A neck strain is a painful and debilitating injury because the pain and associated muscle spasm can inhibit any and all movements of the head/neck. For an athlete who needs to have full movement of his/her head, a neck strain can sideline an athlete until the injury has healed. Athletes who try to play through the pain of a neck strain may inadvertently prolong the healing process.
A strain is an injury to a muscle. A strain to a neck muscle can include any of a number of either deep or superficial muscles located around the neck. The muscles of the neck are responsible for the following movements including flexion (chin to chest), extension (eyes to ceiling), rotation, and lateral flexion (ear to shoulder).
When any one of these muscles becomes injured, the movements of the head can become severely limited because strained muscles often result in associated muscle spasms in the injured or surrounding muscles.
While a strain is a tear to the muscle fiber, a spasm is an involuntary contraction of the muscle that tightens the muscle to a point where movement is not possible. Muscle spasm is a mechanism of the body to protect injured or weakened muscles and often accompanies a muscle strain.
What are the classifications of neck strains?
Muscle strains are classified as mild (first degree), moderate (second degree), or severe (third degree) depending on their severity.
First degree muscle strains are the result of a stretching of the muscle tissue that result in pain, tightness, and discomfort with movement of the head/neck. Depending on the muscle that is affected, some or all movements of the head/neck may be painful for the athlete.
Moderate muscle strains are caused by the actual tearing of some of the muscle fibers within the muscle. This can result in increased pain, muscle spasm, swelling discoloration, and increased limitations on head/neck movement.
The most severe type of muscle strain is the result of a complete tear of the muscle usually at the place in the muscle where the muscle and tendon connect or at the insertion of the muscle into the bone.
This type of injury is a serious injury which may result in deformity of the muscle, intense pain, disability, muscle spasm, swelling, and discoloration. Any athlete suspected of a third degree muscle strain should be immobilized and immediately referred for medical evaluation and treatment.
What is the treatment for a neck strain?
Acute neck muscle strains should be treated with the P.R.I.C.E. principles– Protection, Rest, Icing, Compression, Elevation – to reduce pain and swelling and reduce secondary injury. Ice packscan be applied to the injured muscle for twenty minutes every two hours for the first two to three days.
Resting the neck muscles is the most important component of treatment in the early healing process. This can be accomplished through the use of a soft collar. The soft collar is designed so that the chin can rest on the front of the collar allowing the muscles surrounding the neck to relax.
The athlete needs to understand that the healing process will take longer if the neck muscles are continuously engaged and contracted (as in holding the head up). The neck muscles will still heal in time, but resting the muscles allows for much quicker healing.
The only other way to rest the muscles of the neck is bed rest. When the head is resting on a pillow, the neck muscles can be at rest. Anytime the athlete is sitting, standing, walking or active, the neck muscles are contracted to keep the head upright.
Recovery – Getting back to Sport
The athlete can begin functional sports specific exercises when he/she has full range of motion and full strength in all directions of the head/neck without pain. Functional exercises should mimic the skills that the athlete will need to perform when he/she returns to sport.
Bahr, R. & Maehlum S. (2004). Clinical Guide to Sports Injuries. Human Kinetics: Champaign, IL.
Brukner, P. & Khan, K. (2002). Clinical Sports Medicine (2nd Ed.). McGraw Hill: Australia.
Rouzier, P. (1999). The Sports Medicine Patient Advisor. SportsMed Press: Amherst, MA.