Rehabilitation for Neck Injuries
Russell Gunner, C.A.T. (C)

In a previous article we discussed the major neck injuries that can occur in hockey. Unfortunately this is part of the sport. However, not all neck injuries require a trip to the hospital on a spinal board. Several of them are simple muscle strains and joint irritations. We will discuss the less severe neck injuries and the options on treating them to return to the ice as soon as possible.

When a player goes head first into the boards, we always think the worse. The majority of the times, the player will get up and continue on down the ice looking for the truck that just ran them over. After the game it is not uncommon to hear the player complain of a little bit of neck pain following the hit. As always, the initial treatment for such an injury is ice. You can use the same regular premise of icing for 15-20 minutes with a wet towel underneath it to prevent frostbite. This will help decrease the initial inflammation process and help the muscle spasms.

The general rule of thumb is to ice for the first 24-48 hours, then heat as necessary. It is this authors opinion if the neck pain has not gone away within 3-5 days, you should do something more about it. At this point now, you will have several options.

The general family doctor will often be the player's first approach, but it may not always be the right one. The family doctor will be able to assess the area and probably prescribe some medication to help decrease the pain a little. If there is more than just a small strain of the muscle, this will only be like putting a band-aid on it. It will help a little, but not get rid of the problem.

The chiropractor is often another approach some will take. Unfortunately there have been some issues lately with chiropractors doing neck manipulations and some side effects that may arise from them. What chiropractors essentially do is assess the neck and possibly find a joint that they call subluxed. This means it is not sitting in the exactly as it should. This could be what is causing the pain. They will then often manipulate the neck to readjust the position and hopefully alleviate the pain. You may have to attend a few more appointments, but it will hopefully return you to the ice quicker.

An athletic therapist of physiotherapist will often treat the area slightly differently than a chiropractor. The assessment will be able again to determine the injury, whether it is a joint, muscle or other soft tissue in the neck area. The treatment will then consist of manual therapy to alleviate the soft tissue or joint irritation, modalities for pain and exercises to maintain and increase your range of motion. As with the chiropractor, depending upon the injury, it may take a few treatments to alleviate the problem.

A massage therapist is also another option to help with the neck problem. The massage therapist will often just work to alleviate the muscle spasm that may be associated with neck injury. If this is the only symptom, then this is one type of treatment that may help. If the neck is more joint related, this may only relive a few symptoms but not get rid of the problem.

There are also many other treatment bases that you can approach, i.e. acupuncture, osteopathy, etc. There is not one which may be best, but it is often a personal preference or ask your friends what worked for them. The best form of marketing for a therapist is word of mouth. The one recommendation I would definitely make in choosing the right form of therapy, is it should not take more than 2-3 treatments to get rid of the problem if it just happened. It is impossible for the therapist to unfortunately answer this over the phone, but they should have a good idea following the assessment. So if you go to a chiropractor and they say it will take 84 treatments, look elsewhere.