On Friday night Juan Nicasio, pitcher for the Colorado Rockies was drilled in the head by a line drive. In the immediate aftermath, and before I broke down the video, I was wondering why with the mechanism of injury they were so concerned with the neck. Before I go on, there are protocols that all emergency medical providers must follow in regards to head injuries. The most paramount of that being that if there is a head injury we should ALWAYS suspect a neck injury. That protocol was mainly put in place for those that do not see the injury occur and cannot identify the mechanism of injury. When dealing with head injuries as an athletic trainer it is a rare occurrence that a player would be c-collared and spine boarded; this is because we usually see the injury happen and understanding how physics act upon an injured part helps us make that decision.
In my experience I have spine boarded about 8 athletes and EVERY SINGLE ONE of them had an axial load placed on the neck, the most troublesome direction of force for the vertebrae. A load placed straight down the column of neck bones has the propensity to break bones as the force is translated down onto the very small and fragile body parts. Knowing this and reviewing the video seen below after the ball strikes Nicasio he went straight down on his head producing the aforementioned axial load.
This is most likely the cause of the neck fracture at C-1, resulting in surgery. There was some confusion as to whether the ball striking the head was the culprit; this would be extremely unlikely, the direction of the fall could have been the possible mechanism of injury to the neck. There has been no report of a concussion for Nicasio but his neck injury is of way more importance.
Keith Dugger and the athletic training staff of the Colorado Rockies deserve a ton of credit in all of this.
The Concussion Blog 
Another one bites the dust! Video gone.
Here’s the video.. http://colorado.rockies.mlb.com/news/article.jsp?ymd=20110806&content_id=22849224&vkey=news_col&c_id=col
Just watching the video again and I see the axial load when his head went straight into the mound. I’ve probably watched this video 10-15 times and hadn’t seen it like that until now.
I was not a fan of them putting him onto that scoop stretcher rather than a spineboard. Also was quite surprised to see him with his knees bent and everything..