Cervical range of motion norms9/27/2023 ![]() An athlete with a significant spinal cord injury may not immediately present with emergent signs and symptoms. Considering the mechanism of injury is an important first step for the on-field assessment of any athletic injury. ![]() 13–15 This further complicates the kinematics of the cervical segment and the resultant injury mechanisms. Motion in one plane at the cervical spine requires the contribution of complementary motion from individual vertebrae in other planes. Obviously, the athletic trainer is unable to detect the presence of such a diminutive irregularity in the structure of the spine and must, therefore, assume the worst-case scenario. White et al 12 defined clinical instability in the spine as more than a 3.5-mm horizontal displacement of one cervical segment on another. 10, 11 Clinically, a major CSI results in compromised integrity of the cervical segment due to fracture, dislocation, subluxation, or ligamentous tearing, leaving the cervical spine unstable. The more severe CSIs associated with athletics can be attributed to compressive forces from axial loading. 2–8 Other sports and activities that contribute to a high rate of CSI are wrestling, diving, recreational diving, ice hockey, gymnastics, and horseback riding. The highest rate of severe neck injuries has occurred in American football and rugby. A CSI requires an immediate and deliberate, yet sensitive, response. 1 Major CSIs, although rare compared with sprain and strain injuries to the extremities, are troubling because of mortality rates and the potential permanent loss of neural function. This is evidenced by a multiprofessional task force effort initiated by the National Athletic Trainers' Association to establish general guidelines for the acute care of the spine-injured athlete. Injury biomechanics in the cervical spine are complex, and much can still be learned about mechanisms of the cervical spine injury specific to sports.īecause of the potentially catastrophic and life-altering nature of cervical spine injury (CSI), much concern exists regarding the prehospital management of the cervical spine–injured athlete. However, the cervical spine is unique in its normal kinematics compared with joints of the extremities. Impact location and head orientation affect the degree and level of resultant injury.Ĭonclusions/Recommendations: As with any joint of the body, our understanding of the mechanisms of cervical spine injury will ultimately serve to reduce their occurrence and increase the likelihood of recognition and immediate care. The reaction of the cervical spine to an axial-load impact has been investigated using cadaver specimens and demonstrates a buckling effect. Furthermore, vertebral movement in 1 plane often requires contributed movement in 1 or 2 other planes. Instead, individual vertebrae may experience a reversal of motion while traveling through a single plane of movement. The movement into a single plane is not the product of equal and summative movement between and among all cervical vertebrae. Objective: To provide a foundation of knowledge concerning the functional anatomy, kinematic response, and mechanisms involved in axial-compression cervical spine injury as they relate to sport injury.ĭata Sources: We conducted literature searches through the Index Medicus, SPORT Discus, and PubMed databases and the Library of Congress from 1975–2003 using the key phrases cervical spine injury, biomechanics of cervical spine, football spinal injuries, kinematics of the cervical spine, and axial load.ĭata Synthesis: Research on normal kinematics and minor and major injury mechanisms to the cervical spine reveals the complex nature of movement in this segment.
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