Neck Injuries in Athletes - Types, Symptoms, Diagnosis, and Management

Introduction

Sports and other physical activities often result in injuries to the neck of varying intensity and severity, especially among young athletes and children. Neck injuries include cervical fractures, dislocations, injuries to the intervertebral disc, spinal cord injuries, sprains, and strains to the neck. As per reports, around 13.5 percent of neck injuries were caused by sports involvement, and the most affected population includes children between the age of 5 to 18 years. While some injuries are minor, some of them, like injuries to the spine, require immediate medical intervention. The management options are based on the findings and physical examination and considerations of the mechanisms of the injury.

What Is Neck Injury?

Neck in sports are injuries that happen while playing games or involved in other athletic activities. The cervical area of the spinal column, including seven bones (C1-C7 vertebrae) spaced from one another by intervertebral discs, is located in the neck region. These discs provide the spine with mobility and serve as shock absorbers when people are moving around. The spine permits standing, bending, and twisting along with strong muscles, ligaments, and flexible tendons.

Maximum mobility in youngsters under the age of eight years is seen in the C-1 and C-3 zone. The fulcrum of cervical spine flexion shifts to C3-C5 in children aged eight to twelve. The fulcrum shifts to the C5-C6 region after the child reaches the age of 12, where it stays until adulthood. For instance, flexion-extension injuries, which are frequently sustained in auto accidents, tend to reflect these characteristics.

What Are the Types of Neck Injuries?

Based on the extent and severity of the injury, neck injuries are classified as follows:

1. Fractures: Acervical fracture occurs when one or more of the neck-related (cervical) spine bones are fractured. Examples include odontoid fractures (fracture to the bony projection from C-2), C1 ring fractures, etc.

2. Dislocations: These include injuries that may compress the spinal cord and result in severe neurological impairments. Examples include atlanto occipital (joint between the first vertebrae and the occipital bone) dislocation and instability.

3. Acute Cervical Injury: Involves injuries brought on by a severe injury to the spinal cord that bruises, partially damages, or fully damage it. Examples of acute cervical injury include muscle strain, neuropraxia (injury to the peripheral nerves), and stingers (injury to the nerves in the neck region).

4. Overuse Injuries: Caused by tear and wear of the ligaments or muscles of the neck region. Examples include spondylosis (degenerative condition of the neck and cervical discs), spinous process apophysitis (injury to the growth plate in the vertebral column), etc.

What Are the Signs and Symptoms of Neck Injury?

The various signs and symptoms of neck injury include

• Moderate to severe pain localized in the neck region, which radiates from the shoulder to the arms in progressing cases.

• Stiffness of the neck.

• Reduced sensation in the neck, arms, and hand.

• Weakness, swelling, or bruising in the muscles of the neck, shoulders, arms, or legs.

• Tenderness in the neck or shoulder muscles.

• Breathing difficulties.

• Paralysis of the arms or legs.

If a neck injury is suspected, or if the patient is presented with symptoms of excruciating pain, incontinence, shortness of breath, or numbness in the extremities, seek emergency medical help.

What Are the Preliminary Management Options For Neck Injury in Children?

For minor injuries, the patient may be provided with conventional first-aid management before reaching the hospital. Some of the methods include the following:

• Provide support to the neck and spine and make the patient lie down in a neutral position.

• Ensure proper ventilation to the patient and avoid close spaces.

• Avoid movement and call for immediate medical help.

How Is Neck Injury Diagnosed?

The diagnosis of neck injury through physical examination, imaging, or radiological tests as described below:

• Physical Examination: Physical examination involves inspection and palpation of the neck region and checking for discoloration, scars, swelling, or bruising.

• X-Ray: X-ray images will help the physician understand the alignment and the structure of the vertebrae of the neck region and identify any abnormalities or dislocations.

• Computed Tomography (CT Scan): A CT scan produces images and surroundings structures of the spinal cord and canal.

• Magnetic Resonance Imaging (MRI): MRI scans produce three-dimensional images of the tissues, which aid in identifying enlargement, tear in the muscles, or degeneration of the muscles surrounding the neck region.

How Is Neck Injury Treated?

Treatment depends upon the severity and type of the structures involved in the injury. Based on these findings, the various treatment approaches are as enlisted:

• Medications: Medications are usually employed to treat pain and inflammation caused by the injury. The drugs belonging to the class of NSAID (non-steroidal anti-inflammatory drugs), like Naproxen, Ibuprofen, and Acetaminophen, are commonly prescribed.

• Collars and Braces: The mechanism by which neck collars and braces act is by providing a minor compression that will hasten the healing process. This is particularly employed in case of fractures to the bones in the cervical area.

• Surgery: Severe injuries are often treated using surgical procedures like surgical decompression or spinal instrumentation. In the decompression procedure, different tissue or bone pieces that are compressing and damaging the spinal cord are removed. Spinal instrumentation involves the use of various implants or devices to increase the stability of the spinal region.

How Can Neck Injury be Prevented?

The preventive measures for neck injury in children include:

• The use of helmets while riding motorbikes, bicycles, and skating can reduce the severity of injuries caused due to these activities.

• Providing strengthening exercises to the neck and shoulder can help with injuries caused by playing sports like football, running, etc.

• Checking for warning signs while swimming, diving, skating, etc.

Conclusion:

Neck injuries are common among children and teens who are involved in sports or while playing. Since they can have a profound effect on the child’s health, proper medical considerations should be employed at the right time to efficiently treat the injury, thus combating the long-term adverse effects of these fractures. Proper education and the use of preventive measures may also be adopted to reduce the incidence of these injuries.