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Why Cervical Spine ROM is Crucial for Athletes

By Kyle Kiesel, PT, PhD and Todd Arnold, MD

on September 13, 2016

Categories: Athletic Training, Physical Therapy, Sports

Think you have your athlete’s back? Think again!

The appropriate diagnosis and management of cervical and thoracic spine injures in athletics is critical for returning to high-level performance. Often, an athlete with neck or thoracic pain will seek medical or rehabilitative care but will continue to fully participate in sport. Here are several guidelines to remember that emphasize complete cervical spine function in athletes:

Return to Play vs. Discharge of Care

Rehabilitation providers need to differentiate return to play recommendations from discharge of care. Appropriate discharge testing is crucial to identify all the meaningful impairments so nothing is missed. Leaving modifiable impairments on the table is a recipe for poor performance potential or re-injury.

Full Cervical Spine ROM in Sports

Do not underestimate the function of full cervical spine ROM for sports. The initial validity of cervical rotation may not be that obvious…but when we go into more detail, the cervical spine’s role in full spinal ROM is extremely important. For example, many sports involve generation of high rotational velocities through the hips and spine for throwing and hitting. These velocities hinge on a smooth relationship between cervical, thoracic, and pelvic mobility (among others). Efficient rotational velocity production relies on these linked processes.

For normal thoracic rotation motor control, the athlete needs to possess adequate cervical mobility and control. For example, when in the batter’s box a right-handed hitter needs full thoracic rotation to the right and full cervical rotation to the left. Both of these motions are extremely important in hitting athletes who are taught to keep their “head still” during the execution of the swing.

With these examples in mind, recognize the importance of appropriate discharge testing (rather than just return to sport) and don’t neglect even subtle cervical ROM loss in athletes!

Kyle Kiesel, PT, PhD

Dr. Kiesel is a professor of physical therapy at the University of Evansville and a cofounder of the Functional Movement System. During his 20 years in academics, he has spent nine years directing programs in athletic training and physical therapy. His areas of research include motor control of the core, breathing, and functional movement testing and training. Because of his long-standing interest in athletic performance, injury prediction, and recovery, his research has also led to significant work related to functional movement screening, testing, and assessment for athletes. He has authored more than 40 peer-reviewed publications and regularly presents his work nationally and internationally, in addition to reviewing manuscripts for a variety of journals. He serves as a consultant for professional and college sports teams as well as the military, where he assists with injury prevention and implementation of the Functional Movement System model. He has extensive experience teaching lecture and lab courses emphasizing core training and functional movement assessment and intervention, including both the Functional Movement Screen (FMS) and the Selective Functional Movement Assessment (SFMA), and he has taught in approximately 20 different countries.

Todd Arnold, MD

Dr. Todd Arnold is a primary care/sports performance physician with over a decade of experience caring for athletes of all levels from scholastic to professional. He serves as a sports performance scientist for USA Track and Field, and has worked extensively with over 50 athletes in preparation for the 2012 Olympic Games, where the team won 29 medals. He has served as head team physician at both Division I and Division II colleges. Todd has extensive training through the Titleist Performance Institute in the biomechanics of the golf swing, golf fitness, and healthcare related to the golfer, and he is the co-creator of Prescription Golf & Fitness™. He sees patients daily and is committed to increasing the public’s awareness of concussions.

Dr. Todd Arnold is a board-certified sports medicine specialist. He is currently licensed to practice medicine in Indiana. He received training at the Indiana University School of Medicine, Poudre Valley Hospital, and the University of Colorado Denver School of Medicine.