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FIFA Diploma in Football Medicine: Cervical Spine

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The cervical spine (neck) is the most mobile segment of the spine and is predisposed to complaints brought about by wear-and-tear phenomena. Scientific studies show that around one third of the adult population suffers from neck problems, even though these problems do not always require treatment.

A normal young adult can turn his/her head to either side approximately 90°, incline it forwards at an angle of around 45° and bend it backwards and forwards at an angle totaling 130°. The weight of the head, which averages somewhere between six and eight kilograms, thus has a detrimental lever-arm effect for the facet joints.

The reason why football players may be more prone to developing spinal problems might be that football training often concentrates on building up or exercising the lower body musculature, while the stomach muscles, the back muscles and the shoulder and neck muscles tend to get neglected.

Injuries to the Cervical Spine in Soccer

  • Only 3.6% of soccer players reported injuries to the neck. Most of these injuries were minor.

There should be a gradual progression to more active exercises as the rehabilitation progresses. Exercises designed to improve the neuromuscular control of the cervical spine and to increase the strength of the neck muscles (initially with isometric exercises and progressing to isotonic ones) are useful. Treating the pain with analgesia and cryotherapy can be very useful.

Read more on return to play here.

Congenital anomalies that preclude sports participation:

  • Odontoid (2nd bone in neck) abnormalities (odontoid agenesis, os odontoideum and dens hypoplasia) are absolute contraindications.
  • Klippel-Feil (a congenital fusion of more two or more cervical vertebrae – neck bones)
  • Arnold-Chiari malformation (enlargement of the cerebellar tonsils)
  • Atlanto-axial rotatory fixation (problems with the first two bones in the neck)
  • Patients with rheumatoid arthritis, ankylosing spondylitis or diffuse idiopathic skeletal hyperostosis (DISH) with significant cervical stiffness and radiological disease should also be advised against contact sport.

Actionable Steps for Parents/Athletes

1. Any neck injury is an indication for removal from play.

2. All patients who have sustained an injury to the cervical spine should undergo a neurological investigation

4. Make sure your child is prepared to play sports. Read this article series: Is Your Child Ready To Play Sports?

5. Neck Strength and Exercise. This recent paper Neck Muscular Strength, Training, Performance and Sport Injury Risk: A Review suggests that neck strengthening exercises are helpful for preventing injuries. Specifically, isometric exercises were suggested like the ones below. Hold each position for 2 – 5 seconds (1 rep) and repeat for 3 to 5 sets. Perform these exercises 2 – 3 times per week. They can be done at the beginning or end of each practice.

Cervical Spine

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The above information is intended solely for the general information for the reader. The contents of this article are not intended to offer personal medical advice, diagnose health problems or for treatment purposes. It is not a substitute for medical care provided by a licensed and qualified health professional. Please consult your health care provider for any advice on medications and medical conditions.