Though not common, a spinal injury can be devastating to an athlete.

Roughly 11,000 Americans suffer spinal cord injuries each year. Males are four times as likely as females to suffer spinal cord injuries. More than half (56 percent) of people who suffer spinal cord injuries are between the ages of 16 and 30.

The leading cause of spinal cord injuries is automobile accidents, 37 percent of the total. The second are muggings and other forms of violence (28 percent). Third is falls (21 percent), which plague chiefly the elderly. Fourth, at six percent, are sports accidents. But injuries on the playing field are the second largest cause of acute spinal injuries for Americans aged 30 or younger, says the National Athletic Trainers Association.

"The athletic trainer is very often the first responder when an athlete goes down on the field," said Erik Swartz, the principal author of a paper published in the current issue of the Journal of Athletic Training, the scientific publication of the NATA. "Serious spinal injuries can be devastating, due to the high incidence of long term neurological impairment and premature death."

Football is the sport in which athletes are most likely to suffer acute spinal injuries. But skiers, rugby players, gymnasts, swimmers and divers, pole vaulters and even cheerleaders are at risk, the NATA said.

In order to reduce the likelihood of such injuries, and to avoid exacerbating those that have occurred, the paper in the Journal of Athletic Training lists seven guidelines for athletic trainers, coaches, athletes and spectators at sporting events to follow:

1. Understand how cervical spine injuries occur and be fully aware of the imporance of avoiding contact with the head in any sport.

2. Keep current on all pertinent safety rules enacted for the prevention of cervical spine injures.

3. Properly maintain all sporting equipment, and wear and use equipment as intended by the manufacturer.

4. The importance of a proper fit in equipment (especially in helmets) cannot be overstated.

5. Immediate care by knowledgeable health care providers is critical to the successful treatment of an athlete with a spine injury.

6. Ensure that an emergency action plan is in place and has been reviewed by all medical personnel, administrators, coaches and players, and

7. Non-medical professionals should refrain from touching or moving an athlete who might have a spinal injury and should never remove any helmets, pads or other equipment from an injured athlete.