Collegiate and High School Athlete Neck Strength in Neutral and Rotated Postures

Abstract

A knowledge of neck strength is important for developing conditioning protocols and for evaluating the relationship between neck strength and head and neck injury, but very few studies have examined neck strength in relationship to athletic participation. The purpose of this study was to quantify isometric neck strength in collegiate and high school athletes. We hypothesized that (a) male athletes would have significantly greater neck strength than females; (b) collegiate athletes would be significantly stronger than high school athletes; and (c) neck strength would vary significantly with head posture. A total of 149 subjects participated (77 men and 72 women; 90 college and 59 high school level). Flexion, extension, and lateral flexion neck strength were measured in neutral and rotated head and neck postures. Neck strength varied significantly according to participants' sex, age, and posture (p < 0.05). Male college students were stronger than those in all other groups (female college students, male high school students, and female high school students). The average female neck strength was 61, 54, and 56% of the average male neck strength for extension, flexion, and lateral flexion, respectively. High school athletes' neck strength was 75, 68, and 65% of collegiate athletes' neck strength for extension, flexion, and lateral flexion, respectively. On average, neck strength was the greatest for extension compared with other force directions. The subjects showed large variation in neck strength with posture, but in general, there were no consistent trends among the subjects. This finding suggests that those whose neck strength was considerably lower in nonneutral postures may consider training to increase strength in rotated postures. These data provide important baseline information for future studies evaluating injury risk or training protocols.

Reliability of Repeated Isometric Neck Strength and Endurance Testing in a Simulated Contact Posture

“…Using the raw MVC data, a 2 (direction) 3 3 (session) repeated-measures ANOVA, with a betweengroup factor of gender, revealed a significant main effect for gender F (1,18) = 27.64, p , 0.01 indicating that the males were significantly stronger than the females, justifying the normalization of the data. A 2 3 3 repeated-measures ANOVA for the normalized peak force variables revealed a significant main effect for session (F (2,38) = 6.27, p , 0.00) and direction (F (1,19) = 165.57, p , 0.00), but no significant effect for the interaction (F (2,38) = 0.17, p = 0.84). Examination of the residuals suggested that there was a distributional difference between the 2 directions and that the variance between directions was slightly larger than that between sessions, thus violating the assumptions of the ANOVA.…”

“…This posture is functionally relevant for collision sports where the spine is primarily loaded in an approximately horizontal position. The majority of previous research has however been conducted in a seated position with the neck in a vertical posture (19,24,27). Within our experimental cohort, the relative reliability measures over 3 separate testing sessions ranged from good to excellent (ICCs = 0.80-0.95).…”

Sex Differences in Common Sports Injuries

“…Higher incidence in females [77][78][79][80][81][82][83][84][85][86][87][88][89] Female risk factors include reduced neck girth and strength relative to head size compared to males [88][89][90][91][92][93][94] Females report more symptoms postinjury and have higher rates of postconcussive syndrome [110,111] RED-S ¼ relative energy deficiency in sport; BMI ¼ body mass index; BMD ¼ bone mineral density; BSI ¼ bone stress injury; ACL ¼ anterior cruciate ligament.…”

“…Several different factors have previously been cited to contribute to this sex and gender disparity in concussion incidence. In particular, females tend to have a reduced amount of neck girth and strength relative to head size and head-neck length compared to males [88][89][90][91][92][93][94]. This may reduce the overall stability and stiffness of the head-neck segment such that it is less able to absorb externally applied forces.…”

Neck Musculoskeletal Model Generation through Anthropometric Scaling

“…In most studies, the force was applied or measured at the forehead for flexion, at the opisthocranion for extension, and at the temple for lateral bending. There is a large variation in the strength data from literature and only (19–22) presented data for both males and females. Male flexor strength, for example, ranges from 72 to 197 N and female flexor strength from 41 to 91 N. The reported strength ratios between flexion and extension range from 58% to 85% for male and 57% to 71% for female; and ratios of female to male strength range from 0.42 to 0.68 for flexion and 0.4 to 0.74 for extension.…”