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You are here: Experts > Health/Fitness > Back and Neck Injury/Chronic Pain > Chiropractors > Neck Injury
Expert: Dr. Man Tran, Ph.D., D.C., L.Ac. - 10/30/2009
Question
The Injury and Context:
Five weeks ago I was injured at a mixed martial arts class when I was put into a Guillotine choke hold (http://en.wikipedia.org/wiki/Guillotine_choke - the air choke variety) and there was a pop sound in the front of my neck. There was no immediate (or lasting pain), just discomfort as my neck inflamed. Besides the discomfort due to inflammation (guessing it was inflammation), which lasted about two to three weeks, there has been no pain, no difficulty breathing or swallowing, and no perceived reduction in mobility for my neck.
However, its been about six weeks now, and my neck muscles have been increasingly getting sore (The ones in the back of my neck, and the front right). I cannot do any form of exercise that forces my neck to support my heads weight without the muscles becomming severely sore afterwards, like pushups. I have not tried situps. Even driving for long periods of time causes soreness. I generally keep very good body posture while sitting and standing.
My front left neck muscles also seem numb/week, and I cannot get them to stand out when I flex them, like they normally do. These front left muscles (B in picture) do not seem to be getting any better. When I flex the front of my neck, this muscle (B) typically stands out, just like the one that it mirrors in the picture. The right one stands out prominantly (as you can see), but the left one does not appear at all. In fact, I cannot feel the muscle at all; it is as if the muscle is not there at all. This is not normal for me. Before the injury, I could both feel and see the muscle (when flexing face to loosen up the muscles for acting, or what not).
In addition, whenever I flex my neck like this, the muscle on the left side of my neck (A in picture) quivers, as if it is either very weak, or trying to support do more weight/pressure than it is used to.
As a final issue, about 30-50% of the time I swallow now, there is some sort of dull clicking in my neck. I cannot tell if this is made by two bones scraping against each other, or muscles rolling off each other strangely, or some other cause. When I am swallowing food or water this does not occur - typically it only occurs when I am swallowing saliva.
I have been to the emergency room a week after the injury occured, and they said that as long as the situation does not get worse to just wait. It has been long enough that I believe I need to see a specialist.
Questions:
1) What type of specialist should I see for this type of injury?
2) Do you have an idea about what type of injury this is, and what is my best course of action to treat it?
3) If there is a serious injury, as there appears to be, why is there no pain?
Answer
Dear Jesse,
There are various structures at the neck that could be injured due to the guillotine choke. The mechanism of this technique forced the neck to flex or bend beyond its normal limitation. This can cause the muscle to tear, the neck bone or vertebrae to subluxate or dislocate which will affect the nerve controlling the muscle and swallowing, and/or the collapse of the trachea and esophagus. You also have a bone in front of your neck (Adam apple) which is known as the hyoid bone. This bone moves when you swallow saliva. When you swallow content such as food, it put pressure on the hyoid bone outward so there won't be any clicking or snapping sound.
The prolong swelling that has not gone down is a cause for concern to see a specialist. You may want to look into an EENT (eye, ear, nose, and throat) specialist, neurologist, or chiropractor. For proper guidance as to which is the one for you, you can consider visiting a chiropractor first who once after examination, can direct you to the appropriate specialist if the chiropractor cannot manage your injury.
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