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Here is what one athletic trainer experienced while rehabilitating an athlete's injury:

In the third period of Tommy Davis' wrestling match, with 30 seconds remaining, he was brought down on the back of his head and neck by the opponent. The official instantly blew his whistle to stop the match as Mr. Davis laid motionless. At first I thought he was unconscious. Was he breathing? Had he broken his neck? As I approached Mr. Davis, I saw that he was breathing, his eyes were open, and he was responsive. After evaluating him on the mat, I determined that he had no cervical spine tenderness, no numbness or paraesthesia into his extremities, and no symptoms of a concussion. However, he had point tenderness over the left upper trapezius muscle. Two days after the injury, he saw an orthopedist to rule out anything other than an upper trapezius strain. For the next 2 weeks, Mr. Davis was taught a noncontact practice regiment. He continued to have upper trapezius pain when he rotated his head from side to side. His rehabilitation program included lateral neck side bending stretches, head rotation stretches, and a gentle massage over the upper trapezius. He was also taught strengthening exercises such as shoulder shrugs, isometric neck rotation, and side bending sets. It was important for him to maintain his cardiovascular level; therefore, he was taught a stationary bike interval program. The stationary bike was brought into wrestling practice so that Mr. Davis could do his interval program while watching the team practice. As a result, Mr. Davis still felt like a part of the team. I can still see Mr. Davis lying there on the mat, but I am thankful that an upper trapezius strain was our only concern.

Lori Ulrich, AT, ATC

Head Athletic Trainer, Eaton High School

Dayton Sports Medicine Institute

Dayton, Ohio


learning outcomes

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

  1. Describe seven different goals of rehabilitation and the importance of each in the overall rehabilitation protocol.

  2. Verbalize indications for performing head, neck, and trunk rehabilitative techniques.

  3. Discuss modifications and progressions that are used during a rehabilitation program for the head, neck, and trunk.

  4. Discuss outcome measures used to identify activity levels and return-to-play guidelines for head, neck, and trunk injuries.

  5. Explain what modality choice is proper for rehabilitation by using indications and contraindications and the principles and theory related to the physiological response of the intervention.


Miguel Lopez is a collegiate tennis player who is currently in preseason training. While practicing his serve, he feels a sharp pain in his abdomen. He moves around a bit and then decides that he is fine, so he serves again. The pain is now ...

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