The Prevalence and Management of Stingers in College and Professional Collision Athletes

Bowles, Daniel R; Canseco, José A.; Alexander, Tyler; Schroeder, Gregory D.; Hecht, Andrew C.; Vaccaro, Alexander R.

doi:10.1007/s12178-020-09665-5

Cited by 16 publications

(21 citation statements)

References 97 publications

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“…Because of the low incidence of injuries in this cohort, we are unable to provide a direct correlation between the tackling techniques with the injury incidence; however, multiple previous studies have demonstrated the direct correlation between head-down, helmet-to-helmet, and head-across-the-bow techniques and high rates of brachial plexus, cervical spine, and head injuries. [1][2][3][4][5]9,13 Thus, although helmet-to-helmet tackling was found to be somewhat effective in producing successful tackles within our study, this technique of tackling has been strictly prohibited in American football because of these associated injuries. Furthermore, no previous studies have investigated the injury rate based on per-tackle basis, and thus, our study is unable to compare these injury rates to normal injury statistics.…”

Section: Discussionmentioning

confidence: 97%

At-Risk Tackling Techniques and Effectiveness in NCAA Division I Collegiate Football

Hirase

Bondar

Doucet

et al. 2023

Orthopaedic Journal of Sports Medicine

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Background: Head-down tackling has been associated with injuries to the brachial plexus, cervical spine, and head in high school and collegiate American football. Head-down tackling has also been associated with decreased effectiveness in successful tackles compared with head-up tackling. Purpose: To assess tackling techniques used during National Collegiate Athletic Association (NCAA) Division I football games and to evaluate the successful tackling rates according to technique. Study Design: Cross-sectional study. Methods: Three reviewers analyzed 1000 consecutive solo defensive tackling attempts made in the 2021 season (October to December) by 8 universities within the NCAA Southeastern Conference. Slow-motion replays were used to analyze the success of the tackling attempt, the tackling method, and the initial point of contact with respect to the offensive player’s waist. The chi-square or Fisher exact test was used to analyze categorical data, and the 2-tailed Student t-test or the Mann-Whitney U test was used to analyze continuous data. Results: Head-up and head-down tackling occurred in 902 (90.2%) and 98 (9.8%) tackle attempts, respectively. Head-up tackles were successful in 76.2% of the attempts compared with 55.1% for head-down tackles ( P < .001). Tackles were made at or above the offensive player’s waist in 777 (77.7%) attempts and below the waist in 223 (22.3%) attempts. Tackles at or above the waist were successful in 77.6% of the attempts compared with 61.9% of tackles below the waist ( P < .001). The inside-shoulder method was used in 592 (59.2%) tackles, the arm method in 317 (31.7%), the head-across-the-bow method in 72 (7.2%), and the helmet-to-helmet method in 19 (1.9%). Inside-shoulder tackles had the highest success rate of 93.2%, compared with 41.6% for arm ( P < .001), 59.7% for head-across-the-bow ( P < .001), and 73.7% for helmet-to-helmet ( P = .001) tackles. Inside-shoulder tackles resulted in head-up tackling in 92.9% compared with 41.7% for head-across-the-bow ( P < .001) and 57.9% for helmet-to-helmet ( P < .001) tackles. There were no recorded injuries to the tackler. Conclusion: Head-up tackles, tackles made at or above the offensive player’s waist, and inside-shoulder tackles had the highest success rates. Head-down tackling and tackling below the waist were associated with poor tackling methods, including head-across-the-bow and helmet-to-helmet tackles, which had lower success rates.

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Section: Discussionmentioning

confidence: 97%

At-Risk Tackling Techniques and Effectiveness in NCAA Division I Collegiate Football

Hirase

Bondar

Doucet

et al. 2023

Orthopaedic Journal of Sports Medicine

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“…Limited studies exist to guide treatment, but patients with multiple stingers seem to have a propensity to have more in the future. 49…”

Section: Treatment Outcomes and Return To Playmentioning

confidence: 99%

Evaluation and Management of the Contact Athlete's Shoulder

Arner

Provencher

Bradley

et al. 2022

J Am Acad Orthop Surg

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Shoulder injuries are common in contact athletes and vary in severity because of the required complex interplay of shoulder stability and range of motion for proper function. Pathology varies based on sport but most commonly includes shoulder instability, acromioclavicular injuries, traumatic rotator cuff tears, and brachial plexus injuries. Acute management ranges from reduction of shoulder dislocations to physical examination to determine the severity of injury. Appropriate radiographs should be obtained to evaluate for alignment and fracture, with magnetic resonance imaging commonly being necessary for accurate diagnosis and management. Treatments range from surgical stabilization in shoulder instability to repeat examinations and physical therapy. Return-to-play decision making can be complex with avoidance of reinjury and player safety being of utmost concern. Appropriate evaluation and treatment are vital because repeat injury can lead to long-term effects due to the relatively high effectsometimes seen in contact sports. Contact athletes represent a unique athletic group who place particularly high stresses on their shoulders with the most common injuries, including shoulder instability, acromioclavicular (AC) injuries, traumatic rotator cuff tears, and brachial plexus injuries. With increases in sports participation and trends toward early sport specialization in adolescence, increased injury rates have been seen. 1,2 However, this has not yet been successfully quantified. 3 Acute management includes appropriate on-field and in locker room evaluation followed by immediate treatment and proper return-to-play decision making. Physical examination should then be done without spectators with particular attention to the commonly mentioned pathologies. Initial imaging includes radiographs while MRI can aid in the evaluation of soft-tissue injuries. Typical nonoperative measures include restoration of range of motion and periscapular and rotator cuff strengthening. If surgical treatment is required for successful and durable return to sport, special considerations regarding the particular sport and position are vital. In contact athletes, surgical techniques that give superior stability should be considered to allow for improved durability in return to play. Although these surgical repairs commonly see greater forces, if treated

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“…25 Normally a clinical diagnosis, radiographs should be obtained if symptoms persist for greater than one hour, localize to one nerve root, or include neck pain with limited cervical spine range of motion. 26 Radiographs are also indicated in athletes with a history of more than one stinger episode, which should be followed by an MRI for spinal cord and brachial plexus evaluation. 26 There is no current consensus regarding return to play following a stinger, though some advocate for immediate return to play in the presence of complete symptomatic resolution and full, painless cervical range of motion.…”

Section: Spine Injuriesmentioning

confidence: 99%

“…26 Radiographs are also indicated in athletes with a history of more than one stinger episode, which should be followed by an MRI for spinal cord and brachial plexus evaluation. 26 There is no current consensus regarding return to play following a stinger, though some advocate for immediate return to play in the presence of complete symptomatic resolution and full, painless cervical range of motion. 25 On the other hand, absolute contraindications to return to play include a second stinger in the same match, persistent neurologic deficits, bilateral symptoms (stingers are exclusively unilateral), neck injury suspicion, continued neck pain or discomfort, and lack of full cervical range of motion.…”

Section: Spine Injuriesmentioning

confidence: 99%

“…28 Any trauma patient with potential cervical spinal cord injury should first be evaluated according to ATLS guidelines, which include evaluation for circulatory function, airway patency, and regular breathing. 26 Additionally, in athletes with a history of cervical spine injury, a screening MRI should be used prior to rugby participation. 29 Retired rugby players have a higher incidence of chronic neck pain and reduced neck mobility when compared to the general population.…”

Section: Spine Injuriesmentioning

confidence: 99%

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Injury Patterns in Rugby Union—America’s Fastest Growing Sport

Farah¹,

Mitchell²,

Schmitz³

et al. 2022

Journal of the Pediatric Orthopaedic Society of North America

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Rugby union is the fastest growing sport in the USA, and its growth is only expected to continue to climb with the approaching 2023 Rugby World Cup. Rugby union carries risk for general and sport-specific injury. Tackles and high-impact collisions are a regular component of the game, and although often compared to American football, rugby union carries a unique pattern of injuries, with certain injuries occurring at a significantly higher rate. This review is aimed at familiarizing our orthopaedic workforce to the sport of rugby union and the evaluation, diagnosis, and treatment of the rugby union athlete. Injury prevention strategies guided by epidemiology, risk factors, and mechanisms of injury in rugby union athletes are critical.

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The Prevalence and Management of Stingers in College and Professional Collision Athletes

Cited by 16 publications

References 97 publications

At-Risk Tackling Techniques and Effectiveness in NCAA Division I Collegiate Football

At-Risk Tackling Techniques and Effectiveness in NCAA Division I Collegiate Football

Evaluation and Management of the Contact Athlete's Shoulder

Injury Patterns in Rugby Union—America’s Fastest Growing Sport

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