Head and Neck Injuries
in Football Players
Joel Gonzales, M. D.
Today’s Topics
• Concussions
• Burner Syndrome
• Transient Quadriparesis
• Permanent Spinal Cord Injuries
Concussions
• Player’s initial state of condition does NOT
reliably indicate severity of injury
Concussions
• Evaluate:
– Facial expression
– Orientation to time, person, place
– Amnesia?
– Gait
Grade 1 Concussion
• Player dazed / confused
• May have unsteady gait
• Mildest form
• No loss of consciousness
Grade 1 Concussion
• No Amnesia
• Symptoms last only 10-15 minutes
– Player lucid
– Gait steady
– Eyes clear
Grade 1 Concussion
• TREATMENT: allow return to play under
close supervision
• No return to play if dizzy, have headache, ...
Grade 2 Concussions
• Same symptoms as Grade 1
• Post-traumatic amnesia
(cannot recall events since injury)
Grade 2 Concussions
• NO RETURN to play on day of injury
• Must see neurosurgeon
• No return to play until headache, irrit...
Grade 3 Concussion
• Have Retrograde Amnesia
(cannot recall events PRIOR to injury)
• No return to play
• Need hospital ob...
Grade 4 Concussion
• Loss of consciousness for seconds to minutes
• Emerge confused
• Have post-traumatic and retrograde a...
Grade 4 Concussion
• Place player on stretcher
• Protect cervical spine
• Hospital for observation
• Never allow player wi...
Grade 5 Concussion
• Loss of consciousness
• Cardiorespiratory arrest
• CPR and transport to hospital immediately
Summary on Concussions
• Grade 1 - No amnesia - return to play
• Grade 2 - Post-injury amnesia - see neurosurgeon
• Grade ...
Burner Syndrome
• Common injury - 50% of NCAA players
over 4 yr career
• Player makes contact with head and
shoulder while...
Burner Syndrome
• Complain of burning numbness
• Pain may radiate into arm or hand
• “Dead arm” or numbness / tingling
• R...
Burner Syndrome
• 5-10% of injuries more serious
• Neurologic deficit may last several hours
• Weakness in deltoids / bice...
Burner Syndrome
• Athletes may return to play only if:
– complete recovery of biceps / deltoid strength
– complete resolut...
Burner Syndrome
• Some players more susceptible to repeat injury
• Equip with more cushioned pads and custom
rubber neck r...
Transient Quadriparesis
• Numbness and weakness from neck down
• Persistent numbness or weakness in arms,
legs, trunk
• Ne...
Transient Quadriparesis
• No return to play
• Referral to neurosurgeon
• Must rule out cervical fracture or disc problem
Permanent Spinal Cord Injuries
• 99 permanent spinal cord injuries in H.S.
and college football 1971-1975
• 1976 - “NO SPE...
Permanent Spinal Cord Injuries
• 86 H.S. player / 14college / 5 semi-pro
• Most occur during games
• Defensive backs most ...
Prevention of Spinal Cord Injury
• Teach proper tackling (no spearing)
• Proper conditioning / neck strengthening
• Enforc...
Prevention of Spinal Cord Injury
• Make certain equipment fits properly
• Physician should be at all games
Head and Neck Injuries in Football Athletes
Head and Neck Injuries in Football Athletes
Head and Neck Injuries in Football Athletes
Head and Neck Injuries in Football Athletes
Head and Neck Injuries in Football Athletes
Head and Neck Injuries in Football Athletes
Head and Neck Injuries in Football Athletes
Head and Neck Injuries in Football Athletes
Head and Neck Injuries in Football Athletes
Head and Neck Injuries in Football Athletes
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Head and Neck Injuries in Football Athletes

  1. 1. Head and Neck Injuries in Football Players Joel Gonzales, M. D.
  2. 2. Today’s Topics • Concussions • Burner Syndrome • Transient Quadriparesis • Permanent Spinal Cord Injuries
  3. 3. Concussions • Player’s initial state of condition does NOT reliably indicate severity of injury
  4. 4. Concussions • Evaluate: – Facial expression – Orientation to time, person, place – Amnesia? – Gait
  5. 5. Grade 1 Concussion • Player dazed / confused • May have unsteady gait • Mildest form • No loss of consciousness
  6. 6. Grade 1 Concussion • No Amnesia • Symptoms last only 10-15 minutes – Player lucid – Gait steady – Eyes clear
  7. 7. Grade 1 Concussion • TREATMENT: allow return to play under close supervision • No return to play if dizzy, have headache, or overly emotional
  8. 8. Grade 2 Concussions • Same symptoms as Grade 1 • Post-traumatic amnesia (cannot recall events since injury)
  9. 9. Grade 2 Concussions • NO RETURN to play on day of injury • Must see neurosurgeon • No return to play until headache, irritability, and inability to concentrate resolve
  10. 10. Grade 3 Concussion • Have Retrograde Amnesia (cannot recall events PRIOR to injury) • No return to play • Need hospital observation
  11. 11. Grade 4 Concussion • Loss of consciousness for seconds to minutes • Emerge confused • Have post-traumatic and retrograde amnesia
  12. 12. Grade 4 Concussion • Place player on stretcher • Protect cervical spine • Hospital for observation • Never allow player with l.o.c. to return to play that day
  13. 13. Grade 5 Concussion • Loss of consciousness • Cardiorespiratory arrest • CPR and transport to hospital immediately
  14. 14. Summary on Concussions • Grade 1 - No amnesia - return to play • Grade 2 - Post-injury amnesia - see neurosurgeon • Grade 3 - Retrograde amnesia - hospital • Grade 4,5 - loss of consciousness - hospital
  15. 15. Burner Syndrome • Common injury - 50% of NCAA players over 4 yr career • Player makes contact with head and shoulder while tackling • Intense burning pain about shoulder
  16. 16. Burner Syndrome • Complain of burning numbness • Pain may radiate into arm or hand • “Dead arm” or numbness / tingling • Recovery time = usually minutes
  17. 17. Burner Syndrome • 5-10% of injuries more serious • Neurologic deficit may last several hours • Weakness in deltoids / biceps
  18. 18. Burner Syndrome • Athletes may return to play only if: – complete recovery of biceps / deltoid strength – complete resolution of symptoms • Watch player closely • Equip with more cushioned pads / custom rubber neck roll
  19. 19. Burner Syndrome • Some players more susceptible to repeat injury • Equip with more cushioned pads and custom rubber neck roll • Neck strengthening regimen
  20. 20. Transient Quadriparesis • Numbness and weakness from neck down • Persistent numbness or weakness in arms, legs, trunk • Need immediate spine x-rays / MRI
  21. 21. Transient Quadriparesis • No return to play • Referral to neurosurgeon • Must rule out cervical fracture or disc problem
  22. 22. Permanent Spinal Cord Injuries • 99 permanent spinal cord injuries in H.S. and college football 1971-1975 • 1976 - “NO SPEARING RULE” • 1977-1987 = 105 permanent cord inj. • 50% reduction rate after rule started
  23. 23. Permanent Spinal Cord Injuries • 86 H.S. player / 14college / 5 semi-pro • Most occur during games • Defensive backs most vulnerable
  24. 24. Prevention of Spinal Cord Injury • Teach proper tackling (no spearing) • Proper conditioning / neck strengthening • Enforce “no spearing” rule during practice
  25. 25. Prevention of Spinal Cord Injury • Make certain equipment fits properly • Physician should be at all games

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