Search

The athletic training room is filled with a multitude of conditions encompassing many different specialties of medicine. When it comes to traumatic injuries in the training room, many of them are not musculoskeletal in nature. Ultrasound in the training room can help identify serious and subtle solid-organ injury and small pneumothoraces. The discussion of these conditions follows a simple outline that helps identify injury/conditions through a proper history and physical. Evidence-based treatment/management/return to play guidelines are discussed., (Copyright © 2019 Elsevier Inc. All rights reserved.)

In today's health-conscious society, more people are participating in athletic endeavors. As participation increases, so does the incidence of cervical injuries. Fortunately, most of the cervical injuries seen in sports are minor and can be treated successfully with minimal morbidity. It is important, however, to accurately assess the patient sustaining a cervical injury to rule out the presence of a more severe cervical injury. When practitioners understand the pathophysiology and treatment of common injuries, including sprains, strains, contusions, disc herniations, and simple fractures, most athletes can be returned to full function.

Head and cervical spine sports-related injuries are intimately associated. The on-field evaluation and management of the athlete with these injuries is of paramount importance to stabilize the athlete and prevent further injury. Clinicians need to be aware of the differential diagnoses and consider each possibility based on the mechanism of injury. Although recognition of head and cervical spine injuries has resulted in significant reductions of catastrophic neurological injuries, especially in the cervical spine, further advances to decrease the incidence and long-term sequelae of head and neck injuries are needed. The first step is education of the athlete and the individuals involved in the care of that athlete.

Cervical spine injuries, although relatively uncommon, can be devastating. Proper and prompt management is absolutely essential, even though the complexity of the brain and the lack of objective signs and symptoms make injury assessment difficult. Being prepared for head and neck injury is key to its on-field management. In the event of an injury, the equipment needed to evaluate, and if necessary, to transport the injured athlete must be available. The most important objective of on-field management of head and neck injuries is to prevent further damage and recurrent injury.

Continual improvements in MR imaging, technology and MR imaging-compatible monitoring and fixation devices have allowed the incorporation of this relatively new imaging modality into standard algorithms for cervical spine trauma assessment. The ability of MR imaging to define the type of spinal cord injury, the cause and severity of spinal cord compression, and the stability of the spinal column is unmatched. The heavy reliance of the spinal surgeon on MR imaging for decisions regarding the type of therapy, the timing, the approach of surgical intervention, and for predicting patient outcome attests to the usefulness of this modality.

This article reviews the on the field management of athletic cervical spine and spinal cord injury. The various types of injuries are discussed, as well as the team approach to evaluation, immobilization, and transport of the injured athlete. An overview of treatment rationale and decisions regarding the return of the spine-injured or spinal cord-injured player to competition is given. Emphasis is placed on the prevention of further injury by mishandling the injured athlete.

Neck injuries in sports are common, typically debilitating, and quite predictable in retrospect by mechanism of injury as to one of four natures--sprains/strains, fractures, brachial plexus pinches/stretches, and spinal cord injury. Of these, the spinal cord injury, whether a concussion or contusion or physical disruption, is obviously the most severe and also, ironically, the best tracked because of its definition and notoriety when it is experienced. This article discusses the essence of what has been learned epidemiologically over recent decades since the advent of organized attention to spinal cord injuries among athletes.