Why doctors say Chancellor and Avril’s neck injuries could be career-threatening

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It's a question on all of our minds: Will Cliff Avril and Kam Chancellor ever play football again?

That was one question asked of Pete Carroll at a press conference this week after the Seahawks coach said both defensive standouts will miss the rest of this season because of neck injuries.

Carroll didn’t offer a clear answer.

“I know you guys want more on this stuff,” he said. “But I’m just trying to respect their situations as much as I can.”

Carroll said the players are consulting with doctors and family members about the future of their careers. Avril underwent surgery Tuesday on a disk in his neck, Carroll said.

Chancellor is still weighing his options.

Both players’ injuries were described as stingers at the time they occurred. The team hasn’t offered much more on the severity or nature of the injuries since.

“A stinger in the purest sense of the word refers to a stretch injury of a nerve bundle that lives between the neck and the shoulder,” said Dr. Michele Arnold, a physiatrist at Swedish Medical Center.

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Arnold said that stingers are usually temporary injuries that don’t necessarily lead to long-term damage. But she said the term is used loosely and not always correctly.

Dr. Carlo Bellabarba, a spine surgeon and professor at the University of Washington agreed.

“The term stinger is actually overused,” he said.

A true stinger doesn’t typically affect the spinal cord, he said. But that doesn’t stop people from referring to spinal cord injuries as stingers, especially in sports.

Arnold is the executive director of rehabilitation and performance medicine at Swedish. Bellabarba is a professor of orthopedics and joint professor in the department of neurological surgery at UW. Neither doctor spoke directly about the injuries to Avril and Chancellor, but they both made it clear that the players have a lot to think about.

“Most players are a little gun-shy about returning to play after a neck injury,” Arnold said. “Because it could have big quality of life implications.”

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Bellabarba listed a number of factors doctors consider while evaluating players during recovery. He said the first concern is how the injury occurred. Was it caused by a jarring hit or the symptom of repetitive hits? Other factors include whether the spinal cord was damaged and how stable the player’s neck muscles are, he said.

“If somebody sustained a significant neurological injury from the kind of contact that occurs just about every play, that’s much more worrisome,” he said. “Because they’re subjecting themselves to that risk much more frequently.”

Arnold said the length of recovery could be vastly different depending on how severely nerves have been damaged.

“If nerves have to recover from the neck all the way down to the fingertips, that’s a long road of recovery that usually takes about 1-2 years,” she said. “But if it’s just the nerves to the shoulder that were affected … some of those recover faster but you’re still looking at 6-9 months.”

Carroll said that some players have returned from the type of surgery Avril was set to undergo. But, he added, that others haven’t. Arnold pointed to Peyton Manning, who led the Broncos to two Super Bowls after missing the 2011 season because of a herniated disc in his neck. Three procedures were performed to return him to the field.

But Manning was a quarterback. Although he took the occasional hit, he didn’t often deliver them. That’s something to consider as well, Arnold said.

“To go back to professional-level football, they’ve got to rehab the daylights out of the muscles of the neck and shoulder so that they’re stable to withstand blows and impact,” she said.

Especially because of the increased risk facing football players every time they step on the field.

“There are about 10,000 cervical spine injuries a year in the United States and about 10 percent of them are caused by sports-related injuries,” Bellabarba said, noting that the majority of those come from football.

For defensive players, the repetition of contact can be especially worrisome, he said.

“It’s kind of like, I think, the approach to concussions,” he said “In that there are a lot of things we don’t fully understand in terms of the long-term impact of repetitive injury to the spinal cord, and to the spine in general.”

Both Bellabarba and Arnold work closely with athletes. They stressed that every situation is different. They also emphasized the importance of caution when assessing injuries to the neck and spine.

“Ultimately they have to choose body over career,” Arnold said. “The last thing we want is a player living out their years as a quadriplegic. That’s the biggest fear I think most players and physicians have after a neck injury.”

Whether or not Avril or Chancellor will return to football remains to be seen. If they do, however, the doctors made it clear they will not come back without dozens of tests, several consultations with medical professionals and months of rehabilitation.

Carroll referred to doctors as well.

“It’s up to the docs, totally,” he said about Chancellor’s long-term prospects. “The docs, the trainers and Kam.”

He was a bit more vague about Avril.

“Who knows?” he said. “I don’t know what the future holds.”

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