Effects of Football Collars on Cervical Hyperextension and Lateral Flexion

OBJECTIVES: To evaluate the effectiveness of 3 football collars in reducing cervical range of motion. DESIGN AND SETTING: A repeated-measures design in a controlled laboratory setting. SUBJECTS: Fifteen male National Collegiate Athletic Association Division I varsity football athletes. MEASUREMENTS: Cervical hyperextension and lateral flexion were measured with video analysis. Subjects underwent 5 testing conditions: standard football helmet, standard helmet and shoulder pads, and standard pads with the addition of the Cowboy Collar, A-Force Neck Collar, or a foam neck roll. Subjects performed motions both actively and passively. RESULTS: All 3 collars reduced hyperextension when compared with the helmet and shoulder pads alone (P <.05); in addition, the Cowboy Collar was superior to the foam neck roll (P <.05) in reducing hyperextension. No collar reduced passive lateral flexion when compared with the helmet and shoulder pads, but the foam neck roll permitted significantly less active lateral flexion (P <.01) than the other 3 brace conditions. CONCLUSIONS: In a laboratory setting, cervical hyperextension can be controlled through the use of various cervical collars. Cervical lateral flexion (a more common cause of burners in a scholastic population) cannot be controlled with any of the cervical collars tested. Moreover, foam collars may impede active lateral flexion while not providing additional protection when loaded. These results are limited in that they were produced in a controlled situation as opposed to active football play.