Research Corner - Q&A Shoulder Stinger from Rugby by Anthony Carey | Date Released : 25 Sep 2003 0 comments Print Close Question: The problem has to do with my clients shoulders. He plays Rugby League semi professionally but won't be for much longer if this problem keeps up. What happens is when he makes a big tackle on someone with all the force going through the one shoulder, his entire arm, from his shoulder to finger tips, goes numb. At the same time, his nerves get mixed up, and the signals are all jumbled. When he pumps his arm to get some "feeling" back, his senses are telling him that his arm is flexed at the elbow when it is really extended and conversely when it is extended it is really flexed. Everything goes back to normal after 30 seconds or so but is slightly tender and threatens do the same thing for the rest of the match. I have tried some rotator cuff work with him but have a feeling that is not the key. I have consulted sports physiotherapists, but they have failed to help me in any way. Please help! I would hate for him to leave his sport through injury. Answer: It sounds like your client is experiencing what is often referred to as a “stinger” or “burner.” This type of injury is very common in football players, wrestlers and rugby players. It effects the brachial plexus-the nerve bundle that innervates the upper extremity. Involvement of the brachial plexus could cause both weakness and distorted sensory perception (i.e., elbow feels flexed when it is extended). Therefore, this would be unrelated to the rotatary cuff because this type of injury occurs one of two ways, either one of the nerves off the spinal cord in the neck is compressed as the head is forced backward and toward that side or the nerves in the neck and shoulder are over-stretched as the head is forced sideways away from the shoulder. Both of these issues can occur during a tackling maneuver. Your athlete should be advised by his physician or athletic trainer to stay out of competition until full strength returns to the effected extremity and full range of motion returns to the neck and shoulder. This can often take place on the sidelines with the help of the medical staff within 10 to 15 minutes, depending on the severity. Repeated stingers can cause long term weakness and nerve damage. Your client should be evaluated by a qualified health professional to determine if there are any neurological deficits as a result of repeated stingers. As a trainer, you can definitely provide assistance in the prevention of future occurrences. According to the North American Spine Society, athletes with a forward head posture, tight anterior chest wall musculature and weakness of the thoracic extensors and scapular stabilizes are more prone to this injury. The cervical nerves are more easily irritated on this type of athlete and the space where the neurovascular bundle passes becomes smaller. Therefore, addressing your clients postural imbalances is the most beneficial intervention you can provide. See the many excellent articles on postural assessments and programming available on PTontheNET.com to assist you with your client. Back to top About the author: Anthony Carey Anthony Carey M.A., CSCS, MES is PFP Magazine’s 2009 Personal Trainer of the Year and owner of Function First in San Diego, California and an international presenter on biomechanics, corrective exercise, functional anatomy and motor control and their relationships to pain and function. Anthony has developed the Pain Free Movement Specialist certification and is the inventor of the Core-Tex®. 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