Personally I love the new Under Armour “Protect this House” advertising campaign. So, I am going to infringe on their campaign immediately and title this article, “Protect this Artery”.

Housed in the foramen transversarium of cervical vertebrae’s C6 thru C2 and arcuate foremen of C1, the vertebral arteries are an oft-forgotten topic when looking at the prevention and recovery from concussions and traumatic brain injuries.

Stabilized directly or indirectly by approximately 30 cervical muscles, the vertebral bodies of the cervical spine provide critical protection to the vertebral arteries from unnecessary trauma, maintain their orientation, and permit regulated unobstructed blood flow to the hind brain.

Ascending from the subclavian artery, the vertebral arteries travel up the cervical spine entering the skull through the foramen magnum; travel past the brain stem and converge to form a singular basilar artery. From the basilar artery arise the superior cerebellar artery and the posterior cerebral artery. These arteries are primarily responsible for the distribution of oxygen rich blood to the posterior structures of the brain, which include the brain stem, medulla, Pons, occipital and temporal lobes, the midbrain, thalamus and the diencephalon to name a few.

Now lets imagine a massive collision between player-player, player-ground and / or player-boards, and that there is a temporary or permanent misalignment of the vertebral bodies caused by the extreme physical stress upon impact. Due to the resulting impact of the collision, neuromuscular inhibition (destabilization) of the cervical musculature may occur. Unfortunately, such inhibitions are not detectable through most known testing or screening modalities.

With the loss of neuromuscular support and the realignment of the vertebral arteries one might hypothesize that the cerebral perfusion pressure and the cerebrovascular resistance would be affected causing either an immediate increase or decrease in cerebral blood flow. This alteration may lead to a temporary or more permanent disruption in the hemodynamics of the injured party. This change in cerebral blood flow velocity could directly influence the tissue perfusion rates of the structures with in the brain depriving them of much needed oxygen.

Unfortunately this scenario may have severe consequences and may often be associated with irreversible brain tissue death. Evidence of the above circumstances may influence the rate and success of recovery from concussions and traumatic brain injuries, and might even be visible post-mortem with the eventual diagnosis of Chronic Traumatic Encephalopathy.

You have probably read in the newspaper lately how Sidney Crosby and many others athletes suffer major set backs once they first resume training for their sport. I wonder if they may have overlooked the structures that directly support and stabilize the cervical spine and the vertebral arteries?

How do we help stabilize the cervical spine and “Protect this Artery”?

The answer, GET EDUCATED!!!

For starters let’s get familiar with the muscular tissues directly located within the cervical and occipital regions of the spine and then learn how to strategically apply force to them.

1. Upper Trapezius
2. Levator Scapula
3. Sternocleidomastoid
4. Scalenes
5. Longus Capitis
6. Longus Colli
7. Semispinalis Capitis
8. Semispinalis Cervicis
9. Splenius Capitis
10. Splenius Cervicis
11. Spinalis Capitis
12. Spinalis Cervicis
13. Longissimus Capitis
14. Longissimus Cervicis
15. Obliques Capitis Superior
16. Obliques Capitis Inferior
17. Rectus Capitis Posterior Major
18. Rectus Capitis Posterior Minor
19. Rectus Capitis Anterior
20. Rectus Capitis Lateralis
21. Multifidus Cervicis
22. Mylohyoid
23. Geniohyoid
24. Stylohyoid
25. Digastric
26. Hyoglossus
27. Middle pharyngeal constrictor
28. Thyrohyoid
29. Omohyoid
30. Sternohyoid