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What does having too many stingers mean?

Q: I'm a college football player. The doc says I've had one too many stingers and the problem has become "chronic". What does that mean?

A: As you already know, a stinger is an injury to a nerve in the neck. It's a common injury among players involved in contact sports (football players being the most commonly affected athletes). Getting hit on the head from one side is usually enough to do it. A cervical nerve (coming from the spinal cord to the arm in the neck) gets stretched or pinched.

Besides neck and shoulder pain, there may be additional symptoms of arm weakness and numbness. The symptoms are usually transient (temporary) and go away within 24-hours. But repeated stingers over time can eventually lead to a chronic stinger syndrome. With a chronic stinger, symptoms of neck and shoulder pain with numbness, tingling, and weakness don't go away.

Most players who do experience persistent symptoms from a chronic stinger recover. With conservative care, they are able to return to 100 per cent participation in their sport. Anyone suffering an acute stinger should be advised to rest and avoid contact sports (anything that could cause traction, compression, or direct blow to the head/neck).

Some players use a special collar called a Cowboy Collar to protect the neck. This is worn during play and practice. It is a cervical collar (fits around the neck) underneath the shoulder pads. The Cowboy Collar fills the gap between the helmet and the shoulder pads. When worn with regular shoulder pads, the Cowboy Collar helps absorb shock.

Special exercises to help stabilize the head and neck are encouraged. You should be aware that multiple stingers and chronic stinger syndrome are linked with degenerative changes in the spine that can cause problems much later in life. If you have further questions about this condition, don't hesitate to ask your team physician for more information.

Reference: Jared Greenberg, MD, et al. Predicting Chronic Stinger Syndrome Using the Mean Subaxial Space Available for the Cord Index. In Sports Health. May-June 2011. Vol. 3. No. 3. Pp. 264-267.