Cervical Spine Injury Management in Elite Athletes

Elite athletes in collision and high-velocity sports remain at heightened risk of cervical spine trauma, spanning sprains and strains through to disc herniations, fractures and neurological compromise. Management has evolved into a continuum from on-field assessment with cervical immobilisation and neurological screening, through advanced imaging and multidisciplinary decision making. Acute interventions hinge on rapid recognition of red flags—neurological deficit, spinal instability or vascular injury—and adherence to standardised transport protocols. Subsequent care may involve conservative measures such as rigid or soft cervical collars, targeted physiotherapy and graded strengthening, or surgical intervention, most commonly anterior cervical discectomy and fusion, in cases of persistent radiculopathy or mechanical instability. Rehabilitation is tailored to sport-specific demands and underpinned by objective return-to-play criteria involving pain-free motion, core stability and functional testing. Emerging practices emphasise prevention through technique optimisation, neck-strengthening programmes and real-time biomechanical analysis. The global significance of this field is underscored by its impact on athlete career longevity, health equity across regions and the broader implementation of evidence-based guidelines within sports medicine.

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Cervical Spine Injury Management in Elite Athletes publication trend

The graph below shows the total number of articles in cervical spine injury management in elite athletes across all publications each year (not limited to Nature Index journals).

Technical terms

Cervical disc herniation: Protrusion of intervertebral disc material in the neck region, often causing nerve root compression and radicular symptoms.

Cervical radiculopathy: Neurological deficit resulting from irritation or compression of cervical nerve roots, manifesting as pain, sensory changes or muscle weakness in the upper limb.

Brachial plexus injury: Trauma to the network of nerves emerging from the cervical spinal roots, commonly seen in contact sports as transient sensory or motor impairment (“stinger”).

Conservative management: Non-surgical treatment modalities including immobilisation, physiotherapy, analgesia and activity modification.

Return-to-play protocol: A stepwise framework of functional and strength assessments that an athlete must satisfy before reintegration into full competition following cervical injury.

References

1. Sports-Related Cervical Spine Injury: A Series of Two Cases with Literature Review. Indian Journal of Neurotrauma (2024).
2. Rehabilitation of brachial plexus injury in contact sport: Where are the data that underpin clinical management? A scoping review. PLOS ONE (2024).
3. Analysis of Severe Spinal Injuries in Korean Elite Female Wrestlers. Applied Sciences (2024).