Marcus Mariota, the Titans’ starting quarterback, left Week 11’s game following an injury. Initial reports stated that he re-injured his throwing elbow, which had already suffered an ulnar nerve injury earlier this season. That initial injury made it difficult for him to grip and throw the football for roughly a month, markedly decreasing his effectiveness during that time period.
Upon further review, Mariota did not re-injure his throwing elbow. Instead, he suffered a ‘stinger’ when a defender hit him on the side of the head. This is good news, as Mariota’s chance of playing next Monday night is now greatly increased. While Mariota noted numbness radiating down his arm, similar to that experienced during the ulnar nerve injury at the elbow, the rate of return from this injury is usually quicker compared to a repeat injury to the ulnar nerve about the elbow. It was also reported that Mariota did not suffer a concussion.
A stinger is due to a sudden stretching of the brachial plexus, the nerve trunks that exit the neck and run through the armpit. Stingers can also be due to stretching of the nerve roots as they emerge from the neck, before merging together to form the brachial plexus.
A rapid blow to the side of the head that stretches the neck, or a blow to the top of the shoulder that depresses it violently away from the neck, or both, are the most common causes. While a single episode of a stinger is fairly common among football players, repeated stingers can result in long-term deficits and/or prematurely end athletic careers. I’m not aware that Mariota has had any previous stingers.
Symptoms of stingers include burning electrical pain radiating down the arm, often accompanied by weakness.
As long as Mariota’s X-rays and other radiologic studies are normal (ie. no congenital bony narrowings in his neck, no fractures, etc) he may well be fine after this injury resolves. Players are usually allowed to return to sport following resolution of symptoms: Neck pain and arm pain, return of full neck and arm motion and full strength. Athletes should be able to lean forward and support their body weight on their neck without pain.
It is controversial within the medical literature whether having experienced a stinger (in the absence of radiologic findings) predisposes an athlete to future stingers. More recent studies have suggested that it does not.
I’m not sure how severe Mariota’s injury and symptoms are, but the aforementioned criteria to return to sport are fairly clear. Follow Mariota’s progress and practice reports to see if he’ll suit up for Week 12. Unless the radiological studies show an abnormality or his symptoms are prolonged, there’s a good chance he will.