Specialists

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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 […]

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.

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Resisted flexion of the elbow

Positioning.

The subject stands with the arm alongside the body, the elbow bent to a right angle and the forearm in full supination. The examiner stands level with the subject’s hand.One hand is on top of the shoulder and the other on the distal aspect of the forearm.

Procedure. Resist the subject’s attempt to […]

Resisted external rotation

Positioning.

The subject stands with the upper arm against the body and the elbow flexed to a right angle. The forearm is held in the sagittal plane, so keeping the shoulder in a neutral position.The examiner stands level with the subject’s arm. He places one hand on the opposite shoulder and the other hand against […]

Sciatica, Herniated Disk (‘Slipped Disk’)

Pain that radiates from the lower back down one or other leg is known as sciatica. It is often exacerbated by exertion, coughing, sneezing, or straining. One of its most common causes is a ‘slipped disk’ which exerts pressure on one of the roots of the sciatic nerve, and it can also be triggered by […]

Peripheral Nerve Injuries

Injuries to the peripheral nerves are relatively common, and, if unrecognized can have a devastating effect on the athlete. These nerves can be damaged especially by compression or traction. When nerves such as the common peroneal nerve at the proximal fibula head or the ulnar nerve at the medial epicondyle of the elbow are lying […]

A Patient’s Guide to Cervical Foraminotomy

Introduction

Foraminotomy is a surgical procedure for widening the area where the spinal nerve roots exit the spinal column. A foramen is the opening around the nerve root, and otomy refers to the medical procedure for enlarging the opening. In this procedure, surgeons widen the passageway to relieve pressure where the spinal nerve […]