The other side of the pole vault issue. (Track & Field).

Most coaching at one time or another invokes Murphy's Law: "If anything can go wrong." it will."

Coaches who can avoid the unexpected will usually be able to get their athletes or teams to perform at a high level and in a predictable manner.

Take football. If you can get each offensive player to execute his assignment, your team should score. The team with the least amount of missed assignments will generally win.

In the individual sports, where performance is based on technical execution, the more precisely the athlete performs his technique the better, and generally the safer, will be his performance.

Although I (Hannay) have coached on every level of the pole vault over the past 26 years, assisted and directed nearly 50 camps, and witnessed nearly 450,000 vaults, I have always lived with the fear of witnessing or contributing to an injury that could have been avoided--such as could easily occur to a vaulter wearing a helmet.

Murphy's Law might conceivably place the vaulter on the landing mat in an awkward but not necessarily unsafe position. But put a helmet on him and it might compound the forces that are applied to the head, neck, and brain stem--transforming a minor problem into a catastrophe on any successful vault and landing.

During an indoor pole-vault practice session the past season, Murphy's Law and my worst fears about helmets could have been realized.

A 20-year-old university vaulter of eight years experience nearly became a case study. During a very routine and successful 15'6" vault with the standards set at 30", he made what appeared to be a textbook landing--flat and square with his arms properly extended outward in the front middle of the landing mat. He was, however, a slightly built athlete, with much of his lower body over the center seam of the landing mats between the front base pads, so that his head landed on the back rectangular pads.

His slender torso penetrated the seam deeper than most normal landings, while his head depressed the back mat in a normal fashion. Due to the different degrees of head and torso penetration, his head was forced forward until his chin touched his chest.

The increased penetration of his torso and consequent neck hyper-flexion produced an immediate muscle spasm in his neck, especially in the left upper trapezius and left sternocleidomastoid muscles. This produced an immediate numbness in his left hand and a difficulty generating motion at the cervical spine--causing a severe sharp pain in the neck on the left side at approximately the C6 and C7 vertebrae.

The athletic training staff immediately stabilized the athlete's head and neck, performed a neuromuscular assessment and thorough evaluation, and then called Emergency Medical' Services to immobilize the athlete with a spine board and cervical collar.

The athlete was then ambulanced to a local hospital to rule out such injuries as cervical vertebrae fracture or dislocation, cervical spine injuries, and other possible catastrophic injuries.

Upon his admission to the hospital, the athlete had x-rays taken of his cervical spine. However, due to the localized swelling in the area, the x-rays were unable to determine the extent of the damage to the cervical region due to localized swelling in the area. The athlete was again transported (via ambulance) to a more technologically advanced regional hospital, where additional tests were administered.

A spinal specialist was also brought in and it was he who diagnosed it as a left brachial plexus injury, more commonly referred to as a "stinger."

A stinger is a minor nerve root or brachial plexus stretch injury, rather than a spinal cord injury. Diffuse burning and/or weakness, or even possible transitory paralysis in one of the upper extremities typically accompanies this injury. The recovery from this type of injury generally occurs within minutes. This athlete fully recovered and resumed training within a few days.

Various authorities maintain that injuries of the cervical spine contribute to approximately 68% of all spinal injuries and that sports are among the most common causes of cervical injury. Studies have also indicated that the cervical spine injuries that offer the best rate of recovery are those involving C4 through C6 vertebrae. The neck injuries are common enough to question the additional risks produced by helmets.

As pointed out by J.S. Torg, the primary mechanism of injury for the cervical spine is axial loading with slight neck flexion. He further states that most forces are effectively absorbed by the neck musculature, which prevents injury to the cervical region by controlling the motion of the cervical vertebrae.

However, the addition of a helmet's increased surface area and additional leverage, to the axial loading of the cervical spine could possibly increase the severity of such a neck injury.

We can only speculate on this. Since, however, the addition of a helmet increases the forces imparted on the athlete's neck, we may assume that the dangers far outweigh the benefits of a helmet when landing on the landing mat. Safety equipment should never become safety concerns.

REFERENCES

* Wilberger JE, Maroon JC: "Cervical Spine Injuries in Athletes," The Physician and Sportsmedicine, 1990.

* Torg JS: "Epidemiology, Bionmechanics, and Prevention of Cervical Spine Trauma Resulting from Athletics and Recreational Activities," Operative Techniques in Sports Medicine, 1993.

* Jackson DW, Lohr FT: "Cervical Spine Injuries," Clinics and Sports Medicine, 1986.

* Winkelstein BA, Myers BS: "Biomechanics of Cervical Spine Injury and Implications for Injury Prevention," Med Sci. Sports Exercise, 1997.

W. Mark Hannay (M.S.) is the assistant coach at Slippery Rack, National Chairman of the National Pole Vault Education Initiative, and Northeastern U.S. Region Chairman of the National Pole Vault Development & Education Committee. Michael Fahy (M.S., ATC) is the staff athletic trainer at Slippery Rock.