It’s free agency time, the draft is a month away and March Madness has left me a little bit sleep deprived. Despite that I thought I’d talk about one of the most common injuries in football, the ”stinger” or more serious “burner”.
A stinger or burner happen when there is an impact to the neck and shoulder area. The impact can force the shoulder downward and at the same time the neck and head are forced in the opposite direction. This abrupt movement stretches the nerves coming out of the neck and going into the arm. Depending on how much force is involved the nerve will either be stunned for a brief period of time (stinger) or damaged more severely (burner) or in the worst case completely torn in two.
Stingers are the most common injury. They occur with an impact with the ground or a hard tackle using the shoulder. Immediately the athlete may feel a sharp pain or burning sensation in the arm and the the arm frequently becomes numb and weak. (you’ll see the player come out with an arm just hanging). The player will be quickly evaluated and observed for return of sensation and strength. With a “stinger “ recovery usually occurs in a few seconds to a few minutes. If full recovery occurs in a few minutes or less there is generally no significant injury and the player can return to the game. However if numbness, pain or weakness continues for more than a few minutes there is often a more serious injury to the nerves(a burner).
A “Burner” is a more severe injury to the nerves coming from the neck to the arm. In medical terms it is called a brachial plexus injury. This is broken down into 3 grades. Grade 1 in the least serious and usually involves just the myelin covering of the nerve(think insulation around a wire). This leads to continued symptoms of numbness or pain or a hot burning sensation in the area. Thus the name “burner”. This usually takes 2-3 weeks to heal and the symptoms to resolve. Grade 2 injuries affect the actual nerve fibers. They have similar symptoms but because the nerve is damaged they take longer to heal. Using a test called an EMG the damage to the nerve can be seen by a delayed conduction of a small electrical shock through the nerve. These injuries take much longer to heal and can have symptoms persist for weeks or months. The player will need physical therapy and rehabilitation to regain full strength and sensation.
Grade 3 injuries are a complete tear of the nerve and result in a permanent nerve injury with resultant permanent pain and loss of function. Good news is that these grade 3 injuries are extremely rare in sports.
To reduce this type of injury football players wear, surprise surprise, “shoulder pads “. These help prevent the shoulder from being forced down as far and as hard which reduces the risk of injury to the nerves. Over the years the shoulder pads have been modified to offer even better protection against injury and yet allow better mobility of the arm and shoulder areas So we rarely see a player with a grade 2 injury.
So there you have it. Now you have a better idea of what the player is going through when they come off the field with a “Stinger”. Hope it helps and as always… Go Bills!
So....I have a question Dr. Bruce. If a player comes off the field with an apparent injury and in a few minutes the pain subsides, yet there is still a lingering numbness and lost feeling to extremities for prolonged periods of time beyond the game....is this more of a pinched nerve as opposed to a true injury????