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Key Terms


Axial load

Blood–brain barrier


Fluid challenge


Lateral flexion

Manual stabilization

Motor function





Sagittal plane

Sensory function







You are the staff athletic trainer covering a wrestling match. Your team’s wrestler is picked up and thrown to the mat by his opponent, and he lands on the top of his head. The opponent falls on top of the athlete but immediately jumps up and waves for assistance. As you approach the mat you note that the downed wrestler has not moved and is lying prone with his head turned to the left. He is unconscious and does not respond to your calls or to your touch. He is breathing at a rate of 20 breaths per minute and has a pulse rate of 100 beats per minute. There is no obvious bleeding. What should you do next?


Injuries to the spinal cord can be devastating, often because they are fatal or result in significant lifelong disabilities. Each year approximately 15,000 injuries cause permanent spinal cord injury, approximately 14% of which are related to sports activities. The overwhelming majority of spinal cord injuries in sports occur in collision sports such as football and ice hockey or in high-risk sports such as gymnastics. Because of the debilitating nature of most spinal cord injuries the cost of long-term care is extremely high. This monetary cost does not take into account the emotional toll on the injured individual and his or her family and friends. Injuries to the spinal cord of athletes have been reduced in recent decades by placing greater emphasis on the prevention of such injuries by education with regard to rules changes (e.g., spearing in football, hitting from behind in ice hockey), improvements in protective equipment, and the teaching of proper and safe sport-specific techniques (e.g., tackling with the head up in football).


The anatomy of the cervical spine is complex, designed to allow large ranges of motion in all planes while still affording protection for the spinal cord. The spinal column in the cervical spine consists of the seven vertebrae and their respective intervertebral discs (Fig. 6-1). It functions in part to provide a framework for the axial skeletal system and to protect the spinal cord, which is housed within the column. The anatomy of the cervical spine pertinent to this chapter also includes a ligamentous system providing stability; a complex muscular system for movement; and nerve roots ...

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