Neck Functional Anatomy
Does neck strengthening reduce the likely hood of concussion? (I say reduce because I don't think I will ever completely prevent concussions or any other type of injury. I am simply not that smart. However, I do think many injuries can be reduced.) I believe the short answer is no. Now to justify my answer I will answer a couple questions that I don't believe enough people are asking.
What is the function of the neck?
This is an important question because if one is going to advocate specialized training that person should understand what the function of the neck really is. The function of the neck is mobility and not stability. This is why lots of isometric neck training is a wast of time and has done nothing to reduce concussion rates. If you are not familiar with the functional anatomy of the neck I highly recommend that you read Mechanical Neck Pain: Perspectives in Functional Anatomy by James A. Porterfield and Carl DeRosa. On page 84 the authors state "The various articulations of the cervical spine conspicuously lack bony mass and serve discrete functions. It is apparent that the mass of the various articulations has been sacrificed in favor of increased mobility". Also on page 48 they write "Because of the plethora of reflex connections between the sensory organs of the head and the motor neuron pools related to the cervical spine, the musculature of the neck is required to serve many unique and highly coordinated functions". In other words the neck's job is to position the eyes and ears as quickly and smoothly as possible.
This is in great contrast to the lumbar vertebrae which are massive and allow very little motion. The lumbar spine is designed to be stable. For example, the lumbar spine is capable of only 15 degrees of rotation. However, the articulation between the Atlas and Axis alone is capable of 40 degrees of rotation. Therefore, we train the lumbar spine with lots of isometrics in the form of bracing and planking.
The stabilizing that is done by the neck is dynamic, not isometric, much the same way the shoulder or hip must provide dynamic stability. So how much isometric hip stability training have you done recently? I will quote again from page 47 "...the objectives of this chapter is to provide the clinician with a three-dimensional orientation to the muscles and fascia of this region and an understanding of their contribution to the dynamic stabilization and mobility demands of the spine".
What is the cause of a concussion?
Again an important question to ask because if we are going to try and prevent or reduce something we need to understand how it happens. The answer is simple, the brain sloshes because it does not fit tightly inside the skull. The brain impacting the skull causes brain injury, not the impact of a hit. This is why helmets do not reduce concussions. Helmets don't stop the brain from moving. Helmets protect the skull from fractures and lacerations but they don't protect the brain. In fact a large heavy helmet is a liability because the excess weight causes more intense whiplash forces on the head and neck.
Neurologists have been looking at wild animals for insight on how to deal with concussions. Of particular interest are wild sheep and woodpeckers because they are frequently involved in head impacts without any injury. These animals have mechanisms in place which actually fill their brains with blood making them fit tightly inside the skull and thus preventing brain sloshing. A similar phenomenon has been documented in people when at high altitude and concussion rates in football are significantly lower at altitude. Playing every ice hockey and football game in Denver is certainly not practical. However, maybe this finding will lead us in the right direction, who knows?
1. Porterfield, James A. and DeRosa, Carl. Mechanical Neck Pain: Perspectives in Functional Anatomy. Philapelphia: W.B. Saunders Company, 1995. Print.
