EPIDEMIOLOGY OF ATHLETIC NECK INJURY
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
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Cited by (31)
Sex- and Sport-Specific Epidemiology of Cervical Spine Injuries Sustained During Sporting Activities
2019, World NeurosurgeryCitation 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 MedicineNeck injury response to direct head impact
2013, Accident Analysis and PreventionCitation Excerpt :Neck injuries due to direct head impact may occur during motor vehicle crashes, contact sports, or falls (Clarke, 1998; Torg et al., 2002).
Cervical spine injuries in athletes: Cervical disk herniations and fractures/ligamentous injuries
2010, Seminars in Spine SurgeryKinematic Cervical Spine Magnetic Resonance Imaging in Low-Impact Trauma Assessment
2009, Seminars in Ultrasound, CT and MRICitation 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 JournalCitation Excerpt :Cervical spine injury can occur during automobile collisions and diving, football, and equestrian accidents [1–3].
Address reprint requests to Kenneth S. Clarke, PhD, SLE Worldwide, Inc., 27751 Calle Rabano, Sun City, CA 92585
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Risk Analysis, SLE Worldwide, Inc., Sun City, California