Module 2: Wrestler’s neck common Injuries- Prevention exercises

Cervical Spine injuries

Nearly 15% of all spine injuries occur in sport-related activities, making sports the fourth most common mechanism behind motor vehicle collisions, violence, and falls. Up to 10% of all cervical spine injuries happen in sports. The sports associated with the highest rates of spine injuries include football, ice hockey, wrestling, driving, skiing, snowboarding, rugby, cheerleading and baseball. (Kleeman, et al. 2015).

One way of categorizing the mechanism of injury to the spine is through the causal factor. Non-traumatic mechanisms of injury include overuse and overload injuries to the bone, ligaments, muscle, disc or neuronal elements. Traumatic mechanisms of injury include direct impact or indirect injuries again to all tissues that make up the spine. Muscle injuries are very frequent, and so are bone injuries (e.g. spondylolysis and spondylolisthesis) and disc injuries (disc prolapse). A special type of injury that needs to be commended on is the whiplash-type injury of cervical or lumbar spine following either direct or indirect impact mechanisms of injury. This type of injury may result in bone, joint, ligament, muscle, disc and neuronal tissue long-term histological and clinical sequelae.  The most catastrophic type of injury that may be encountered in sports is paraplegia following an injury to the thoracic or cervical spinal cord, or tetraplegia following an injury to the cervical spinal cord (Kleeman, et al. 2015).

In a study carried out by Lorish et al. (1992) in adolescent and preadolescent boys, the primary areas of injury were to the upper extremities (33%), and the neck and back (24%). Such findings can be attributed to the fact that in Greco-Roman style wrestling, most of the techniques executed in order to bring the opponent down and defeat him, involve the trunk. The consequence of such mechanical action on the opponent body will be to crash fall onto the mat, with the possible likelihood of injurious involvement of the skin, followed by extraordinary pressure on the trunk. In addition, following the landing on the mat, additional pressure is exerted to the trunk by rubbing the body on the mat, which may lead to simultaneous injuries of the skin, neck and trunk, as well.

Although rare, cervical spine and catastrophic injuries do occur in wrestling. In their retrospective review of catastrophic injuries in wrestling, Boden, et al., (2002) found that the highest incidence of injuries occurred in match competitions (80%) with a trend toward more injuries in the low- and middleweight classes. The authors examined 35 incidents that were reported to the National Center for Catastrophic Sports Injury Research over an 18-year period from 1981 to 1999. The position most frequently associated with injury was the defensive position during the takedown maneuver (74%), followed by the down position (23%) and the lying position (3%). The authors conclude that although rare, catastrophic injuries do occur in wrestling. The researchers found that athletes are commonly injured by one of the two mechanisms. In the first scenario, the wrestler’s arms are held in such a manner that he is unable to prevent himself from landing on his head when thrown to the mat. The second situation involves the wrestler attempting a roll but instead being landed on by the full weight of his opponent, causing a twisting hyperflexion, and neck injury. In 10 of the 26 takedown injuries (38%), the wrestler landed on the top of his head, sustaining an axial compression force to the cervical spine.

Lower back injuries in wrestling commonly take place during takedowns. While sparring for position, wrestlers push against each other with the lumbar spine in mild hyperextension. This extension, coupled with twisting, results in injuries. Extension against resistance, as in lifting an opponent off the mat, and hyperflexion, as in rolling, are also mechanisms that account for low back sprain or strain.

In elite wrestlers the cervical extensor muscles were more strongly developed and had a larger cross-sectional area than amateur wrestlers, judo practitioners and non-athletes. This strength enables them to keep their head and neck in a fixed position despite the opponent’s maneuvres to push both of their shoulders onto the mat to accomplish a takedown. Greco-Roman wrestlers have higher levels of cervical muscle strength/kilogram of body mass compared with freestyle wrestlers, helping them achieve manoeuvres such as the salto which involves lifting and taking the opponent down on the mat (Chaabene et al. (2017).