The effectiveness of cervical strengthening in decreasing neck-injury risk in wrestling

Clinical Scenario: In wrestling, athletes often support a large amount of weight on their heads or are forced into extreme ranges of motion. These suboptimal movement conditions lead to a high prevalence of neck injuries in wrestlers. A large portion of the work done by the cervical musculature in wrestling is theorized to be eccentric or isometric types of contractions. Strengthening of these cervical muscles is clinically considered to play a vital role in being competitive on the wrestling mat. The cervical stability provided by strengthening these muscles may also play a part in injury prevention among wrestlers. Focused Clinical Question: Does increased cervical strength lead to a decreased risk of injury in wrestling? Summary of Search, "Best Evidence" Appraised, and Key Findings: The literature was searched for studies of level 4 evidence or higher using the Oxford Centre for Evidence-Based Medicine level of evidence system that investigated the relationship between cervical strength and injury risk in wrestling. No studies were found comparing cervical strength to injury risk in wrestling, but 2 related studies were found and have been included in this critically appraised topic. Clinical Bottom Line: There is poor evidence to support a relationship between cervical strength and injury risk in wrestling. Strength of Recommendation: There is grade C evidence to indicate that increased cervical strength decreases the risk of injury in wrestling.