Introduction Stingers, characterized by unilateral arm weakness, are seen in up to 65% of football players.
Stingers, characterized by unilateral arm weakness, are seen in up to 65% of football players. In an NCAA study, they found that the highest incidence of stingers occurred with making a tackle and blocking. The pathophysiology regarding a stinger is a downward depressed shoulder with cervical spine side-bending away from the shoulder, leading to stretching of the C5 or C6 nerve.
Debate exists whether a stinger is due to C5 or C6 nerve root injury or a brachial plexus injury. EMG studies have identified injuries to the cervical nerve roots, brachial plexus, and peripheral nerves in patients diagnosed with a stinger. Recurrent stingers in a single season require further evaluation.
Diagnosis The symptoms of a stinger typically occur immediately after a hit and typically involve a burning pain that radiates down the arm in a non dermatomal distribution. The athlete may also have weakness and numbness in the upper extremity that typically resolve in seconds to minutes. Classification of a stinger is based on the Seddon and Sunderland classification.
Grade 1 injuries are a nerve stretch injury that give transient symptoms, grade 2 involve injury to axons and myelin sheath which cause symptoms that last up to two weeks, and grade 3 symptoms are complete nerve root transection which can lead to permanent damage. Important in the diagnosis of a stinger is differentiating a stinger from a spinal cord injury. Any patient complaining of stinger like symptoms in 2 or more extremities should be evaluated for cervical spine injury.
[INSERT_ELEMENTOR id="9725"] A chronic stinger syndrome typically involves symptoms that last greater than 24 hours. Patients with prolonged stinger symptoms and those with more than two stingers in a season need an evaluation of their cervical spine. Typically, athletes with recurrent stingers will have narrowing of the cervical neural foramen or degenerative disk disease.
If you are experiencing symptoms that may be related to management of recurrent stingers, it is important to see a sports medicine physician. Early evaluation and treatment typically lead to better outcomes. Do not ignore pain or symptoms that are limiting your activity.
*This article is for educational purposes only and does not substitute for professional medical advice. Always consult a qualified healthcare provider.*
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