The Application of a Cervical Collar to the Football Player Wearing Athletic Protective Equipment

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The Application of a Cervical Collar to the Football Player Wearing Athletic Protective Equipment
May 2007
Conrad, Bryan P.; Koenig, Christopher J.; LuCante, Kathryn J.; Horodyski, MaryBeth; Rechtine, Glenn R. II; Kleiner, Douglas M. FACSM
Medicine & Science in Sports & Exercise
Lippincott Williams & Wilkins

University of Florida, Gainesville, FL.

PURPOSE: Applying a cervical collar to a victim suspected of having a spine injury is one of the requirements for achieving definitive immobilization to a backboard. However, it has been stated that cervical collar application can not be accomplished in the athlete wearing football equipment. Rigid cervical collars are currently available in single-piece and two-piece designs. The purpose of this study was to quantify the amount of head and neck movement during the application of the cervical collar.

METHODS: Movement of the subjects' cervical spine was evaluated by measuring movement of the head from the torso during the application of both cervical collars. The same two Certified Athletic Trainers applied both a single-piece and a two-piece cervical collar to six different models wearing a football helmet and shoulder pads. Motion analysis of the head and neck was obtained by an electromagnetic three-dimensional motion analysis system (Polhemus Inc., Colchester, VT). This is a non-invasive method by which two small tethered sensors were attached to the patient on the football helmet at the forehead and the shoulder pads at the sternum.

RESULTS: The mean amount of movement [degrees (± SD)] for the single-piece design was: 14.14 (± 5.34), 22.42 (± 7.0), and 17.59 (± 4.14) for flexion/extension, lateral flexion, and axial rotation, respectively. For the two-piece design the data were: 12.62 (±3.55), 11.86 (±5.67), and 11.29 (± 1.41) for flexion/extension, lateral flexion, and axial rotation, respectively. More importantly, the single-piece collar was unable to be secured during each of the six trials. The two-piece cervical collar was unable to be secured in 1 of the 6 trials, and was not secured properly in the 5 trials.

CONCLUSION: Although the two-piece design allowed for some degree of application around the neck, whereas the one-piece did not, the two-piece was not applied correctly due to the obstruction caused by the shoulder pads. It should be noted that the two-piece design is not considered a prehospital appliance and is not commonly carried by Emergency Medical Service units. Our data support the notion that cervical collar application can not be accomplished in the athlete wearing a football helmet and shoulder pads, and attempting to apply a cervical collar produces considerable and unnecessary movement.

©2007The American College of Sports Medicine