Doctor’s Corner: Management Of Neck Injuries

The key goals in early management following neck injury are reduction of pain, reduction of muscle spasm and restoration of normal range of motion.

Empirical evidence supports a combination of therapeutic modalities including, massage, electrical stimulation, heat, analgesics and range of motion exercises.

This should be combined with postural education and ensuring there aren’t compensatory dysfunctions throughout the rest of the kinetic chain, especially the shoulder girdle, thoracic and lumbar spine.

Initial treatment should be carried out with the neck in neutral alignment with a cervical support and a ‘gravity-eliminated’ position to reduce any nerve root, disc or facet joint irritation and limit involvement of over active superficial muscles.

Gentle range of movement has good analgesic qualities and should begin as soon as possible taking care not to commence aggressive stretching of the muscles in spasm, which may reduce the stability of the neck.

Research shows that in patients with neck pain, the key stabilisers (deep neck flexors) become inhibited therefore must be retrained prior to further rehabilitation or loading.

Deep neck flexor training can begin immediately and is carried out using the stages as described by Jull et al. (2008) in the ‘Cranio-Cervical Flexion Test’ using a pressure cuff for feedback and working through progressive pressure increases and holds.

Once the athlete can achieve this, avoiding compensation strategies, the routine should be done independently regularly throughout the day, and can be progressed to more gravity challenging and sport specific positions.

Following the reduction of acute symptoms, the restoration of cervical motion in all planes required for the athlete’s specific sport, and the ability to activate and maintain deep neck flexors, the athlete can then progress to the next phases of rehabilitation.

The Author is Isaac Gabriel Otuk, the CEO of Fitness Health Nutrition Sports (FHNS) company.

THE FHNS brand provides sports medicine like injury management and REHABILITATION services, injury Prevention programs and performance enhancing services to Athletes from all sports disciplines in Uganda, East Africa and around the world through its Physical and online medical Platforms.

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Phone – +256778092815

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