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This is my first year as a parent volunteer with a private high school football team. I played football in high school and college but I'm not a trained coach or athletic trainer. A couple of our kids got a stinger in the game last week. The symptoms seem to be lingering. How do we know when it's safe to let them play again?

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 symptoms are brought on by trauma to the nerves in the neck and don't usually last long. When the symptoms of a stinger have not gone away two to four weeks after the injury then diagnostic X-rays, the findings aren't always very clear or helpful. Further assessment may be needed with CT scans, MRIs, or electrodiagnostic studies (EDX). These tests can help identify which nerves are affected and check the function and integrity of the nerves. Deciding whether or not a player can return-to-play (practice or game play) isn't always a cut-and-dried decision. Many factors must be taken into consideration. For example, one stinger with rapid return to normal is easy: no diagnostic tests are needed and the player is safe to return to the game as soon as the symptoms are gone. Two stingers in the same season should be checked by X-ray and in some cases, an MRI should be done. Persisting pain, numbness, weakness, and/or loss of motion are signs that electrodiagnostic tests are needed. The athlete is held out of the game until it is safe to play again. Two or more stingers in different seasons are assessed first by symptom resolution, then by X-rays, MRIs, or electrodiagnostic testing if symptoms persist. Three or more stingers in the same season or in different seasons put the player at risk for being benched and out for the season (if not permanently). These are the cases where it is clearly in the best interest of the individual to be protected from any further injuries. When is it safe to return to the practice field? When the player has full, painfree neck motion and strength to perform all the sport-specific skills needed to play without any symptoms.

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