Spine Injuries

Sports Med

Cervical Neck MOI

Axial LoadFlexionHyperextensionRotation and FlexionRotation and Hyper-flexionLateral Flexion

Cervical FractureGymnasts, hockey, diving, football, rugby

Relatively uncommon in athletics but you should always be prepared to handle the situation.

MOIAxial loading and flexion, rotation, hyperextension

S/SMost common in 4-6 cervical vertebraePoint tenderness, restricted movementMuscle spasmsNumbness & pain in extremities, loss of bladder/bowel control

TXRule out spinal injuryX-ray, refer to physician

Cervical Sprain Whiplash

MOIViolent flexion, extension or rotationAffects anterior and posterior ligaments

S/SPersistent, tender over transverse and spinous

processesPain occurs a day later

TXRefer to rule out a fxNeurological examPRICE, traction

Acute torticollis Wry Neck

MOIPain on one side of the neck upon waking

up Synovial lining or capsule is pinched

S/SPalpable pt. tenderness and muscle

spasmLimited side flexion, and rotation

TXX-ray, traction, AROM, PROM, modalities

Scheuermann’s Disease Thoracic

Gymnastics, butterfly swimmingMOI

Kyphosis resulting from wedged fx of 3 or more vertebraeCauses nucleolus pulposis to enter into vertebrae

S/SKyphosis and lumbar lordosis but no painPoint tender over spinous processes and back ache at end

of day

TXPrevent progressive kyphosis Extension exercises, anti-inflammatory

Lumbar MOI

CongenitalMechanicalPresent at birth

IdiopathicTraumaticOveruse injury

Strains, sprains

Lumbar Strain

MOISudden extension and rotationFaulty posture, excessive lumbar lordosis

S/SPain with active extension and passive flexion

TXPRICE, elastic wrap to compressStretching, strengthening exercises should not

cause pain

Sciatica

Inflammatory condition of the sciatic nerve

MOINerve compression, irregularities in

vertebrae tight piriformis muscle

S/SAcute or chronicSharp shooting pain that follows the nerve

pathwayStraight leg raise increases pain

TXRest, traction (if necessary), stretching,

NSAIDS

Spondylolysis

MOICongenital degeneration of the vertebraeAppears as a stress fx, most common in boys

S/SAsymptomatic until hyperextension or disk

herniation

TXBracing, rest, stabilization exercises

Spondylolisthesis

MOIOne vertebrae slipping on one below itA complication of spondy higher in girls

S/Shyperlordosis

TXBracing, rest, stabilization exercises

Sacroiliac Pain

MOITwisting with both feet on the groundFalling backward, landing heavily on one leg

S/SPoint tender on SI jointASIS and PSIS may be asymmetricalStraight leg raise increases pain after 45

degreesSide bending toward the injury side increases

painTX

Modalities, brace, strengthening, stretching, PRICE