Specialists

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Management-Operative Management

Recurrent burners rarely require surgical intervention. Nerve root avulsions are serious injuries, and treatment is controversial. Surgical options for nerve root avulsions include nerve repair or grafts.

Evaluation-Imaging

For any significant neck injury, radiography of the cervical spine should be performed, including AP, lateral, bilateral oblique, lateral flexion, and extension views. Imaging may be deferred in cases of recurrent burners in which symptoms resolve, but radiography should be considered for any athlete with first-time symptoms. Radiographs should be evaluated for loss of cervical […]

Evaluation-Physical Examination

The athlete with a burner may come off the field shaking his or her arm and hand. If significant neck pain exists, or when neurological symptoms involve two or more extremities, cervical spine precautions should be taken with the athlete until the player is cleared from having a cervical spine injury.

A typical examination of […]

Biomechanics

Three main mechanisms have been described that may result in a burner or stinger:

(a) nerve compression,

(b)nerve traction,

(c) or a direct blow to the brachial plexus,

resulting in upper trunk or cervical root symptoms, particularly involving C5 and C6. Lower cervical roots are less susceptible to damage, but injury can occur with the […]

Complications

When obtaining consent for spinal surgery, the possibilities of complications must be discussed with the athlete. Again, the details of the complications of spinal surgery could fill a book, and they are beyond the scope of this chapter.

In general, however, the possible complications include wound infections, postoperative bleeding that requires transfusion, nonunion of the […]

Squeezing

Squeezing: 1/-/11

Procedure.

Resist the subject’s attempt to squeeze your finger between index and middle fingers

Anatomical structures tested:

Muscle function:

• interosseus palmaris II • Interosseus dorsalis II.

Squeezing: /II-IV Procedure

Resist the subject’s attempt to squeeze your finger between middle and ring fingers.

Anatomical structures tested:

Muscle function:

• Interosseus dorsalis III […]

Resisted extension

Procedure.

Resist the subject’s attempt to extend the thumb Common mistakes.

Hyperextension of the first metacarpophalangeal joint takes place.

Anatomical structures tested:

Muscle function: • Extensor pollicis longus • Extensor pollicis brevis • Abductor pollic;s longus. Common pathological situations:

• Pain occurs in tendinous lesions of the abductor pollicis longus and extensor pollicis brevis […]

Resisted extension of the wrist

Positioning.

The subject stands with the arm hanging, the elbow extended and the wrist in neutral position (between pronation and supination,and between flexion and extension). The examiner stands level with the subject’s elbow. The contralateral arm lifts and carries the elbow and keeps it extended. The hand stabilizes the forearm. The other hand is placed […]

Resisted extension

Positioning.

The subject stands with the arm alongside the body, the elbow flexed to 90° and the forearm in supination. The examiner stands level with the elbow. One hand supports the distal part of the forearm and the other hand is on top of the shoulder.

Procedure.

Resist the subject’s attempt to extend the elbow.

[…]

ISOMETRIC CONTRACTIONS

Resisted flexion

Positioning

The subject stands with the arm hanging, the elbow flexed to a right angle and the forearm supinated. The examiner stands level with the elbow. One hand is on the distal part of the forearm and the other hand on top of the shoulder.

Procedure.

Resist the subject’s attempt to flex the […]