Be aware of Neck injuries!

Dr. Ian Morris, teamdoctor of the Vodacom Cheetahs has took the time to inform the other keen rugbyplayers as well as supporters out there about the dangers of neck injuries.

This is a very significant injury with a high morbidity and unfortunately is reasonably common in the game of rugby. Fortunately though, the incidence of debilitating/serious injuries is low but this most certainly doesn’t mean that injuries to the neck should be taken lightly.

 

The Golden rule when dealing with suspected neck injuries is to always assume that the injury is severe until proven otherwise. In other words, always err on the side of caution.

 

Any injury to the head and or body can result in a neck injury.  Incidents such as high and ‘spear’ tackles (the latter being when a player is lifted off his/her feet, during a tackle and then dumped, by the tackler), have been identified as high risk and are severely punished in the game if they occur, although any phase of play can lead to an injury to the neck.

 

The initial treatment of any player with suspected neck injury is to keep the player still and to attempt to stabilise the head and neck by using both hands, placed on either side of the head. If medical assistance (e.g paramedics/physios/doctors) is available then they must be included in the treatment as soon as possible. Attempt to reduce the amount of movement in the neck region by not moving the player unnecessarily. If in doubt, do not move the player at all and rather wait for an ambulance or qualified medical personnel.

 

Important signs to look for that may indicate a severe or serious injury are:

 

• Loss of consciousness
• Numbness/tingling in hands and feet
• Weakness in any limbs
• Tenderness in the neck area

 

The player must be transported to the nearest medical facility/hospital on a trauma board, with the neck brace, head block and spider harness (this is a series of seat belt-like straps used to secure the patient to the trauma board/stretcher) attached and these are only to be removed by a qualified medical doctor, in the controlled environment of a trauma unit unless this isn’t possible.

 

A full neurological examination is a pre-requisite in order to exclude any deficits or fallout. Once this has been completed, a decision can be made regarding the removal of the safety devices, admission to hospital or other necessary investigations such as MRI/CT scanning etc.

 

 

 

 

Return to Sport 

 

The player with a suspected neck injury must be returned to sport in a slow and progressive manner. He/she should be seen by a physiotherapist and a full rehabilitation programme should be implemented which includes muscle spasm removal and neck strengthening exercises.

 

The best general rule of thumb when deciding if the player is ready to return to training, is to ensure that the player can perform all his/her neck movements without any pain.

Again, the best treatment of a neck injury is to prevent them from happening. Whilst this is an ideal situation and near impossible to achieve, measures can be taken to reduce the incidence and severity of the injury.

 

These include:

• Strict application of the rules of the game
• Ensuring optimal fitness of the players
• Attention to the application of correct technique in all phases of play
• Ensuring proper muscle strength in the neck and shoulders
• Not allowing players with existing injuries to return to sport prematurely or without appropriate treatment and rehab.

 

Finally, the recommended approach is to treat any neck injury with the utmost concern and to assume a high level of severity until it has been proven otherwise. When in doubt, consult your doctor/sports physician

 

 

 

 

Disclaimer:

 

This is a simplified report on a complex subject and is by no means intended to provide the reader with the skills or knowledge to diagnose any illness or injury. It is merely intended to create awareness of the conditions discussed.

The diagnosis and management of any injury or illness should remain the responsibility of a doctor or other qualified personnel