Cervical Side Bending with some associated rotation

The normal mechanism of injury occurs when a player's body is tackled form one side and the head and neck are quickly side bent toward that side. This occurs frequently in hockey, wrestling, and football. There is compression of the structures on one side and tension on the opposite side. Excessive side bending may cause a fracture through the pedicle, vertebral foramen, or facet joint on one side with ligamentous sprain or ruptures on the opposite side. Damage to the brachial plexus or...

Lateral View Fig 31 Boney

CRANIAL CARRIAGE (FORWARD HEAD POSTURE) Fig. 3-17 Lateral view. Boney alignment. Fig. 3-17 Lateral view. Boney alignment. Atrophy in the deltoid (and teres minor) can be from an axillary nerve injury, which can occur after anterior glenohumeral dislocation. Atrophy of the coracobrachial is, biceps brachii, and brachialis indicates an injury to the musculocutaneous nerve. Loss of proper muscle contour may also be the result of a muscle tear or rupture such as the Fopeye biceps, which develops...

Axilla Fig 363 Soft Tissue

Teres Major Muscle Teres Minor Muscle Biceps Brachii Muscle Serratus Anterior Muscle This muscle can become strained or overused. It will be point tender in the axilla and into its insertion on the humerus. Its trigger points are in the axilla (see section on Posterior Structures). Strain and tendonitis can affect this muscle and cause point tenderness. Occasionally this muscle can be torn. Strain can develop in this muscle and cause point tenderness. There are trigger points in the axilla (see...

General Carriage and Movements

Observe the cervical and thoracic spine for problems. Observe arm carriage during the athlete's gait (Fig. 5-17). Observe the athlete for limb and hand function during clothing removal and the remainder of the assessment. Compare bilaterally the postural positions. Excessive cervical lordosis, forward head, or cervical muscle spasm should be looked for and recorded. Any cervical or upper thoracic problems will make it necessary to rule out spinal pathology that might affect the whole quadrant....

Overuse

Was it an overuse, repetitive mechanism The mechanical actions involved in the overhand throwing pattern are used in many sports such as volleyball, tennis, baseball, basketball, water polo, and javelin throwing. This repetitive and ballistic action could cause microtrauma to the muscles involved. These muscles are often compressed in the subacromial space, especially the supraspinatus muscle and the long head of the biceps brachii muscle. The position of abduction and external rotation...

Mechanism of Injury Direct Trauma

Direct blows to the anterior, posterior, or lateral aspect of the neck can be serious, depending on the force of the blow, the object involved, and the cervical spine position. For example, contact with a puck, softball, or baseball moving at full speed can be serious. Contact with an opposing player's stick, arm, knee, or elbow is fairly common in contact sports and results in mild to moderate injury. In football, piling on, late hits, and hitting on the numbers can cause serious head and neck...

Bibliography

Albright J et al Head and neck injuries in college football an 8-year analysis, Am Sports Med 13(3) 147, 1985 Anderson JE Grant's Atlas of anatomy, Baltimore 1983, Williams & Wilkins. Aprill C, Dwyer A, and Bogduk N Cervical zygapho-physeal joint pain patterns. II A clinical evaluation, Spine, Vol 15, Number 6 458-461,1990. APT A Review for advanced orthopaedic competencies. Personius W The cervical spine, Chicago, 1989. Bland JH Disorders of the Cervical Spine, Toronto, 1987, WB Saunders...

Temporomandibular Assessment

The temporomandibular joint can not be viewed in isolation. Dysfunction of this joint can be a result of a problem anywhere along the kinetic chain, which includes Cranium position in relation to the cervical vertebrae teeth and the dentoalveolar joints (joints of the teeth) Temporomandibular joint problems often coexist with upper cervical joint dysfunction and shoulder girdle postural problems (Grieve G). Temporomandibular joint (TMJ) dysfunction can cause a variety of symptoms in the...

Overstretch

Make sure that the bursitis is not caused by infection, since this needs prompt medical attention. This is particularly important in football players who hit the bursa on the field and may have also abraded the injury site. Such an infection often occurs in the wrestler who abrades the site while wrestling on an unclean wrestling mat. Elbow Joint Hyperextension FALLING ON THE OUTSTRETCHED ARM Fig. 4-6 Hyperextension injury mechanism. Fractures of the upper humerus can occur with this mechanism,...

Assessmentinterpretation

Cranial position -Acromioclavicular joint Fig. 3-15 Anterior view. Boney alignment. A 'drop' or 'droop' shoulder (according to Priest and Nagel) is a visible depression of the athlete's dominant shoulder as a result of repeated overhand throwing postures and hypertrophy of the dominant arm. It is commonly seen in tennis players because of their serving style and in overhand pitchers. During the overhand motion, the repeated downswing follow-through across the body stretches the shoulder...

Temporomandibular Overload

Are the temporomandibular joints Overload problems are usually related to emotional stress, overloaded Stress leads to excessive musculature activity the lateral ptery- Are there psychological or emotional goid is particularly overworked. A raised muscular activity level factors affecting the athlete may be found in several of the muscle groups, not only around the TMJ but also around the cervical spine and cranium. For example, emotional tension causing the masseter and temporalis to contract...

Resisted Mandible Depression

Ask the athlete to open his or her mouth 1 to 2 cm. Push the underside of the mandible upward while the athlete attempts to keep the mouth open. Place one hand behind the athlete's head to prevent head movement. The contraction by the athlete and the therapist's resistance must be a gradual, gentle force. Pain and or weakness can be caused by an injury to the muscles or their nerve supply (see Active Mandible Depression). Lateral pterygoid and hyoids should be strong in comparison to the...

Biceps Reflex C5 Fig 347

The athlete's forearm is placed over your forearm so that the biceps is relaxed. Place your thumb on the biceps tendon in the cubital fossa (flex elbow with resistance to make sure you are over the tendon). Tap your thumb nail with a reflex hammer, held in the other hand. The biceps should jerk slightly, the elbow may flex, and the forearm supinate slightly. The tendon should be tapped several times. Although the biceps is innervated by the musculocutaneous nerve at neurological levels C5 and...

Cervical Spine Assessment

Examining the cervical spine requires a thorough neurological and a rthrological scan of the spine and entire upper quadrant. The temporomandibular joint, upper thoracic spine, costovertebral joints, costotransverse joints, first rib, rib cage, and shoulder complex also have a large influence on the cervical spine and should be ruled out when assessing cervical pathologic conditions. Because of the frequent occurrence of motor vehicle accidents, the athlete must always be questioned regarding a...

Boney

External Occipital Protuberance, or Inion Palpate the axis spinous and transverse processes to determine their depth and prominence and to determine if there is rotation of the axis on the atlas. Palpate the facet joints for point tenderness suggesting dysfunction. The external occipital protuberance, or inion, is a bump in the midline of the occipital region on the center of the nuchal line. It acts as a reference for the center of the skull. A prominent C3 spinous process frequently is...

Clicking and Popping Rocabado M

Does the temporomandibular joint click or pop The muscles of mastication are innervated by the same nerves as the tensor tympani and tensor palatini. This may explain the ear symptoms caused by temporomandibular joint dysfunction. If the tensor muscles go into spasm, it may lead to tinnitus, hearing problems, and a sensation of ear stuffiness. There is also a reflex arc with sympathetic nerve fibers. The fibers originate in the temporomandibular joint and end up in the cochlea. This could also...