Wearing a Hard Cervical Collar

There are many possible reasons your child’s doctor may want them to wear a hard cervical collar. The main reason is to limit the movement of the bones in your child’s neck either to prevent injury or to allow an injury to heal.

Unless you are told differently, your child should wear their hard cervical collar at all times. This includes wearing it in bed and in the shower. It is recommended that you remove your child’s collar for a short period of time at least once a day to clean the collar and to clean your child’s neck underneath the collar. It is safe to do this as long as your child is sitting or standing in one place and you take special care that they do not move their head and neck around a great deal.

Your child may be given a firm, styrofoam hard cervical collar called a Philadelphia Collar. These come in many sizes and nurses will fit your child with the proper one. Your child’s chin should rest comfortably in the molded cup in the front, and the back should be snug around your child’s neck without rubbing on their ears. Let your child’s nurses know right away if your child feels any rubbing or sharp pain anywhere under the collar. If the collar fits correctly your child should not be able to look down at their toes while standing or look up at the ceiling. Your child should need to turn their chest and shoulders as well as their head to look to either side.

Another kind of hard cervical collar is called the Miami-J Collar and is often used if your child will have to wear the collar for several weeks while their neck heals. Again, a nurse will fit your child with the proper size collar. This collar has washable padding that can be changed when it becomes soiled. You should be given replacement pads to take home with you and a nurse will show you how to change these. Your child can wear one set while the other set dries. 

An adolescent or teenage child may be able to put this collar on easily on their own. Younger children will need your assistance or assistance from another adult. You should fit the front piece of the collar snuggly under your child’s chin and then wrap the sides around their neck, securing it with the Velcro strap. Then place the back piece around your child’s neck and secure it. Once again, if the collar fits correctly, your child should not be able to look down at their toes while standing or look up at the ceiling. They should need to turn their chest and shoulders as well as their head to look to either side.

It is very important that your child take care not to injure their neck. Your child shouldn’t engage in sports of any kind until their doctor tells you it is okay for them to do so. Your child should take special care not to fall. If it is slippery outside or if you have many steps, have your child take it slow and give them help if needed. Don’t allow your child to do any heavy lifting. They should use good posture and keep their neck, back and hips in a straight line.

Your child will not be able to drive while wearing a hard cervical collar. The movement of their head will be limited and they would not be able to look to the side suddenly if needed. Your child may ride as a passenger, but they may find this uncomfortable especially if they are having neck pain. Try to keep car trips short and always be sure there is a head rest behind your child’s head (not down at neck level). If the car your child is riding in is rear ended, the headrest will keep their head and neck from snapping backwards and possibly hurting their neck again.

It is never very comfortable wearing a hard cervical collar. Some people have put a light coating of talcum powder inside the collar to reduce chafing (rubbing). YOU SHOULD NOT PUT POWDERS OR LOTIONS OF ANY KIND IN YOUR CHILD’S COLLAR IF YOUR CHILD HAS HAD SURGERY ON THEIR NECK. Some people wear crew neck T-shirts or shirts with high collars that go under the bottom edge of the collar to relieve chafing. Young men should either be careful to stay close shaven or decide to let their beards grow. Stubble on the chin causes the skin to get sore more easily. Some people find that it helps to put padding in places that tend to rub. Use a thin layer of padding, just enough to relieve chafing, but not so much that you change the fit of your child’s collar so that it no longer supports their head and restricts movement of their neck.

Sleeping may be difficult for your child at first, but they will soon find a position most comfortable for them. Your child’s regular pillow may be too high. You may find that a towel or blanket folded flat under your child’s head may keep their head and neck more comfortably in line or normal position.

www.gillettechildrens.org/EDR018