Football related spinal cord injuries

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The transition from summer to fall prominently features the beginning of football season throughout the United States. While head injuries have dominated the national media's discussion of football-related injuries in recent years, football-related Spinal Cord Injuries continue to be problematic. According to the National Spinal Cord Injury Statistical Center's 2014 Annual Statistical Report, 0.5% of all traumatic SCI were due to playing football.

While it is difficult to establish a clear cause-and-effect relationship for any prevention campaign, in 1976 the NCAA and National Federation of State High School Associations devised a rule change intended to decrease the number of catastrophic cervical spine injuries among football players1. This involved a broadening of the rule against “spearing” to include any deliberate use of the helmet as the initial point of contact against an opponent. This rule change correlates with a remarkable decline in cervical SCI among college and high school football players: from 34 cervical SCIs in 1976 to 18 in 1977, and down to an average of 6.8 cervical SCIs per year in the 1990s. The severity of the penalty (15 yards and automatic first down) likely added to the culture-changing power of this rule.
More recently in another campaign to prevent football-related cervical SCI, The American College of Sports Medicine published guidelines2 for sideline medical personnel responding to a suspected neck trauma on the field. These guidelines include recommendations to keep the player's helmet on during the initial evaluation, during immobilization, and even during transportation to a hospital. It is thought that removal of the helmet while the shoulder pads are still in place may place the traumatized neck into hyperextension when the injured athlete is lying supine. To access the face for evaluation and possibly resuscitation, they recommend removing the face mask while keeping the helmet in place. This can be achieved quickly with specialized tools, which should be readily available to trainers on the field.

1 “National Athletic Trainers’ Association Position Statement: Head-Down Contact and Spearing in Tackle Football”, Journal of Athletic Training, 2004;39(1):101-111.


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