This response in in regard to the letter written by Mr. Richard Tuthill on the
Travis Roy cervical spine injury.  As an athletic trainer, I think it is great
that you are trying to use your education to try to prevent injuries like this
in the future.  As an A.T. I never want to be in the situation where any of my
hockey athletes (or any sport for that matter) injures his/her c-spine.  This
is an injury that is difficult if not nearly impossible to prevent when not
due to a deliberate action of an athlete.
 
The mechanism of injury for a c-spine injury in athletics is almost always
axial loading.  When the head is flexed (bent) to approximately 20 degrees,
the c-spine is in a straight line and becomes a segmented column.  When a
force is applied in this  position to the top of the head, the column has to
give somewhere.  Due to the bones being in a straight alignment, the
supportive ligaments and muscles can't act to absorb any of the force.
Usually, the c-spine gives somewhere between C4 and C7.
 
When I speak of deliberate action, I mean spearing.  Spearing is initiating
contact with the head.  I have this particular injury (T.Roy) on video and
have watched it with my student athletic trainers. Although we can't see the
actual contact with the boards, it is obvious that he contacted the boards
with the top of his head.  In no way was this a deliberate action on his part,
this was one of those rare "fluke injuries".  In football, it is rarely a
fluke, but in ice hockey an athlete can easily crash into the boards at
anytime out of control.
 
To further enhance your understanding of c-spine injuries and the mechanics,
it isn't really the lack of protective equipment in this case.  In c-spine
injures due to axial loading, the head contacts the boards and stops
immediately.  The body continues to move and decelerate which crushes the
spine between the head and the body.  It is the body weight that actually
fractures the spine.
 
I don't know anything about engineering, but if this helps your understanding
and something can be done anyway, we all benefit.  I'm not sure if added
padding in a helmet would even help since we are talking about deceleration
and not direct transmission of force.
 
I can work with my football players to keep their heads up and prevent such an
injury.  Spearing is not very common in hockey (at least not with their head)
and coaching really can't do much else to prevent this from occurring.  This
injury is truely a tradegy and is real unfortunate.  It seems that he just
slid off of a check and fell off balance into the boards.
 
Hope this helps you understand a little more about the injury.  I don't know
much in particular about this specific injury, but I can speak in general
about c-spine injuries.
 
Stuart A. Balter ATC
Head Athletic Trainer
Hudson Valley Community College
Troy, NY  12180
 
email: [log in to unmask]
 
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