New Guidelines Urged for Young Athletes' Neck Injuries

Helmets, pads should be left on, then removed as a unit once patient is stabilized

MONDAY, March 10, 2008 (HealthDay News) -- During on-field treatment of young athletes with suspected neck injuries, both helmet and shoulder pads should be kept on for initial stabilization and transport, and removed when the patient is in a controlled setting, a new study finds.

"There was a clear hole in the on-the-field guidelines in the treatment of young (8 to 14 year olds) contact and collision sports athletes with possible neck injuries," first author Dr. Gehron Treme, former sports medicine fellow at the University of Virginia, and now with the Center for Orthopaedics in Lake Charles, La., said in a prepared statement.

"Skeletal proportions are different in children than adults. Kids have larger heads than torsos. With this study, we looked to see if this disproportion would result in a different recommendation, such as removing the helmet only. Our study found, however, just as is the case with adults, that both the helmet and shoulder pads should be left on for initial treatment and removed as a unit once the patient is stabilized," Treme said.

In their study, Treme and principle investigator Dr. David Diduch, professor and team physician at the University of Virginia, took X-rays of 31 boys, ages 8 to 14, lying down wearing shoulder pads only, wearing a helmet and shoulder pads, and wearing no equipment. The researchers then measured the alignment of the head, neck and spine to determine if the head tipped back, which could lead to further damage in the case of a neck injury.

The researchers concluded there was no statistically significant difference in alignment when the boys wore no equipment and when they wore both helmet and shoulder pads. However, wearing shoulder pads alone resulted in unacceptable alignment changes that could put a patient at risk if the helmet alone was removed.

While rare, neck injuries suffered by youngsters who play contact sports such as football, ice hockey and lacrosse can be catastrophic, Treme noted.

"Although these events are uncommon, they can be tragic. The initial treatment, usually within the first 10 minutes, is critical to how the patient will do in the long term. The goal, of course, is to avoid paralysis or neurological damage," Treme said.

The study was presented March 8 in San Francisco at the American Orthopaedic Society for Sports Medicine Specialty Day.

More information

The Nemours Foundation has information for parents about children and sports injuries.

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