focus, it took longer for football programs to turn to and realize that nonfatal catastrophic neck injuries were on an upward climb, but based on a more subtle

Historic Perspective

Tator's28 review of spinal cord injuries in Canadian sport from 1948 to 1983 picked up the first case in hockey in 1976, with 27 more occurring by the study's completion. In the United States and Canada, the recent introduction of this risk into hockey was the advent of the protective helmet in hockey and, as in football, the resulting tendency of the helmeted player to let the head take the hit (in this instance, typically, into the boards).

Also, as in American Football with the advent of a

SWIMMING

Data are not in hand, but anecdotally, it is well accepted that a new cause of quadriplegia in aquatic sport emerged in the mid-1980s— stemming from the “pike” racing dive made popular by a few swimmers at the 1984 Olympic Games. In the hands of a skilled swimmer, a few milliseconds were said to have been gained by this form of entry into the water. In the hands of an unskilled (as to this technique) swimmer, especially in the shallow pools of older design, it led to head contact with the pool

BASEBALL

The data on baseball quadriplegia are limited, but it demonstrates that it can happen, and that the pattern is one of head-first sliding in which the hands separate, allowing the crown of the head to “inadvertently spear” the shin of the baseman or catcher.22

CONCLUSION

Quadriplegia, the permanent loss of sensory and motor pathways below the cervical spine, is a devastating injury. It is now well known as a possible occurrence in virtually any sport, and receives due attention when patterns of occurrences become observed. The discipline and tools of epidemiology assist these attentions by tracking their relative frequency and accompanying associated factors continuously, by providing a sensitivity to change, and by enabling one to see the validity of

First page preview

First page preview
Click to open first page preview

References (33)

  • J. Albright et al.

    Nonfatal cervical spine injuries in interscholastic football

    JAMA

    (1976)
  • American Alliance for Health, Physical Education and Recreation

    The Use of Trampolines and Minitramps in Physical Education

    (1978)
  • A. Ashare et al.

    On the safe side

    (Jan:16, 1996)
  • C. Christensen et al.

    Fourth Annual National Gymnastic Catastrophic Injury Report

    (1983)
  • K. Clarke

    Calculated risk of sports fatalities

    JAMA

    (1966)
  • K. Clarke

    Premises and pitfalls of athletic injury surveillance

    J Sports Med

    (1975)
  • K. Clarke

    A survey of sports-related spinal cord injuries in schools and colleges, 1973–75

    Journal of Safety Research

    (1977)
  • K. Clarke et al.

    Football fatalities in actuarial perspective

    Med Sci Sports

    (1979)
  • K. Clarke et al.

    Football helmets and neurotrauma—an epidemiological overview of three seasons

    Med Sci Sports Exerc

    (1979)
  • K. Clarke

    Spinal cord injuries in organized sports

    SCI Digest

    (Summer 1980)
  • K. Clarke
  • Committee on Accident and Poison Prevention
  • Committee on Accident and Poison Prevention and Committee on Pediatric Aspects of Physical Fitness, Recreation, and Sports

    Trampolines II

    Pediatrics

    (1981)
  • Committee on Competitive Safeguards and Medical Aspects of Sports
  • Committee on the Medical Aspects of Sports
  • Cited by (31)

    • Sex- and Sport-Specific Epidemiology of Cervical Spine Injuries Sustained During Sporting Activities

      2019, World Neurosurgery
      Citation Excerpt :

      Sporting activities are the fourth most common cause of cervical spine injury (after motor vehicle accidents, violence, and falls) and account for approximately 15% of injuries.1,2

    • Management of Cervical Injuries in Athletes: Timing of Treatment

      2013, Operative Techniques in Sports Medicine
    • Neck injury response to direct head impact

      2013, Accident Analysis and Prevention
      Citation Excerpt :

      Neck injuries due to direct head impact may occur during motor vehicle crashes, contact sports, or falls (Clarke, 1998; Torg et al., 2002).

    • Kinematic Cervical Spine Magnetic Resonance Imaging in Low-Impact Trauma Assessment

      2009, Seminars in Ultrasound, CT and MRI
      Citation Excerpt :

      A strain is defined as an injury of the paraspinous muscle itself. Pain is typically localized and associated with restricted cervical range of motion, without radiculopathy or clinical signs of nerve impingement.13 Acute disk herniations are less common but typically present with transient neurologic deficits, varying from radiculopathy to anterior cord syndrome.

    • Dynamic mechanical properties of intact human cervical spine ligaments

      2007, Spine Journal
      Citation Excerpt :

      Cervical spine injury can occur during automobile collisions and diving, football, and equestrian accidents [1–3].

    View all citing articles on Scopus

    Address reprint requests to Kenneth S. Clarke, PhD, SLE Worldwide, Inc., 27751 Calle Rabano, Sun City, CA 92585

    *

    Risk Analysis, SLE Worldwide, Inc., Sun City, California

    View full text