Pain guide · Neck pain

Stingers and burners: a burning, dead arm after a tackle, when it's an emergency, and playing again

A stinger, or burner, is a sudden burning, electric pain that shoots down one arm after a tackle, a scrum, a takedown or a fall, often with tingling, numbness or a heavy, weak arm. The head is forced sideways or the shoulder is driven down, stretching or pinching a nerve in the neck or the brachial plexus, the network of nerves above the collarbone. Stingers are common in collision sport, and most settle within seconds to minutes.

Some aren't simple stingers. Neck pain, symptoms in both arms or in the legs, or weakness that doesn't settle within minutes can mean a neck or spinal cord injury: the player stays still and someone calls 999. This guide gives the pitch-side check, your sport's own rules, the checks before playing again (there is no formal consensus), why repeat stingers need a specialist, and a staged neck and shoulder plan with 3D demos.

3-stage exercise plan When to get help 26 sourcesUpdated 22 October 2026

When to get help first

Exercise is for pain that has been checked or is clearly mild and settling.

Get urgent medical help if

At the pitch: neck pain or tenderness after a collision, or severe neck pain. Keep the player still and call 999. Only trained healthcare professionals should move a player with a suspected neck injury.
Numbness, tingling, burning or weakness in both arms, in more than one limb, or in the legs: keep the player still and call 999. It can be an injury to the spinal cord, even if it passes in minutes.
Weakness in the arm that doesn't settle within minutes: the player doesn't go back on, and needs urgent medical assessment, by ambulance if necessary.
After a collision: loss of consciousness, a fit, increasing drowsiness or confusion, double vision, repeated vomiting, or a severe or increasing headache. Call 999 or go to A&E.
Same day: arm weakness, numbness or burning that is still there after the game, or that keeps coming back. Go to an urgent treatment centre or A&E, or get help from NHS 111.
Any sign of concussion: no more play that day. If in doubt, sit them out. Get help from NHS 111 the same day after a head injury if the player is being sick, feels dizzy, or takes medicine that thins the blood.

See a doctor or physiotherapist if

Arm symptoms or weakness that last more than a few days: see a sports doctor or physiotherapist for a full examination. Symptoms beyond 2 to 3 weeks need further tests, such as nerve tests and an MRI (magnetic resonance imaging) scan.
A second stinger, or stingers that keep coming back: see a sports medicine or spine specialist, usually with an MRI scan, before going back to contact sport.
A shoulder blade that sticks out, or a shoulder you can't lift properly after the injury: see a doctor. A nerve to the shoulder muscles may be injured.
Neck pain or stiffness after a collision without arm symptoms, once a serious injury has been ruled out: our neck pain and whiplash guides cover the next steps.

Understand it

What a stinger is

US orthopaedic surgeons (the American Academy of Orthopaedic Surgeons, AAOS) describe stingers and burners as injuries in which nerves in the neck and shoulder are stretched or squeezed by an impact, causing a stinging or burning pain that spreads from the shoulder to the hand, like an electric shock. Numbness and weakness in the arm can come straight after the hit. Symptoms usually affect one arm only.

There are three common ways it happens: the head is forced sideways while the shoulder is driven down, stretching the brachial plexus; a direct blow lands just above the collarbone; or the neck is forced back and to the side, squeezing a nerve root where it leaves the spine.

Sources 1, 2

Not always just a stretched nerveEmerging evidence

In 55 college and professional players with repeat stingers, the neck forced back and to the side was the usual cause (83%), 53% had a narrow spinal canal, and 93% had disc wear or narrowed nerve exits. A UK brachial plexus team argues that similar symptoms can come from nerve roots or even the spinal cord, that burning pain and tingling are signs of an irritated nerve rather than a harmless short circuit, and that repeated strain may make later injuries worse; that is expert opinion. About half of athletes with more serious nerve injuries had had a stinger before.

Sources 3, 4, 2

Who gets themStrong evidence

In the National Football League (NFL), 691 stingers in games were recorded over 5 seasons, a risk of about 1 in 27 players each season, highest in running backs and linebackers. In US college football, 93% came from contact with another player, mostly tackling and blocking, and 18.8% were repeats. Surveys suggest about half of American football players have one at some point in their career.

Of 569 Japanese high school and university rugby players, 33.9% had had a stinger, 20.9% had one during the season, and 37.3% of those had another that season; a stinger in the previous season was the strongest risk factor. In US college wrestlers, an injury to the brachial plexus was the commonest spine injury diagnosis (20%).

Sources 5, 6, 2, 7, 8, 9

How it's recognised, and what scans showEmerging evidence

It's a diagnosis from what happened and an examination. AAOS says X-rays, MRI (magnetic resonance imaging) scans and nerve tests aren't usually needed for a stinger that settles, but a fuller examination is needed for weakness lasting more than several days, neck pain, symptoms in both arms, or repeat stingers. Symptoms in both arms or in the legs, weakness without any change in feeling, neck pain, or signs of concussion point to something more serious.

For repeat stingers, an MRI or CT (computed tomography) scan looks for a narrow canal or narrowed nerve exits. In 266 college players, those with a narrow canal on an X-ray measure had 3 times the risk of stingers, but scans are more accurate than X-ray measurements. Disc bulges are common on neck MRI in people without symptoms (87.6% of 1,211), so a scan finding has to be read alongside the examination.

Sources 1, 2, 10, 11, 12, 13

Both arms or the legs: a different injuryEmerging evidence

Burning, numbness, tingling or weakness in both arms, both legs or all four limbs after a collision can be a temporary injury to the spinal cord (cervical cord neurapraxia). It usually recovers in 10 to 15 minutes, sometimes over 36 to 48 hours, and is linked with a narrow spinal canal. In 110 cases, 56% of those who went back to contact sport had another episode, the risk rising as the canal narrowed, though none had permanent damage.

A 2026 review says episodes usually resolve within 48 hours, but recurrence is common, and athletes with a lasting narrowing of the canal, repeat episodes or an unstable neck need careful counselling and may be advised against contact or high-risk sports. It needs emergency care, and a specialist before any return.

Sources 14, 15, 12

How long stingers lastStrong evidence

Most are short-lived: symptoms usually last seconds to minutes, but sometimes hours, days or longer. In the NFL, 76% of stingers cost no playing time, and the rest an average of about 5 days. In college football, 63.8% cost less than a day. In young rugby players, 79.3% cost no time, the average was 2.9 days, 5.8% took more than 2 weeks, and a weak grip was the most lasting symptom, sometimes beyond a month.

Symptoms lasting beyond about 2 weeks suggest damage to the nerve fibres themselves, which recovers more slowly and needs investigating.

Sources 1, 5, 6, 8, 2

What helps, and how strong the evidence is

On the field: the sport's emergency rules come firstStrong evidence

The UK grassroots concussion guidelines, World Rugby and the Gaelic Athletic Association (GAA) agree: if a neck injury is suspected, only trained healthcare professionals should move the player, and severe neck pain, weakness, tingling or burning in the arms or legs, or signs of concussion need urgent hospital assessment. A suspected concussion means no more play that day: if in doubt, sit them out.

AAOS says athletes shouldn't return until their symptoms have completely gone, and never with weakness or neck pain. NFL protocols require every player with a stinger to have a concussion assessment at the side of the pitch, and 7% of NFL stingers came with another injury.

Sources 16, 17, 18, 1, 2, 5

Return to play: no formal consensusEmerging evidence

No formal consensus exists. A 2002 review found no agreed approach, and a 2016 review found that guidelines come almost entirely from expert opinion, though everyone agrees an athlete should be pain-free, with normal nerve function, full strength and full movement, before going back. For stingers, a 2025 review adds pain-free neck and shoulder movement and a clear concussion check.

One narrative review from 2026 gives a view, and says plainly that it is not a formal guideline: after a single brief stinger that settles fully, with normal strength, feeling and neck movement on a medic's check, a same-day return isn't necessarily ruled out. The same review says repeat stingers need an MRI or CT scan, usually after two or more in a season, and that weakness that lasts, symptoms in both arms, or symptoms lasting more than 1 to 2 weeks rule out a return until a specialist has assessed them.

Sources 19, 20, 2, 12

Repeat stingers and a narrow neck canalEmerging evidence

Repeats are common, and a previous stinger is the strongest risk factor. Players with repeat stingers more often have a narrow spinal canal or narrowed nerve exits: 53% of 55 players with repeat stingers had a narrow canal, and in 266 college players a narrow canal on X-ray tripled the risk. MRI or CT shows a true narrowing more accurately than X-ray measurements, so repeat stingers need a specialist assessment, usually with a scan, before going back to contact.

Sources 8, 6, 3, 10, 11, 12

Rehabilitation: thin evidenceEmerging evidence

There's no standard rehabilitation programme. Suggested plans focus on neck and shoulder movement, then strengthening the neck, upper back and shoulder muscles, once nerve function has returned. A scoping review found only 8 case reports (10 athletes, average age 20) describing rehabilitation; 9 of the 10 returned to sport, and the most consistent sign of readiness was pain-free shoulder movement and strength.

One college football programme proposed 4 weeks of rest after the season, then 8 weeks of reconditioning (neck exercises 3 times a week, neck mobilisation and shoulder work twice a week) and a gradual return to collision work. It is a description, not a trial.

Sources 2, 21, 1, 22

Neck strength: sensible, but unproven as preventionMixed evidence

Neck training can raise neck strength: it did in two of the three studies in one review, but that review found none that reported any effect on neck injuries. In a professional rugby squad, a 26-week isometric neck programme was followed by fewer injuries recorded in matches (11 to 2), but not by significantly fewer neck injuries (8 to 6) or a significant gain in neck strength.

No trial has tested neck or shoulder strengthening against stingers. Strength work is standard rehabilitation and good preparation for contact, not proven prevention.

Sources 23, 24

Equipment and tackle techniqueEmerging evidence

AAOS says a neck roll or cowboy collar may give extra stability for players prone to stingers. Laboratory studies show they limit backward bending of the neck, but not sideways bending, a main cause, and the evidence is case reports.

Technique matters more. In 3,970 university rugby tackles, tacklers whose head was in front of the ball carrier had 69.4 head, neck or shoulder injuries per 1,000 tackles, against 2.7 with the head behind or to the side, and stingers were among the injuries far commoner with the head in front.

Sources 1, 2, 25

When it isn't a simple stingerEmerging evidence

Symptoms beyond 2 to 3 weeks suggest a more serious nerve injury, investigated with nerve tests and an MRI scan. When the nerve is still intact, waiting about 3 months for natural recovery before considering surgery is usual, while a nerve root torn from the spinal cord usually needs prompt specialist surgery.

Sources 2, 12

How much pain is OK while you exercise?

Nerve symptoms: zero tolerance

Any burning, tingling, numbness or weakness down the arm, or neck pain, during or after an exercise means stop and get it checked. Returning to play needs nerve function back to normal and pain-free neck and shoulder movement, and AAOS says athletes should never return with weakness or neck pain.

Muscle effort is fine. During strengthening, the effort and mild next-day muscle soreness that any new exercise brings are acceptable. This part is borrowed from our neck guides' rule (up to 5 out of 10, settled by the next morning).

Before contact: pain-free, full neck and shoulder movement and full strength on both sides, then a gradual return to collision work.

Sources 2, 1, 20, 22

The exercise plan: 3 stages

Start at the first stage. Each move opens a full guide with a 3D demo.

Stage 1

Settle and restore movement (the first days, once the warning signs are ruled out)

Full, pain-free neck and shoulder movement without bringing back any arm symptoms. Start only when any warning signs have been checked and the arm symptoms have gone or are fading; no contact training until the return-to-play checks are met.

Neck CARs (controlled articular rotations) demonstrated on the 3D figure

3D demoNeck CARs (controlled articular rotations)Beginner · No equipment

Separate nods, tilts and turns first, each held 5 s, 5 times; then 3 slow circles each way, once or twice a day · The move page's dose. Stop any direction that brings back burning or tingling

Harder: Rabbit pose (Sasangasana)

3D demoChin tuckBeginner · No equipment

5 to 10 repetitions with a 5 s hold, 2 to 3 times a day · Editorial dose

Easier: Lying chin tuck · Harder: Isometric neck holds (four-way)

Shoulder rolls demonstrated on the 3D figure

3D demoShoulder rollsBeginner · No equipment

10 to 15 slow circles each way · The move page's dose

Harder: Shoulder CARs (controlled articular rotations)

Thoracic rotation demonstrated on the 3D figure

3D demoThoracic rotationBeginner · No equipment

6 rotations per side, moving with the breath · The move page's dose

Easier: Side-lying open book · Harder: World's greatest stretch

Band pull-apart demonstrated on the 3D figure

3D demoBand pull-apartIntermediate · A band

2 sets of 12 to 15 with a light band · Editorial dose

Easier: Prone Y-T-W raises · Harder: Tuck back lever

Move on when: Your neck and shoulders move fully both ways without pain, and you've had no arm symptoms for at least a day.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 2

Rebuild neck and shoulder strength (symptom-free)

Neck and shoulder blade strength and endurance, the focus of the published rehabilitation plans.

Isometric neck press, front and back demonstrated on the 3D figure

3D demoIsometric neck press, front and backBeginner · No equipment

Build to a 10-second press, 3 times each way, for 3 rounds, light at first · The move page's dose, from an NHS leaflet

Easier: Chin tuck · Harder: Chin tuck with head lift

Isometric neck press, sides demonstrated on the 3D figure

3D demoIsometric neck press, sidesBeginner · No equipment

Build to a 10-second press, 3 times each way, for 3 rounds, light at first · The move page's dose, from an NHS leaflet

Easier: Chin tuck · Harder: Chin tuck with head lift

Chin tuck with head lift demonstrated on the 3D figure

3D demoChin tuck with head liftIntermediate · No equipment

3 to 5 holds of 5 s, building to 10 holds of 10 s · Editorial dose

Easier: Chin tuck

3D demoBand rowBeginner · A band + An anchor point

3 sets of 10 to 15 · The move page's dose, itself an editorial starting point

Harder: Supported single-arm dumbbell row

Standing band external rotation demonstrated on the 3D figure

3D demoStanding band external rotationBeginner · A band + An anchor point

2 to 3 sets of 12 to 15 · Editorial dose

Easier: Stick-assisted external rotation (lying) · Harder: Side-lying external rotation

Scapular push-up (push-up plus) demonstrated on the 3D figure

3D demoScapular push-up (push-up plus)Beginner · No equipment

2 sets of 10, hands on a wall or bench at first · Editorial dose

Easier: Dumbbell shoulder-blade punch · Harder: Push-up

Move on when: Both arms and your neck feel equally strong, and two or three sessions a week bring no arm symptoms.

Follow along: a timer, a cue and the next move, one step at a time.

Stage 3

Build for contact (before collision training)

Heavier neck, shoulder and upper body strength, then a gradual return to contact once you've been cleared (written steps below).

Dumbbell shrug demonstrated on the 3D figure

3D demoDumbbell shrugBeginner · A dumbbell

2 to 3 sets of 8 to 12 with a pause at the top · Editorial dose

Harder: Snatch shrug

Supported single-arm dumbbell row demonstrated on the 3D figure

3D demoSupported single-arm dumbbell rowIntermediate · A dumbbell + A bench or box

3 sets of 8 to 12 on each side · Editorial dose

Easier: Incline ring row · Harder: Bent-over barbell row

3D demoFace pullIntermediate · A band

3 sets of 12 to 15 · Editorial dose

Easier: Prone Y-T-W raises · Harder: Tuck back lever

3D demoPush-upIntermediate · No equipment

3 sets of 8 to 15; start with incline push-ups if you need to · Editorial dose

Easier: Wall push-up · Harder: Close-grip push-up (close triceps position)

Farmer's carry demonstrated on the 3D figure

3D demoFarmer's carryBeginner · A dumbbell + A kettlebell

3 carries of 20 to 30 m · Editorial dose

Harder: Suitcase carry

Isometric neck holds (four-way) demonstrated on the 3D figure

3D demoIsometric neck holds (four-way)Beginner · No equipment

5 holds of 10 s in each direction at moderate effort · Editorial dose. The neck move in our rugby, American football, wrestling and martial arts workouts

Easier: Chin tuck · Harder: Chin tuck with head lift

Move on when: You meet the return-to-play checks and have been cleared. Then go back to contact gradually, over several sessions, and keep two strength sessions a week in season (our suggestion).

Follow along: a timer, a cue and the next move, one step at a time.

What to change for now

The stinger check at the side of the pitch (written steps)

For players, coaches and parents. From the UK, World Rugby and GAA guidance and AAOS, with our suggestion marked.

1. Stop. Ask the player where it hurts and what they feel, and look at how they are holding the arm and neck.
2. Neck pain or tenderness, symptoms in both arms or in the legs, weakness that doesn't settle within minutes, or any sign of concussion: don't move them, keep them still, and call 999. Only trained healthcare professionals should move a player with a suspected neck injury.
3. Follow your sport's own rules. A suspected concussion means no more play that day: if in doubt, sit them out.
4. If it is one arm only and it settles completely within minutes, the player still comes off until a medic has checked their arm strength, feeling, neck movement and concussion signs.
5. Without a medic, the safest choice is to sit out the rest of the game (our suggestion).
6. Before any return: full, pain-free neck and shoulder movement, equal grip and arm strength on both sides, and no tingling.
7. Write it down. A second stinger, symptoms that last more than a few days, or weakness that comes back need a professional review before the next contact session.

Sources 16, 17, 18, 1, 2

Going back to contact (written steps)

A college football reconditioning programme ends with a gradual return to collision work after medical clearance. The steps below are our suggestion for how to stage it.

1. Start only once you've been cleared: no symptoms, full pain-free neck and shoulder movement, and equal strength on both sides.
2. Non-contact skills and fitness at full pace first (our suggestion).
3. Then controlled contact, such as tackle bags, shields and walk-through drills, with the head up and to the side (our suggestion).
4. Then full contact in training, before any match (our suggestion).
5. Move up a step after a session with no symptoms. If burning, tingling or weakness comes back, drop back and get checked.
6. Keep two strength sessions a week in season (our suggestion).

Sources 22, 20

Pads, neck rolls and collars

Make sure your shoulder pads fit properly. After repeat stingers, ask your medical team about a neck roll or a high collar: they may help, though they limit backward bending more than sideways bending, and the evidence is case reports.

Sources 1, 2

Positions to swap, and why

Habit or position	Why it matters	Instead
Playing on with arm symptoms, weakness or neck pain	AAOS says athletes should never return to sport with weakness or neck pain.	Come off, and do the stinger check.
Shaking the arm out and going straight back on without a check	A player with a stinger needs a neck and concussion check, and stingers can come with other injuries.	A medic's check, or sit out the rest of the game.
Tackling with your head in front of the ball carrier	In a video study of rugby tackles, it went with far more neck injuries and stingers.	Head up and to the side, as your coach teaches.
Side neck stretches that pull the head away from the sore arm	That movement stretches the nerves, which is how many stingers happen, and our pinched nerve guide notes it can bring on arm tingling.	Small, comfortable neck movements.Try: Neck CARs (controlled articular rotations)
Heavy behind-the-neck presses, heavy neck bridging or heavy shrugs while symptoms linger	There's no evidence either way; this is a cautious swap while the nerve settles, as our neck guides advise.	Light isometric neck holds, and presses in front of the head.Try: Isometric neck holds (four-way)
Loose shoulder pads, or no neck roll after repeat stingers	Well-fitted padding and collars may help players prone to stingers.	Properly fitted pads, and ask about a neck roll or collar.
Going back after repeat stingers without a specialist review	Repeat stingers can point to a narrow canal or narrowed nerve exits.	A sports medicine or spine specialist review, usually with an MRI scan.

Routines to follow

Neck and shoulder strength routine

Deep neck holds and shoulder-blade strength in under 20 minutes: one of the best-supported kinds of exercise for a stiff, sore neck.

18 minBeginner11 movesA band, An anchor point

Shoulder mobility and stability routine (with a band)

A 25-minute band routine for healthy shoulders: move the shoulder and upper back through their range, then strengthen the rotator cuff and shoulder blades.

25 minBeginner12 movesA wall, A band

Strength workout for rugby players: legs, upper body, hamstrings and neck

A 55-minute gym session for rugby: jump squats and chest throws, heavy squats, bench press, Romanian deadlifts, rows, Nordic lowers, shoulder and neck work.

55 minIntermediate15 movesA band, Medicine ball

Strength workout for American football: power, legs, upper body, hamstrings and neck

A 55-minute gym session for American football: hang cleans or jump squats, back squats, bench press, Romanian deadlifts, rows, Nordics, neck work and carries.

55 minIntermediate16 movesA band, A barbell

Wrestling strength workout: jumps, deadlifts, split squats, pull-ups, grip and neck

A 55-minute strength and power session for wrestlers: jump squats, medicine-ball throws, trap bar deadlifts, split squats, pull-ups, carries and neck holds.

55 minIntermediate16 movesA wall, A band

Strength workout for martial arts: hips, grip, neck and shoulders

A 45-minute strength and power workout for BJJ, judo, karate, taekwondo and MMA: jumps, squats, single-leg work, pull-ups, carries, shoulders and trunk.

45 minIntermediate17 movesA wall, A band

Activate rugby warm-up: the adult sample phase

England Rugby's and World Rugby's Activate warm-up, the manual's adult sample phase: running, balance, partner holds, hops, sprints and neck holds.

25 minBeginner15 movesCardio machine, A wall

More moves for this area

Questions people ask

What is a stinger?

A sudden burning, electric pain, often with tingling, numbness or weakness, that shoots down one arm after a hit to the head, neck or shoulder, from a stretched or squeezed nerve. It's also called a burner.

How long does a stinger last?

Usually seconds to minutes, and sometimes hours, days or longer. In the NFL, three in four stingers cost no playing time, and in young rugby players about 1 in 17 took more than 2 weeks to recover.

When is a stinger an emergency?

If there is neck pain, symptoms in both arms or in the legs, weakness that doesn't settle within minutes, or any sign of concussion. The player stays still, isn't moved except by trained professionals, and someone calls 999: these can be signs of a neck or spinal cord injury.

When can I play again after a stinger?

Only when every symptom has gone, your neck and shoulder move fully without pain, your strength is equal on both sides and a concussion check is clear; never with weakness or neck pain. Follow your sport's own rules, and if in doubt, sit out. No formal consensus exists: one review's view is that a medic who finds everything normal after a single brief stinger may allow a same-day return, but repeat stingers need a specialist before you play again.

Is a stinger a pinched nerve?

In a way: it's a stretched or squeezed nerve root in the neck, or the network of nerves above the collarbone (the brachial plexus). Unlike a pinched nerve from a disc, it starts at the moment of a collision and usually settles quickly. Our pinched nerve in the neck guide covers arm symptoms that last.

Do I need a scan after a stinger?

Not usually for a single stinger that settles completely. A doctor may arrange nerve tests or an MRI scan if symptoms last more than a couple of weeks, if you have neck pain or symptoms in both arms, or after repeat stingers.

Why do I keep getting stingers?

A previous stinger is the strongest risk factor, and players with repeat stingers more often have a narrow spinal canal or narrowed nerve exits. Repeat stingers need a specialist review, usually with an MRI scan, before you go back to contact.

Will neck strengthening stop stingers?

It can build neck strength and is part of rehabilitation, but no study has shown that it prevents neck injuries or stingers. Shoulder and neck strength, good tackle technique and properly fitted pads are all sensible.

Does a neck roll or cowboy collar help?

It may help players who keep getting stingers, by limiting how far the neck bends back. It doesn't stop the neck bending sideways, and the evidence is limited.

Is a stinger the same as concussion?

No, but both can happen in the same collision, so a player with a stinger should also be checked for concussion. Follow your sport's concussion rules: if in doubt, sit them out.

What if both arms tingle or burn?

That isn't a typical stinger: it can be a temporary injury to the spinal cord (cervical cord neurapraxia). Keep the player still and call 999, and they need a specialist assessment before any return to sport.

Related exercise guides

Other pain guides

Sources

Exercise education, not a diagnosis or treatment plan. It is written from the guidelines and studies listed above; review by a clinician is pending. If your pain follows an injury, is severe, is getting worse, or comes with any warning sign listed on this page, get it assessed. Health disclaimer.