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Out there in the real world, one athletic trainer experienced the following:

Late in the afternoon in mid-January at the finals of a middle school wrestling invitational, a 128-lb wrestler's headgear slipped down around his neck. The official stopped the match and called for an injury time out. While evaluating the young wrestler, I noticed that he was having difficulty catching his breath and he said that he was "a little dizzy." Being the typical athlete, he was furious with me when I defaulted him in the finals, because he was sure that he could continue with the match. After monitoring him briefly, his signs and symptoms did not improve. When he tried to take a drink of sports drink, I could hear a clicking sound and he could not swallow. Immediately, I notified the athlete's parents and coaches that he needed to be taken to the emergency department. After radiographic imaging, a fracture of the hyoid bone was diagnosed, which is an injury normally seen only with hangings and strangulation cases. Luckily, the young man's condition was stabilized and he was sent to a children's hospital, where he was monitored and treated. His season was finished, but he was allowed to return to wrestling the next season.

Mindy Smith, MS, AT, ATC, PTA

Drayer Physical Therapy Institute

Head Athletic Trainer, Wilmington High School

Physical Therapy Assistant

Wilmington, Ohio


learning outcomes

After working through this chapter, you will be able to:

  1. Verbalize the questions to use when obtaining a thorough medical history for an assessment.

  2. Describe the principles of body movement at the head, neck, and trunk and the various mechanisms of injury that affect the head, neck, and trunk.

  3. Compare and contrast the findings of various special tests and the role of diagnostic tests used during a head, neck, and trunk evaluation.

  4. Explain the medical terminology associated with the assessment of musculoskeletal injuries.

  5. Verbalize the standard procedures used for a clinical evaluation of the head, neck, and trunk and interpret the findings for differential diagnoses


Debra Ross is a soccer player who is playing midfield and confronts another female player for a head ball. The two girls collide in midair while fighting for a line-driven ball from the defensive sweeper. Ms. Ross makes contact with the ball, but with poor form. As a result, the ball hits her head more anteriorly and forces her neck to go farther into extension (Fig. 9-1). She finishes the first half of the game, which has approximately 7 minutes left to play; however, at halftime she complains of neck pain and stiffness while performing active neck range of motion (ROM). She is point tender, bilaterally, on the lateral sides ...

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