Injuries that are more than just a pain in the neck

FOR those of us who look after sportsmen and women, the one injury which never fails to produce apprehension and a need to maintain expert on-field skills is injury to the neck.

While sometimes obvious, it is important to have a suspicion of a possible neck injury every time height and speed are involved in the injury mechanism.

Outdoor sports such as rock climbing and horse riding and those at speed such as skiing and driving are considered high risk.

Many sports such as rugby have modified the rules to minimise the risk of spinal injury, not only at the professional level but even more importantly for younger players where rule changes ensure teams are matched, especially in the scrum, by weight and age.

High tackles have long since been banned. Referees have the power to abandon matches where they consider the inequality of the teams and thus the risk too great.

In other sports, such as gymnastics, trampolining and horseriding, the neck injury is the result of a fall from height and its incidence can be partly reduced by measures such as softer landing mats and protective headgear.

Less serious forms of neck pain commonly present to doctors and physiotherapists working within sport and also with the public in general and can arise as a result of many conditions.

One of the main jobs of the neck muscles is to support the head, which is actually very heavy, about 10lbs, over 4kg.

Where the body’s posture results in the head not positioned directly over the neck, such as working at a computer all day, the enforced increased tension in the muscles will result in neck pain.

This neck discomfort is usually localised and does not radiate outwith the neck to the arms with no associated pins and needles or numbness.

Treatment aims to reduce the pain and encourage relaxation of the tight muscles with local heat and massage. Muscle relaxants may be required if severe and disturbing sleep.

If it recurs, the cause, such as poor posture, should be corrected and may require a workplace assessment. If persistent, the physio will try to restore the mobility and flexibility with later strengthening work to prevent reoccurrence.

Neck pain that spreads to the arms suggests a trapped nerve as a result of muscle spasm, damage to a disc or the result of small bony prominences seen in the cervical spine as we get older, especially in those in manual jobs.

Whiplash is the term given to an acceleration/ deceleration injury when the head is forced rapidly forwards then immediately backwards.

It is most commonly seen in road accidents but is also seen in sports where there is direct contact with an opponent or the ground after a fall.

Interestingly, the symptoms of whiplash may not be evident right away but most commonly are felt the following day.

It is associated with neck pain and stiffness, a reduced range of movement in all directions and often a generalised headache and dizziness.

More prolonged symptoms or pain spreading into the arms require a more detailed medical assessment.

Like all sports injuries, time out of sport with this type discomfort really is a pain in the neck!