Collegiate football players display more active cervical spine mobility than high school football players

Objectives: To compare the active cervical spine range of motion and resting cervical spine alignment (sagittal plane) of collegiate and high school football players using the Cervical Range of Motion (CROM) Measurement System and to identify normative values for these populations. Design and Setting: A 2 × 7 factorial design for main effects was used to evaluate the influence of level of play (college, high school) on the cervical spine range of motion of football players. Data were collected during preparticipation physical examinations. Subjects: A convenience sample of 189 unimpaired collegiate (n = 70, age = 19.5 ± 1.5 years) and high school (n = 119, age = 15.7 ± 1.4 years) football players participated. Measurements: Subjects were measured for active cervical spine range of motion using the CROM system and the manufacturer's recommended measurement techniques. Results: Collegiate football players had increased active cervical spine range of motion for flexion, extension, left cervical rotation, and left lateral flexion (overall mean increase = 4.3 ± 2°) compared with high school players. Collegiate players also assumed a more flexed resting sagittal-plane cervical spine posture (P = .001). Conclusions: Collegiate players generally displayed greater active cervical spine range of motion than high school players. The increased resting sagittal-plane cervical spine flexion alignment we report among the collegiate players suggests a change in the natural cervical spine lordosis, possibly due to a neutral-zone shift associated with combined increases in lower cervical spine flexion and upper cervical spine extension as an adaptation to football training or playing. Further study using radiographic or magnetic resonance imaging techniques is warranted. The CROM system is a useful tool for identifying aggregate hypomobile or hypermobile active cervical spine mobility among football players that might otherwise remain unrecognized during standard preparticipation physical examinations. In combination with manual segmental assessments of passive accessory intervertebral movements, CROM enables early identification of players with impaired or excessive cervical spine mobility, thus facilitating proactive injury-prevention intervention.