Cervical Spine Injuries and the Return to Football

BACKGROUND: The literature dealing with the diagnosis and treatment of cervical spine injuries is considerable. Absent, however, are comprehensive criteria or guidelines for permitting or prohibiting return to collusion activities such as tackle football. OBJECTIVE: The purpose of this report is to describe developmental and posttraumatic conditions of the cervical spine as presenting (1) no contraindication, (2) relative contraindication, or (3) an absolute contraindication to continued participation in tackle football and other contact activities. STUDY DESIGN: Systematic review. METHODS: Analysis of data compiled from more than 1200 cervical spine injuries documented by the National Football Head and Neck Registry, in addition to a review of the limited published literature, plus an understanding of the recognized axial load injury mechanism and extensive anecdotal experience. CONCLUSION: The one overriding principle regarding the return to football or, for that matter, any collusion activity is that the individual be asymptomatic, pain-free, and neurologically intact and have full strength and full range of cervical motion.