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Manual therapy treatments for c-spine injuries in American football
In contemporary American football cervical spine injuries have become typical practice as they one of the most often happening on the field: “The game of football, as it is played today, poses serious risk of injury for players of all ages. Injury may occur to any structure of the spinal column, including its bony, ligamentous and soft tissue components. The majority of cervical spine injuries occurring in football are self limited, and a full recovery can be expected. While these injuries are relatively uncommon, cervical spine injuries represent a significant proportion of athletic injuries that can produce permanent disability. The low incidence of cervical spine injuries has lead to a lack of emergency management experience of on-site medical staff” (Breslow & Rosen, 2000). It goes without saying that this is very significant problem and now a number of investigations are held in order to provide good treatment and manual therapy for the players. It is especially significant for those who wish to continue their sport career and keep on promoting themselves within American football industry. It is essential that this problem is investigated on different levels and it would be important to note that different authors have different attitude to the manual therapy treatments of c-spine injuries.
Henry Pollard, Lotte Hansen, and Wayne Hoskins (2005) investigated particular case dealing with c-spine injury of rugby player. The research examined possible and successful methods of treatment and manual therapy was included as a part of the complex treatment processes. The authors dealing with the subject insist of the fact that manual therapy could hardly be used as a separate treatment only in complex with other treating methods such as: “chiropractic manipulation and ancillary therapies, can be successful in the absence of progressive neurological deficit. The current case highlights the initial successful management of a football athlete and the later unsuccessful management” (Pollard et al, 2005).
Wetzler et al (1996) in their “A retrospective study of cervical spine injuries in American rugby, 1970 to 1994” provided supportive data over the studied data and considered that manual therapy during the treatment could be used only as a part of the complex study. They also supposed that treatments of c-spine injuries are sometimes not efficient and everything depends on the individual case peculiarities and sometimes manual therapy could do nothing with it and better using prevention methods of the injuries than to treat them medically. The after effects of such injuries could be unpredictable and it goes without saying that specialists could hardly provide any prescriptions and manual therapy could damage in some cases than treat.
Gerard Malanga et al (2008) within their recent investigation also come to the conclusion that the manual therapy should be used very carefully in the case of the c-spines injuries as it could cause serious problems as a separate method of treatment. Malanga suggests to use mnual therapy alongside with the other therapeutic activities such as “Relative rest, Nonsteroidal anti-inflammatory drugs (NSAIDs), Physical therapy modalities, Manual therapy approaches, Protected ROM and stabilization, Isometric muscle strengthening, Conditioning of other areas” (Malanga et al, 2008) and he suggested usage of manual therapy on rehabilitation stage it would be helpful in decreasing paine “Manual therapy techniques can also help to decrease pain and improve mobility and function to the point that the patient may begin to exercise in a painless manner. These techniques include soft-tissue massage, manually sustained or rhythmically applied muscle stretching, traction applied in the longitudinal axis of the spine, and passive joint mobilization. To help decrease pain and spasm, a trained therapist may apply grade 1 or grade 2 mobilizations” (Malanga et al, 2008).
Cantu R. (1997) providing an investigation within the same subject in “Stingers, transient quadriplegia, and cervical spinal stenosis: return to play criteria” made a stress on the fact on understanding the injury mechanisms before selecting manual therapy as a treatment for it. Understanding that every sportsman is intended to be back to the professional career the correlation between manual therapy usage and c-spine injury mechanism are very significant as it was mentioned earlier the manual therapy in treatment of such types of injuries could provide either positive or ruining effects. The appropriate usage of manual therapy in the particular case of injuries is very important. This author also supports the idea of manual therapy usage on rehabilitation phase.
Weinberg J., Rokito S., Silber J. S. (2003). Within their research supported the idea of usage of manual therapy but also made a stress on the fact how damaging could be the fact of its inappropriate usage. The pain relief is very important and manual therapy is good for providing pain relief on rehabilitation phase. They also made a stress on the fact that every medical case is unique and should be treated as a unique with understanding the significance of the whole situation as further return to professional sport is based on the number of symptoms observed during the treatment and usage of manual therapy as a part of this treatment: “Return-to-play criteria are largely based on the number of previous episodes and the duration of symptoms. These criteria also require appropriate consideration of any underlying pathological conditions” (Weinberg et al, 2003).
“Cervical spinal cord injury without radiological abnormality in adults” (2000) by H. Bohatoe also deals with the c-spine injury and provides understanding of the subject and necessity of usage manual therapy. The author provides evident facts for usage manual therapy on different stages of injury treatment, taking into consideration the individual mechanism of injury, statement of the patient and his perception of such methodology of treating injuries. It goes without saying that treatment of the traumas got within the sport career should be treated specifically as sportsmen need to be back into the professional leagues and keep on playing after they would treat c-spine after effects. The author perfectly deals with the subject and understands the necessity of individual approach in using manual therapy.
Breslow M, Rosen J. completely agree to all the authors’ opinion presented ahead and within their work they also touch the question of the manual therapy usage and the necessity of individual approach. It goes without saying that American football c-spine injuries and their after affects (that could occur on the field) need detailed individual investigation as well as individual selection of manual therapy methods for every sportsman. It goes without saying that such attitude and understanding of the situation is very important for contemporary American football players and good medical treatment would help them to avoid following relapse of the injury. The researches consider that treating of the c-spine injuries with the help of manual therapy would be used also for removing the after effects when the recovery period is over. This approach could be used as additional to provide prevention from the relapse.
Understanding the problem of individual treatment all the specialists are mainly dealing to one and the same theme – t5he choice of individual method of treatment for every patient. Understanding the mechanism of every particular injury and do not try to find general solution for the problem, using the fact that all the treated c-spine injuries are got on the field during the American football. It goes without saying that treatment of all the previous injuries of such type could provide more thorough choice for the medical treatment, especially manual therapy. As it was mentioned earlier manual therapy is a good method for providing pain relief without medications but it should be used very accurately only within the necessary time and place under the prescription of the doctor or the after effects of such treatment could hardly be predictable.
It goes without saying that the methodology provided by the practitioners and theorists may also differ and would be better to use practical experience, hence do not forget about theoretical basis. Under every of the mentioned investigation process and a number already used for this literature review there are standing a number of people with diagnosis c-spine injuries. Each of them understood the necessity of medical treatment and manual therapy as a part of it, but the same time the necessity of quick return on the field should also be taken into consideration. Manual therapy as a method of pain relief on the recovery stage and further usage of it as a method of treatment after effects provided really good results. It goes without saying that the individual understanding is the core idea of the majority articles and every author understand inability of using manual therapy as a separate treatment on the certain stages. There should be provided complex measures for treatment and manual therapy should be used as a part of them. It goes without saying that for the sportsmen, especially playing in American football the treatment and the manual therapy approaches should be selected individually.
In the end I would like to make a stress on the fact that all these investigation me and a lot as in educative as well as in practical patterns. All the articles are written in understandable language and people who read them could easily get in touch with the material and understand what is the author (s) talking about. It goes without saying that this researches provide also significant contribution to the preventing the c-spine injuries within the American football rugby and other traumatic sports competitions. The authors also share with their colleagues with the methods they treat c-spine injuries in the American football and their attitude to the manual therapy, which is very significant for further development of the subject and seeking new methods of treatment on different stages and different usage of various techniques. All authors demonstrate their well awareness within the subject providing examining data and clear evident facts. They understand the peculiarity of manual therapy treatment of c-spine in American football as the players need to return to the professional sports as far as possible. That is why they try and share with the masses various techniques either they used in their personal practice or summoned the investigations provided within research centers. Manual therapy is very important part for c-spine treatment and every practitioner use this approach in order to achieve quick recovery results and ease the pain of the patients. It goes without saying that in nearest future the usage of manual therapy would be spread wider within the treatment of different injuries and c-spine injuries in American football are good illustration.
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