Recommendations are based on current evidence pertaining to prevention strategies to reduce the incidence of cervical spine injuries in sport; emergency planning and preparation to increase management efficiency; maintaining or creating neutral alignment in the cervical spine; accessing and maintaining the airway; stabilizing and transferring the athlete with a suspected cervical spine injury; managing the athlete participating in an equipment-laden sport, such as football, hockey, or lacrosse; and considerations in the emergency department.
Professionals responsible for the care of football athletes must be knowledgeable in the types of equipment used and the best option available for effective airway access.
Ulnar nerve entrapment is the second most common compressive neuropathy in the upper extremity because of its anatomy and superficial location. Major aetiological factors in the development of ulnar neuropathy of the elbow are compression, inherent anatomical structures, or lesions within the cubital tunnel. Extrinsic nerve compression may be elicited by acute or recurrent trauma. Nerve mobility may be impeded by congenital deformities. Ulnar nerve dysfunction has been associated with metabolic conditions, certain occupations and athletes involved in repetitive overhead activities. Ulnar nerve injuries may result in both motor and sensory abnormalities. Common symptoms include point tenderness, digital numbness and hand weakness. Evaluation of suspected neuropathy includes physical inspection for muscle atrophy, bony or muscle hypertrophy, deformities, digital clawing and a radiographic examination. Clinical techniques include the elbow flexion test, strength testing of hand intrinsics, flexor carpi ulnaris and digitorum profundus, and Tinel's sign. Sensory testing and McGowan's grading system may confirm the diagnosis and prognosis. Treatment options range from conservative (i.e. rest, splinting, nonsteroidal anti-inflammatory drugs, ice and abstinence) to radical surgical intervention (i.e. decompression, medical epicondylectomy and anterior transposition). In the throwing sport athlete, nerve involvement typically occurs along with other medical elbow problems.
The incidence of catastrophic cervical spine injury in sports is low compared with other injuries. However, cervical spine injuries necessitate delicate and precise management, often involving the combined efforts of a variety of health care providers. The outcome of a catastrophic cervical spine injury depends on the efficiency of this management process and timeliness of transfer to a controlled environment for diagnosis and treatment. The objective of the National Athletic Trainers' Association (NATA) position statement on the acute care of the cervical spine-injured athlete is to provide the certified athletic trainer, team physician, emergency responder, and other health care professionals with recommendations on how to best manage a catastrophic cervical spine injury in an athlete. Recommendations are based on current evidence pertaining to prevention strategies to reduce the incidence of cervical spine injuries in sport; emergency planning and preparation to increase management efficiency; maintaining or creating neutral alignment in the cervical spine; accessing and maintaining the airway; stabilizing and transferring the athlete with a suspected cervical spine injury; managing the athlete participating in an equipment-laden sport such as football, hockey, or lacrosse; and imaging considerations in the emergency department.
ATHLETIC THERAPY TODAYFactors involved in the accurate performance of the Lachman test and its interpretation are numerous and include examiner hand size, individual knee size, examiner psychomotor skill, relaxation, and examiner appreciation of anterior translation and end feel.The prone Lachman test has been shown to be an acceptable alternative in determination of ACL disruption and might have numerous advantages over the standard Lachman test.
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