Green Bay Packers tight end Jermichael Finley sustained a serious head injury this past weekend while the team hosted the Cleveland Browns at home, for the second time this month. Though he appears to be recovering movement in his extremities, despite having suffered temporary paralysis immediately after the injury, it’s a stark reminder that the effects of head trauma in football can be brutally immediate.
We still don’t know which neurological injuries will be transient and which will be permanent. Assuming Finley is able to regain full sensation in his arms and legs, he will have suffered something called transient paresis, a horrible consequence of cervical spine injury.
Athletes can experience this type of injury in one of four ways; the neck may be 1. hyperextended, 2. hyperflexed, 3. compressed, or 4. subjected to indirect blunt force.1 Assuming any of those occur, and cause an interference with teh spinal cord, the thin bundle of neurons that extends down from the base of the skull and serves as a mean of transporting sensory and motor information to other parts of the body, as well as being a center for coordinating certain reflexes, it spells disaster.
Hyperextension and hyperflexion of the neck can result in what we commonly call whiplash2, a catchall term for sudden strain to the muscles, bones and nerves in the neck. During whiplash, ligaments or vertabrae can fold into the spinal canal, compromising the spinal cord. Reasons for neurologic symptons haven’t been sorted out yet, however it seems to be related to physical trauma to the neurons in the cord or a compromise in blood flow.
In addition to whiplash, neck injury can result from compression or blunt force trauma, which destabilize the vertebrae, ligaments, and connective tissue that support and protect the neck. In this scenario, blunt force trauma can cause any of these body parts to herniate into the spinal column, causing neurologic symptons, like the ones Finley had experienced after he connected with Browns safety Tashaun Gipson. However, before we attempt to prognosticate, it is important for us to know exactly the type of injury Finley sustained and, more importantly, what his neck anatomy looked like before and after the latest injury.3
In the fourth quarter of last night’s Packers game, Finley took a slant pass from Aaron Rodgers and lowered his head just as Gipson was moving in to tackle him. Gipson connected with Finley by hitting his head with this right shoulder-pad, and Finley fell limply to the ground almost immediately, signaling, initially, what most though was an immediate knock-out caused by concussive force, i.e. it was assumed Finley was immediately and severely concussed. This signaled the medical team to hit the field promptly. The tight end then spent the next few minutes on his back on the turf as the Packers’ training and medical staff immobilized his head and neck before he was taken off the field in a stretcher and brought to the ICU.
Players and fans were understandably disturbed by the play. When teammate Andew Quarless initially approached Finley, he said his fallen teammate couldn’t move and players could be seen with tears in their eyes as he was carted off the field. ESPN has since reported that Finley has regained almost all movement and a source has since told NFL.com that Finley’s hospital stay is precautionary and that “he’s going to be fine.”
The truth is that that statement cannot be made with 100% positivity, because it’s simply too soon to tell.
Whenever a football player hits the field and is expected to incur a tackle (just about every player on every down is expected to incur a tackle), he’s potentially at risk of one of the four aforementioned types of neck injuries. If a player is hit the wrong way, and the spinal cord is compromised, players like Finley can feel unusual sensations in their extremities immediately. The most common symptom is the so-called burning hands syndrome, which is suggestive of a lesion to the central part of the spinal cord. In addition to numbness and tingling, the player may be unable to move certain parts of the body. This lack of movement can range from mild weakness to full paralysis, dependent on the severity of the injury. Often, there is no other neck pain at the time of injury. Symptoms can generally last less than 10 – 15 minutes, but may last as long as two days. It’s important to know that Finley is still in a critical recovery window, and will be for at least one more day.
It’s unclear as to whether Finley should ever return to Football even if he recovers. A recent study suggests that some NFL players can safely return to the field after certain types of head and neck injuries. That’s far from medical dogma, though, especially for a repeat victim like Finley.
Finley’s first injury of the season occurred on Sept. 22, when he was the victim of a helmet-to-helmet hit by Bengals safety George Iloka. Finley staggered off of the field and was soon after diagnosed with a concussion. Finley was visibly shaken by the head injury, as were those around him. Speaking to ESPNWisconsin, Finley said at the time, “I get calls from my grandma all the time. I tell her I only want to play 8 to 10 more years, and she says, ‘Boy, you need to quit this dang game.’ That’s the thing. I know the risks. But family members that care about you, they see it from a different perspective than we do.”
It’s a perspective that is worth considering by Finley. While fans may want Finley back, and the organization may want him back (Finley is currently having a great season through week 7, racking up 300 yards on 25 receptions and 3 touchdowns) one can reasonably argue that he should never step on a football field again. There are reports of athletes with transient neurological symptoms—the same as Finley reportedly experienced here—who subsequently developed permanent neurological injury. No one wants to see his name added to that list.
After his previous concussion, Finley’s five-year-old son had one request. “Daddy,” he said, “I want you to stop playing football.” He’s not the only one.
1A recent case of a Canadian professional hockey player recently developed transient paresis after being struck in the back of the neck by a puck Winder MJ, Brett K, Hurlbert RJ. Spinal cord concussion in a professional ice hockey player. J. Neurosurg. Spine. 2011; 14: 677–80. [Context Link>).
2Before the invention of the car, whiplash injuries were called “railroad spine” as they were often seen in connection with train collisions
3Football players often have unusual neck anatomy. In 1993, a new condition was described called Spear tackler’s spine that occurs in football players who habitually tackle using the top of the head as the initial point of contact. These players have narrowing of the cervical spinal canal and straightening of the normal neck curvature. They are also predisposed to permanent neurologic injury and should avoid all contact sports.