Clinics in sports medicine
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Second impact syndrome (SIS) occurs when an athlete who has sustained an initial head injury, most often a concussion, sustains a second head injury before symptoms associated with the first have fully cleared. While most commonly reported in football, the SIS can occur during any sport that can produce head blows. Any athlete still complaining of post-concussion symptoms after a head injury must not be allowed to return to play.
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Although more common in collision sports, head injuries (for this article confined to cerebral neurotrauma) may occur in virtually any form of athletics. A few such injuries result in death, especially the second-impact syndrome and subdural hematoma. ⋯ These misunderstandings in the field have contributed to a paucity of reliable epidemiological information about its actual frequency. The concerns accompanying cerebral insult are discussed more than studied, but much can be gained in principle from the history of attention to concussions in football.
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Stingers are the most common athletically induced nerve injury of the cervical spine, but often underdiagnosed or inadequately assessed. In addition to neurologic dysfunction, biomechanical and postural faults are frequently associated with stingers. This article addresses the pathomechanics of the stinger, comprehensive clinical assessment, appropriate diagnostic testing, and a thorough review of rehabilitation techniques to allow return to competition. The principles and practical suggestions can be applied to most cervical spine injuries.
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Unfortunately, spine and spinal cord injuries occur frequently in athletic competition. Most, however, are minor injuries requiring short-term medical treatment and vigilance. This article briefly reviews the athlete who suffers a spinal cord injury in competition while focusing on initial management.