Neck Strengthening Reduces Concussion Risk

By Dr. Rob Lemyre, PT, DPT

According to the Centers for Disease Control and Prevention, approximately 250,000 emergency room visits by adolescents under the age of 19 are precipitated by sports-related concussions and non-fatal traumatic brain injuries in the U.S. annually. The multiple benefits of a physically active lifestyle are unquestionable, such as weight management, increased strength, endurance, flexibility, improved self-esteem, confidence, and emotional stability; but student athletes are also at greater risk for concussions than those choosing a more sedentary lifestyle. Young athletes are more prone to concussions than their adult counterparts, and often experience a greater degree of severity in the initial and long term negative effects related to concussions secondary to the continued development of neurological and cognitive body systems occurring throughout adolescence.  

In more recent years, an increasing number of students of all ages are being drawn to participate in school and community based sports for a variety of reasons. Increasing community awareness relative to the importance of staying active and pursuing a healthy lifestyle, proposed cuts to physical education classes being considered in many school districts across the country, and increasing college tuition fees resulting in greater competition for sports-related scholarships, are all contributing to an ever-increasing student athlete population. As the number of student athlete participants increases, so will the number of sports-related concussions, prompting the need for development of effective concussion prevention programs.

To date, areas of research relative to concussion prevention have focused on three general components: (1) Production of improved helmet technology, (2) Expansion of helmet utilization to a greater number of sports, and (3) Institution of rule changes to facilitate avoidance of head trauma.

Despite modern advances in helmet technology, and their introduction to sports other than football in more recent years, helmets have been shown to fall relatively short in reducing exposure to concussions. A helmet’s primary function is to reduce skull fractures. Cutting edge helmets have improved their ability to diffuse direct, external fracture-causing forces on the skull, yet do little to combat acceleration and rotational forces, the primary components producing concussions. Recent rule changes, such as “heads up tackling,” instituted in the sport of football, are a good attempt at reducing brain trauma, yet as with any game-time situation, rules are broken from time to time, whether advertently or inadvertently. So perpetually stands the need to pursue other avenues of research to identify a concussion prevention mechanism that is cost effective, easy to implement, and accessible to any student athlete. More recent research demonstrates that neck strengthening may be the answer. A study by Christy L Collins and R. Dawn Comstock, published in the Journal of Primary Prevention in June 2014, collected data on 6,704 student-athletes in six sports: boys’ and girls’ soccer, basketball, and lacrosse. The study demonstrated that athletes with the weakest necks experienced the largest number of concussions. Conversely, those with the strongest necks sustained the fewest number of concussion incidents. According to the study, “Smaller mean neck circumference, smaller mean neck to head circumference ratio, and weaker mean overall neck strength were significantly associated with concussion.” The study also showed that even a minimal one pound increase in neck strength can reduce concussion risk by as much as 5% in a given athlete.

The research about the benefits of a stronger neck is now present, yet is there a given protocol to follow? The answer is, researchers are working on it. In the meantime, a starting point for any student athlete can be execution of self-performed, manual resistance exercises such as neck isometrics. An example of a neck isometric is placing one’s hand on the side of the head, just above the ear. While sitting with good posture and neck alignment, gently apply pressure with the hand to the side of the head while the head resists the applied pressure, staying in place without any movement for 5 seconds. Relax. Repeat 10 repetitions. The same technique can be applied to the opposite side of the head, as well as the front and back. Starting with 1 to 2 sets of 10 repetitions is a good starting point, while working up to 3 sets in each direction can be an ultimate goal. As with any exercise program, no athlete should participate without first consulting their physician, and, when cleared by their doctor to begin, performing it under the direct supervision of a licensed healthcare or fitness professional to ensure safety and proper technique. For more information on neck strengthening, consult your physician, school’s athletic training department, your chiropractor, physical therapist, or other licensed health professional. As it turns out, if you want to “keep your head in the game,” start with adding a neck strengthening routine.

Dr. Rob Lemyre is a physical therapist at ProClinix Sports Physical Therapy & Chiropractic, practicing in their Ardsley location (within House of Sports). He can be reached at 914-202-0700. 

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