The Prevalence and Management of Stingers in College and Professional Collision Athletes

Current Reviews in Musculoskeletal Medicine, 2020 · DOI: https://doi.org/10.1007/s12178-020-09665-5 · Published: July 20, 2020

Neurology Orthopedics

Simple Explanation

Stingers are common nerve injuries in collision sports like football, causing temporary pain, numbness, and weakness in the arm. They occur due to forceful contact that affects the cervical nerve roots or brachial plexus. Athletes often underreport stingers, making it difficult to determine the true incidence. Diagnosis involves understanding the injury mechanism, physical examination, and sometimes imaging to rule out more serious conditions. Management includes immediate assessment to rule out life-threatening injuries, followed by physical therapy and, in rare cases, surgery. Return to play depends on symptom resolution, full strength, and normal imaging results.

Study Duration

Not specified

Participants

304 American football athletes (high school, college, and professional players), 569 high school and college rugby players

Evidence Level

Review

Key Findings

1
The incidence of stingers has slowly increased among collision athletes, and nearly half of all players report sustaining at least one stinger in their career.
2
Certain anatomical changes in the cervical spine are related to acute and reoccurring stingers. Most players who experience stingers do not miss practices or games.
3
Athletes with cervical stenosis often have more stingers and recurrences than athletes without cervical stenosis.

Research Summary

Stingers, although likely underreported, are the most common cervical spine injuries in collision sports. These athletes generally show characteristic unilateral upper extremity symptoms, the majority of which spontaneously resolve with conservative treatment. Decisions permitting return-to-play are contingent upon symptom resolution; a benign physical exam; and, in cases of recurrent stingers, imaging within normal limits.

Practical Implications

Improved Screening Practices

Future research is needed to identify appropriate screening practices for athletes with reoccurring stingers to mitigate the risk of injury.

Protective Equipment Development

Further study on the use of protective equipment can help in reducing the incidence and severity of stingers among collision athletes.

Rehabilitation Strategies

Developing and refining rehabilitation strategies are essential to restore full functional strength and ability in athletes who have experienced stingers.

Study Limitations

1
Literature highlighting the impact of stingers on college and professional collision athletes is limited.
2
Athletes are prone to self-underreport stingers due to playing-time concerns and potential career implications.
3
Lack of standardized return-to-play protocols for athletes experiencing stingers.

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