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Our high school son has had two stingers playing football this past season. The coach assures us that everyone playing football gets these from time to time. Should we be worried?

Athletes participating in collision or contact sports are at risk for stingers. Usually it's a temporary injury but it can put a player out permanently. Stingers refer to the burning, electrical, or shooting sensation a player feels after forceful contact to the head and/or shoulder by another player. The injured player's neck is bent away from the side of the injury. At the same time, the shoulder on the injured side is depressed forcefully. The combination of rapid, forceful movement and direct pressure pulls and presses the nerves in the neck area. No matter which area of nerve supply is affected, most players are able to get back into play during the same game. In some cases, a stinger (or more often, repeated stingers) causes permanent nerve damage. That's a problem, and one we don't really know how to predict or prevent. Despite the fact that this is a fairly common injury (up to 65 per cent of college players have at least one sometime -- high school athletes may not be quite as common), there are no clinical guidelines for how to evaluate and treat players. Some experts suggest that players who have had two or more stingers should consider having an X-ray to check for instability. There could be a protruding or herniated disc pressing on the nerve root. Such findings would change the entire picture. Any of these problems can put the player at increased risk for significant nerve injury. A more thorough diagnostic evaluation will be needed to decide if the player is safe to return-to-play.

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