Injury-Reduction Programs Containing Neuromuscular Neck Exercises and the Incidence of Soccer-Related Head and Neck Injuries.

CONTEXT: Concern is growing among soccer players, coaches, and parents regarding head and neck injuries, including concussion, particularly from heading a ball. Thus, we need to explore soccer-specific head injury risk-reduction initiatives. One such initiative is to condition the neck musculature of young players by adding neuromuscular neck exercises to existing injury-reduction exercise programs. OBJECTIVE: To investigate the effect of neuromuscular neck exercises completed as part of an injury risk-reduction exercise program on the incidence of soccer-related head and neck injuries in adolescent soccer players. DESIGN: Prospective cohort study. SETTING: Two sports high schools and 6 soccer clubs during the 2021 soccer season. PATIENTS OR OTHER PARTICIPANTS: A total of 364 male and female soccer players, aged 12 to 18 years. INTERVENTION(S): Members of 1 sports high school and 2 soccer clubs performed neuromuscular neck exercises as part of an injury-reduction program during training (neck training group). Members of another sports high school and 4 soccer clubs performed an injury-reduction program but without neck exercises (comparison group). MAIN OUTCOME MEASURE(S): Self-reported injury data were collected from each player at the end of the season and used to calculate incidence rate ratios (IRRs) with 95% CIs. RESULTS: In total, 364 players completed the study, including 146 players in the neck training group and 218 players in the comparison group. Despite players in the neck training group being less likely to self-report a concussion (IRR = 0.23; 95% CI = 0.03, 1.04) and pain on heading a ball (IRR = 0.62; 95% CI = 0.34, 1.07), only a lower incidence of possible concussive events (IRR = 0.38; 95% CI = 0.14, 0.90; P < .05) was significant. CONCLUSIONS: Integrating neuromuscular neck exercises into injury-reduction exercise programs has the potential to reduce the risk of adolescent soccer players sustaining a possible concussive event, concussion, or pain on heading a ball.

Evaluating the Effects of a Novel Neuromuscular Neck Training Device on Multiplanar Static and Dynamic Neck Strength: A Pilot Study.

Versteegh, TH, Dickey, JP, Emery, CA, Fischer, LK, MacDermid, JC, and Walton, DM. Evaluating the effects of a novel neuromuscular neck training device on multiplanar static and dynamic neck strength: A pilot study. J Strength Cond Res 34(3): 708-716, 2020-The neck serves an important function in damping the transference of acceleration forces between the head and the trunk, such as that occurring during contact sports or motor vehicle collisions. An inability to adequately dissipate forces has been proposed as a potential mechanism for clinical conditions such as whiplash or concussion, but current approaches to neck training may not be targeting the correct mechanisms. The purpose of this study was to explore the training effect of a novel neuromuscular strengthening protocol on dynamic and static neck strength. This was a quasiexperimental pilot study design with intervention (n = 8) and control (n = 10) groups. The intervention group was trained (twice/week, ∼10 minutes, for 7 weeks) on a training device that uses self-generated centripetal force to create a dynamic rotational resistance. This protocol is intended to target the ability of the neck muscles to perform coordinated multiplanar plyometric contractions. Both groups also continued with traditional neck strengthening that included training on a straight-plane, isotonic, 4-way neck machine. Performance on the training device showed improvement after routine practice within 1 week, as evidenced by a trend toward increased peak speed in revolutions per minute (RPM). After 7 weeks, peak RPM increased from 122.8 (95% confidence interval [CI], 91.3-154.4) to 252.3 (95% CI, 241.5-263.1). There was also a large positive effect size (Hedge's d, 0.68) in isometric composite (multiplane) neck strength favoring the intervention group over the control group (difference, 20 N; 95% CI, -8 to 48). The largest magnitude strength improvement in a single plane was in axial rotation and also favored the intervention group over the control group (Hedge's d, 1.24; difference, 46 N; 95% CI, 9-83). Future studies should explore whether the dynamic training presented here could help reduce the risk of sports concussion, whiplash, or other head-neck trauma.