CHAPTER 95 • WRESTLING 555EAR INJURIES
- Auricular hematomas aka cauliflower ear are a
common injury for many competitive wrestlers. The
advent of wearing properly fitted protective head gear
has reduced but not eliminated the incidence of this
injury. The pathogenesis of this injury is usually from
a direct blow to the soft tissues of the auricle. Fluid
collects between the auricular cartilage and the peri-
chondrium disrupting blood flow to the auricular car-
tilage (Kelly and Suby, 2002).
•Treatment of auricular hematomas requires aspiration
or incision and drainage. Without immediate aspira-
tion, new auricular cartilage will form that is tightly
encased. This can cause discomfort and eventual dis-
figurement. Compressive dressings after aspiration
are usually applied. These dressings are worn for a
period of 3–5 days before reevaluation. Return to play
is individualized based on pain and a discussion of
risk/benefits of continuing competition with possible
fluid reaccumulation (Kelly and Suby, 2002).- One technique described involves suturing the pres-
sure dressing to the auricle with resultant return to
play in 24 h with a low incidence of complications
(Schuller, Dankle, and Strauss, 1989). This tech-
nique involves suturing dental roll on both sides of
the pinna with 1.0 nonabsorbable suture. - A second technique involves aspiration followed
by a collodion pressure dressing in the antihelix
and an Ace wrap to insure uniform pressure in the
area of the hematoma. The athlete is then reevalu-
ated in 3–5 days. Earlier return to play is preceded
by a careful discussion of risks and benefits. - A dry aspiration represents an organization of the
hematoma and the early stages of formation of
neo-cartilage consistent with cauliflower ear.
Long-term management (otoplasty) is generally
deferred until completion of the wrestling season.
- One technique described involves suturing the pres-
NECK INJURIES
- Neck injuries usually occur during takedowns espe-
cially throws or when a wrestler is diving for the
opponent’s legs and the head is the first part of the
body that strikes the mat. This may cause injuries,
such as strains/sprains, stingers, disk injuries, degen-
erative joint disease, and even fractures or spinal cord
injuries (Kelly and Suby, 2002). - The etiology of neck injuries is most commonly from
hyperextension (Kelly and Suby, 2002).
•A stinger is a neck injury in which the participant has
transient burning or shooting pain or paresthesia in an
arm directly related to neck or shoulder trauma. This
may be from traction on the brachial plexus or from
cervical nerve root impingement. Wrestling is second
only to football in regards to stinger injuries
(Lillegard, Butcher, and Rucker, 1999). (See chapter
65)- If cervical fracture or spinal cord injury is suspected
then prompt medical attention should be sought
(Kelly and Suby, 2002).
BACK INJURIES- Acute back injuries occur most often during take-
downs and throws. Mechanisms that may lead to back
injury include torsional movements, exertion against
resistance, and hyperextension while in the standing
position, or hyperflexion while on the mat with an
opponent (Kelly and Suby, 2002). - Chronic or recurrent back pain is not unusual in
wrestlers and may include spondylolysis, spondylolis-
thesis, or sacroiliac dysfunction (Kelly and Suby,
2002).
CHEST INJURIES- Chest wall injuries may occur in a variety of ways.
Strains from torsion, direct blows, compression, and
exertion against resistance are the most common
mechanisms (Kelly and Suby, 2002). - These mechanisms may cause rib contusions/frac-
tures, costochondral separations, and abdominal wall
strains. Competitors often present with pain on
breathing and moving or point tenderness. If a rib
fracture is suspected than careful monitoring of the
patient must be initiated because of the possibility of
a hemothorax or pneumothorax. Prompt medical
attention must be sought if this is suspected.
Treatment with rest, anti-inflammatory medications,
and local steroid injections may be beneficial. Taping
or padding of ribs may be instituted after the initial
symptoms have been treated (Kelly and Suby, 2002).
SHOULDER INJURIES- Shoulder injuries comprise approximately 14% of all
injuries and rank second to knee injuries. Injuries may
include acromioclavicular strain, shoulder disloca-
tion, shoulder subluxation, and sternocalvicular
strain. Shoulder instability is not uncommon in
wrestlers (Kelly and Suby, 2002).