Q : What Are Burners or Stingers caused by? Are they Dangerous? Can they be prevented?
A:Burners or Stingers are technically known as Transient Brachial Plexopathy. They are experienced by 65% of football players during their careers. These are usually caused by a head injury in which the head is bent one way, and the opposite shoulder is pushed down. This causes stretching of the nerves that run from the neck to the arm, which are called the brachila plexus.
The brachial plexus is a complex network of nerve roots. It starts as nerves from the C5,C6,C7,C8, and T1 nerves from the cervical and upper thoracic spine. These roots form three trunks:
Upper trunk from:
C5: motor power to the biceps and deltoids, sensation the the lateral arm
C6: Power to the biceps and wrist flexors, sensation to the thumb and index finger
Middle trunk from C7
Lower trunk from C8 and T1.
These trunks will divide to form the three peripheral nerves of the arm: Radial, Ulnar, and Median.
When an injury occurs athletes will often feel a sudden onset of burning and numbness down the lateral arm, thumb, and index finger. In addition, weakness may occur in the deltoid, bicep, or shoulders. Usually the symptoms last only several minutes then resolve on their own.
Injury can be divided into three grades:
Neuropraxia: recovers in minutes today. Mechanism is similar to hitting your funny-bone
Axonotemesis: Leads to permanent damage to some axons. Symptoms may last weeks to months.
Neurotemesis: Rarely seen. This is destruction of a nerve or nerve root leading to permanent damage.
In general most burners represent neuropraxia, and resolve
spontaneously. One should always be on the watch for more serious
injuries however such as bony neck injuries or fractures to the
shoulder girdle. If pain or numbness persists the athlete should not
return to play until further investigation is performed.
If burners become recurrent, athletes may benefit from passive and active neck flexion exercises, and strengthening of the neck muscles.
Equipment and technique may be modified to prevent burners. Players should consider cowboy collars or shoulder lift pads. In addition, players should have their tackling technique reviewed by a competant coach.