Sports Injuries
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Summer 2000
Volume 11, Number 1
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 Contents
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From the Guest Editor
Don Gerber, PsyD Guest Editor
Cervical Spine Injury in Athletes
Brian H. Wieder, MD
As humanity pushes forward in its relentless drive to expand its
physical capabilities and surpass traditional human limits, the stresses
the body endures would be expected to yield to a higher incidence of
mechanical failure. The cervical spine, its eloquent contents, and its
precarious interposition between a 60 kilogram body mass and a 10 kilogram
head mass make it exquisitely susceptible to such mechanical failure.
Unfortunately, this can lead to catastrophic neurologic injury. Athletes
are bigger, stronger, and faster than ever before. What is common place
today was considered extreme 10 years ago. What is considered extreme
today was considered ridiculously inconceivable 10 years ago. Yet, in
professional athletics, the incidence of cervical spinal cord injury is
actually decreasing. Neuroepidemiologic and biomechanical studies combined
with improved understanding of kinesthetic physiology, have protected
athletes from succumbing to the injuries associated with the
ever-increasing demands we place on the human body. An understanding of
these sciences and the athletic activities themselves, allows those that
train, coach, parent, or otherwise care for athletes to contribute to the
overall success of an athlete while minimizing the risks of spinal cord
injury.
The Concussed Athlete
Alan H. Weintraub, MD
Sports related brain injuries represent approximately 20% of the 1.5
million brain injuries estimated annually in the United States.
Concussion, a term synonymous with "Mild Traumatic Brain Injury"
(MTBI), is an alternation in mental status due to biomechanical forces
affecting the brain which may or may not cause loss of consciousness. This
article will provide an overview of the challenging problems facing
clinicians responsible for the health of athletes in recognizing and
appropriately managing MTBI.
Peripheral Nerve Disorders In Athletes
Marc M. Treihaft, MD
With the growth of athletic participation there has been a commensurate
increase in sports-related neurologic disorders. Peripheral nerve injuries
in sports are caused by trauma, compression, and traction. Prompt
evaluation and treatment of the professional and recreational athlete
enable an earlier return to competition.
Migraine in the Athlete
Judy C. Lane, MD
Migraine in the athlete may occur secondary to effort, prolonged
exertion, trauma, or as a posttraumatic event. The chemistry is probably
akin to that of spontaneous migraine. The purpose of this discussion is to
outline the differential diagnosis of the athlete presenting with
headache. Appropriate treatment can enhance athletic performance and
enable the migraineur to participate in athletic endeavors.
Helmets for Sports and Recreation: An Injury Battle Far from Over
A. Stewart Levy, MD
Sports and recreation are an integral part of life in Colorado.
Traumatic brain injury is the leading cause of death and serious injury in
sports and recreation related accidents. Many head injuries can be
prevented or mitigated through the use of protective helmets. There is
still significant work to be done in the areas of helmet design and
testing, public awareness and education, and policy formulation in order
to maximize head injury prevention.
Neuropsychology of Sports Concussion
Donald Gerber, PsyD and
Elizabeth Kozora, PhD, ABPP/ABCN
There is growing concern in sports medicine about the risks of chronic
brain dysfunction from repetitive concussions, yet the risk factors have
not been clearly identified. Recently, neuropsychological research
methodology has been utilized to systematically evaluate the cognitive
effects of sport concussion. This line of research has identified
objective measures that are sensitive to concussion and has shown that
even a single mild concussion produces slowed processing speed and memory
difficulties during the first week post-injury. Additionally, these
studies raise concern about slow or incomplete recovery following
repetitive concussions. This article reviews the major studies of acute
and long-term effects of concussion in organized sports and the
application of neuropsychological evaluation to sport concussion.
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