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Approach to the child or adolescent athlete with neck pain or injury

Jason E Decker, MD, FAAP
Albert C Hergenroeder, MD
Section Editors
Joseph Chorley, MD
Richard G Bachur, MD
Deputy Editor
James F Wiley, II, MD, MPH


The anatomy of the cervical spine and the diagnostic approach to the young athlete with complaints of neck pain or injury will be discussed here.

The care of the athlete with an acute neck injury and specific cervical spine injuries are discussed separately. (See "Field care and evaluation of the child or adolescent athlete with acute neck injury" and "Overview of cervical spinal cord and cervical peripheral nerve injuries in the child or adolescent athlete" and "Overview of musculoskeletal neck injuries in the child or adolescent athlete".)


A basic understanding of cervical spine anatomy is critical to the evaluation and management of the young athlete with complaints of neck pain or injury.

Cervical spine — The main function of the vertebral column is to protect the spinal cord. The vertebrae of the cervical spine are smaller and more delicate than those of the thoracic and lumbar spine. Nonetheless, during contact-collision sports, the cervical spine may be required to dissipate axial forces that are several times the individual player's body weight.

The first two cervical vertebrae are specialized bones that function as an important unit. The atlas (C1) articulates with the occiput of the skull superiorly and with the axis (C2) inferiorly (figure 1). Approximately 50 percent of cervical spine motion occurs at these two joints [1,2]. The atlanto-occipital joint permits the majority of flexion and extension, whereas the atlantoaxial joint permits the majority of rotation [3]. Varying amounts of flexion, extension, lateral bending, and rotation occur from C3 through C7. In the child older than eight years and in the adult, flexion is centered in the area of C5-C6, and extension in the area of C6-C7 [1]. These areas are particularly vulnerable to injuries and degenerative changes.

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Literature review current through: Nov 2017. | This topic last updated: May 06, 2016.
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