Reenacting the Mechanism

Can the athlete demonstrate the mechanism of injury (if it is not too painful) or the position that causes the most discomfort?

Fig. 2-14 Insidious onset—excessive cervical side bending during sleep (pillow too thick.

phone. Hearing-impaired athletes may rotate or laterally bend their necks when turning their ears closer to sounds.

Occupations requiring constant lifting can aggravate a neck lesion (especially an intervertebral disc herniation) because of the compressive forces.

Prolonged static work positions with a forward head posture, such as keyboard and terminal operators, have a high incidence of neck and shoulder pain and muscle spasm.

Sleeping positions with too thick or too thin a pillow or not enough support can lead to undue stress on the cervical joints. This is important to determine, since it can be the cause of, or add to, the athlete's injury. Sleeping in the prone position subjects the cervical region to hyperextension and rotation for long periods of time.

Excess stress from sport, work, or life-style, can lead to neck problems. Tension in the suboccipitals, erector spinae, and trapezius muscles can subject the cervical spine to compressive forces. Fatigue from stress can affect the athlete's posture, which can add to problems.

Athletes such as football players can have reoccurring brachial plexus overstretch or nerve root impingement problems.

Athletes with cervical hypermobility can have reoccurring neck sprain problems.

Reoccurring problems are common with poor cervical posture.

Athletes with poor posture can have ongoing degenerative changes especially in the facet joints and the intervertebral disc.

Have the athlete demonstrate the cervical positions and movements that occurred at the time of injury. This helps clarify their description of what happened and helps determine which structures were stressed. If the athlete can remember the posi-

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