Transcript cervical spine injuries - Doral Academy Preparatory

CERVICAL SPINE
INJURIES
Care and Prevention of
Athletic Injuries
Ms.Herrera MS, ATC/L
Bony Anatomy
Bony Anatomy Cont’d
Vertebrae Anatomy
Demonstrate importance of
atlas and axis
Soft Tissue Anatomy
Importance of
ligaments
Cervical Spine FACTS
Made of 7 vertebrae
8 cervical nerves
Sensory vs motor
dermatome vs myotomes
Atlas supports base of skull on spine
Atlas-Axis relationship
Cervical Spine FACTS cont’d
Transverse foramen
Opening allows the nerves to go through
Capable ROM:
Flexion
Extension
Lateral Flexion
Lateral Rotation
Intervertebral Disk
 Disk made of
fibrocartilage
 Function:
Shock absorber
 Nucleus Pulposus:
Think of “jelly doughnut”
History & Observation
 HX Essentials:
MOI
Parathesia in
extremities
Hit someone with the
top of your head?
Loss of strength?
LOC?
 Observation
Essentials:
Head tilted to one side
Shoulder higher than
other side
Scapula
protruding/atrophied
Forward posture
POSTURAL CONSIDERATIONS
Study using “plumb line” and chart
Abnormal postures:
Forward head posture
Every inch head is forward, adds 10lbs more of
resistance to posterior neck muscles
Kyphosis
Hunchback appearance caused by excessive flexion
of thoracic spine
Lordosis
Excessive lumbar curve
Cervical Fracture & Dislocation
 Cervical Fx
 MOI:
 Axial load
 Flexion
 Hyperextension
 S&S:
 Parathesia
 TTP over C-Spine
 Loss of movement
 Loss of bladder control
 Management:
 EMS
 In-line stabilization
 Cervical Dislocation
 MOI:
 Flexion
 I.e. diving, football tackles
 S&S:
 Head tilted to dislocated
side
 Pain
 Numbness/loss of
function
 Management:
 Same as C-spine fx
Sponylolysis Vs. Spondylolisthesis
Sponylolysis
 A.k.a. stress fx or
degeneration of pars
interaricularis
Spondylolisthesis
 Due to fx, vertebrae
seperates and becomes
displaced making the
spine unstable
 Dangers?
 Can sever spinal cord
Management:
-See physician ASAP
-Place in lumbar brace to add stability to spine
-Complete rehabiltation exercises that focus on strengthening the core
muscles
Cervical Sprain (Whiplash)
 MOI: sudden snap of the neck
 Examples?
 Can cause…
 Sprain of ligaments
 Strain of neck muscles
 Isolated incident
 S&S
 Pain on transverse and spinous
processes
 Inflammation
 Muscle spasms
 Why?
 Management:




ER to r/o serious injury
NSAIDS
Rest for 48-72 hours
Ice, heat, massage
Acute Torticollis (Wryneck,stiff neck)
 MOI: small piece of
synovium trapped within
facet joint

Demonstrate on anatomy
 Holding head to 1 side
for extended time
 S&S
 TTP
 Muscle Spasm
 Restricted movement
 Which side?
 Management:
 Modalities to break painspasm cycle
Brachial Plexus Neurapraxia
 A.k.a “burners” or
“stingers”
 MOI: Compression or
distraction of brachial
plexus.
Examples of MOI’s?
 S&S
“elephant trunk”
Burning/numbness/
tingling down arm to hand
Weakness (temporary)
Burners Management
Assess myotomes/dermatomes
Determine location of weakness
Ice over brachial plexus for 10-15 minutes
Re-assess
Recurrent?
Neck collar/roller for fb players
Strengthening program of neck and shoulder
muscles
Stretching
Neck Collars
Herniated Disks
 MOI:
 Repetitive loading on CSpine
 Common in sports
 Disk commonly herniated
posteriorly.
 S&S
 Pain
 Limited ROM
 Motor weakness
 Parathesia down arms
 Management:
 Conservative tx
 Examples?
 If fails, then SX.
Types of Herniated Disks
Prevention of Spine Injuries
 Maintain optimal flexibility
 How? Stretching hamstrings, hip flexors, gluts, and paraspinal
muscles
 Exercise
 Strengthen core muscles, specifically:
 Abdominals, erector spinae, quadratus lumborum
 Gluteus maximus, why?
 Wear back supports when lifting heavy weight
 Pick up boxes/heavy items using your legs NOT bending forward
and reaching for it
 Use correct technique during sports activities
 i.e. in football ‘NEVER HIT WITH YOUR HEAD DOWN (AXIAL LOAD)