Management of Neck Pain in a 14-Year-Old Football Player
A 14-year-old with neck pain after a football injury should initially be treated with rest, ice, over-the-counter pain medication, and neck strengthening exercises, while ensuring proper tackling technique is taught to prevent future injuries. 1
Initial Assessment and Management
Immediate Care
- Rest: Avoid activities that exacerbate neck pain
- Ice: Apply for 15-20 minutes every 2-3 hours for the first 48-72 hours
- Pain management: Ibuprofen 400mg every 4-6 hours as needed (not to exceed recommended daily dose) 2
- Activity modification: Temporarily avoid contact sports until symptoms resolve
Red Flags Requiring Immediate Medical Attention
- Numbness or tingling in arms or legs
- Weakness in extremities
- Severe pain that doesn't improve with rest and medication
- Difficulty with neck movement in all directions
Rehabilitation Approach
Neck Strengthening Program
Neck muscle strengthening is strongly recommended by the National Athletic Trainers' Association to:
- Decrease neck fatigue
- Maintain proper head-up position during tackling
- Reduce risk of neck injuries and concussions 1
Specific Exercises
- Isometric neck exercises in all directions (flexion, extension, lateral flexion)
- Progressive resistance training for neck muscles
- Core strengthening exercises to support proper posture
Research shows that neck strengthening programs can:
- Increase isometric neck strength
- Decrease peak linear head acceleration during contact 1
- Potentially reduce injury risk when incorporated into regular training
Prevention of Future Injuries
Proper Tackling Technique
- Keep the head up: "Heads-up" tackling is essential to avoid flexion injuries 1, 3
- Lead with the shoulder: Initiate contact with the shoulder while keeping the head up 1
- Avoid spear tackling: Never lead with the crown of the helmet 1
Equipment Considerations
- Ensure properly fitted helmet with secured chin strap
- Consider protective neck collars for players with history of neck injury 3
Return to Play Guidelines
The athlete should not return to football until:
- Complete resolution of neck pain
- Full, pain-free range of motion
- Normal strength in neck muscles
- Demonstration of proper tackling technique 4
Common Pitfalls to Avoid
- Premature return to play: Returning before symptoms resolve increases risk of reinjury or more serious injury
- Ignoring technique issues: Failure to address improper tackling technique will lead to recurrent injuries
- Neglecting neck strengthening: Strong neck muscles are crucial for injury prevention 1, 3
- Dismissing mild symptoms: Even "minor" neck pain should be taken seriously in young athletes
By following these guidelines, most young athletes with neck pain after football injuries can safely recover and return to play while minimizing the risk of future, potentially more serious injuries.