It is that time of year again when weekends are spent at stadiums taking in football games, or at home watching them on TV. From a sports and entertainment standpoint, for me this is the best time of the year. From a professional standpoint, this is a busy time due to the increased number of traumatic sports injuries. So much so that we host a Saturday morning sports injury clinic at my office during football season to help manage these football injuries.
One of the most common injuries that can occur during football but is often ignored by players is a burner or stinger. Most people who watch football have heard of these injuries, and many players have sustained at least one. But what exactly is a burner or stinger? After contact, the player feels an immediate burning or stinging pain down one arm all the way to the fingers. It can also feel like an electric shock or “lightning bolt” sensation down the arm. This sensation is temporary, and usually resolves after seconds to minutes. The player will typically run off the field with a “dead arm”, holding it motionless down at their side.
Burners or stingers are caused by a stretch injury to the nerves of the arm. They usually occur during a tackle, where the shoulder is forced down and the neck is forced to the opposite side. This causes stretching of the nerves exiting the neck and going to the arm. A minor stretch injury may cause temporary symptoms that resolve completely, whereas a more significant stretch can cause residual symptoms of weakness in the muscles of the arm until the nerve fully recovers. This can sometimes take weeks or more to resolve.
Is it safe to go back to play after a burner or stinger? When I examine a player on the sidelines with a stinger, I will let them return to the game if their symptoms have resolved and they have no neck pain and no muscle weakness anywhere in the arm or shoulder.
When are burners or stingers a concern? When should a physician check them? If there are symptoms in both arms or if there is neck pain associated with it, this should definitely be checked right away because it could point to a more serious neck injury. If there is a history of multiple burners or stingers, this could be a result of a congenital abnormality of the spinal canal called spinal stenosis, and should be checked. If weakness persists for more than a few days, this should also be examined and may require therapy to help regain strength.
Can stingers or burners be prevented? Not completely, but at least in football, there are special shoulder pads and collars that can be worn that can help minimize the risk of sustaining a burner. These are usually only recommended for players that have had multiple stingers or burners in the past. Focused neck and shoulder exercises to strengthen the muscles that support the head and shoulder can help prevent future stingers. This is especially important in young athletes that haven’t developed strong neck musculature and aren’t able to fully support the weight of a football helmet during activity. These exercises can be directed by a physical therapist at first, and should be continued throughout the season.
Question or comments? Have you ever had a stinger?