1. Injuries to the Spine

3. Anatomy- Spine
Spine consists of several curvatures in specific regions of the spine
Cervical and lumbar spine are concave
Thoracic spine is convex

4. Anatomy- Cervical The cervical spine consists of 7 vertebrae
Movements of the neck
Extension
Flexion
Rotation
Lateral Flexion
C1- Atlas
First cervical vertebrae
Articulates with the occipital bone and forms the atlantooccipital joint
Allows for nodding of head
C2- Axis
Second cervical vertebrae
Articulates with atlas and forms atlantoaxial joint
Allows for rotation of the head on the neck

5. Injuries to the Cervical Spine
Historically it was thought that forced flexion of the neck was the most common MOI
Any injury to the neck has the potential for neurological complications
It is important to take every injury to this region seriously

6. Injuries to the Cervical Spine
Sprains and Strains
Fractures and Dislocations
Most of these injuries are self- correcting and will resolve over a period of time
Signs and symptoms are similar
Localized pain
Point tender over injury site
Pain with certain movements
Treatment
Ice and rest
Refer to physician if neurological symptoms are present or pain does not resolve
Will result from direct or indirect trauma to the head or neck region
Signs and symptoms
Athlete may report feeling pop or snap in their neck
Severe pain in the cervical area
Complete absence of sensation in the extremities
Treatment
If suspected, initial EAP immediately
Spineboarding and emergency transport is necessary

8. Anatomy- Thoracic Thoracic spine consists of 12 vertebrae
Thoracic vertebrae, ribs and sternum compose the thoracic cage
Thoracic spine is much less mobile than cervical or lumbar spine
Majority of movements aid in respiration

9. Skeletal Problems
Scoliosis – lateral and/or rotary curvature of the spine
Lordosis – increased concavity of the spine (sway back)
Kyphosis- exaggeration of the normal curve of the thoracic spine

10. Ribs 12 pairs of ribs Rib fractures will occur due to a direct blow
7 pairs- True ribs
8-10 attach via common costal cartilage
11-12 do not connect to the sternum
Rib fractures will occur due to a direct blow
Fractures can occur anywhere in the rib, most commonly occur at the angle of the rib

11. Rib Fractures Signs and symptoms Initial Treatment Painful respiration
Deformity in the region of the injury
Swelling and discoloration
Pain when rib cage is compressed
In severe cases, the rib can dislodge and puncture a lung resulting in a traumatic pneumothorax
Initial Treatment
Secure area with 6 inch (double) elastic wrap
Treat for shock
Refer to physician for further evaluation

12. Rib Fractures
Complications of these injuries are rare but can be quite severe if mistreated
Displaced rib fractures may damage internal thoracic structures
Pneumothroax- collapse of lung as a result of air in the pleural cavity
Hemothorax- bloody fluid in the pleural cavity

13. Sprains & Strains- Ribs
Sprains and strains will occur whenever a joint is forced through an abnormal range of motion
Evaluation of sprain or strain is difficult and must be based on history of injury
Athlete will report having sustained an “unusual” movement of the thoracic spine
Signs and symptoms are hard to differentiate from each other
Dyspnea- Difficult or painful breathing

14. Sternal Fracture Infrequent in sports Complications
Manubrium is dislocated and moves posteriorly resulting in an airway obstruction
Sternum and ribs are separated resulting in a flail chest
Loss of stability to the thoracic cage