Acute Lower Extremity Musculoskeletal Injury Rates Increase Following Concussion

This week’s EXSS Impact post represents the initial work being done to better understand the inter-play between sport-related concussion and musculoskeletal injury.  Many thanks to Robert Lynall and Tim Mauntel (PhD students in the Human Movement Science Curriculum) for their combined efforts on this project and for developing this week’s EXSS Impact content under the guidance of their faculty advisors (Jason Mihalik and Darin Padua, respectively).

Why did you do this study?

con_robConcussions affect millions of athletes each year, and continue to be a popular topic of discussion in the media. Almost 2 decades of research have identified deficits in several key areas following concussion, including balance, neurocognition, and symptom reporting. This research has led to improved clinical management standards and overall improved patient outcomes following concussion. More recent research has described differences in how people move following concussion as compared to people who have not sustained a brain injury. Importantly, these movement differences often remain present even after balance, neurocognition, and symptom reporting return to normal in concussed athletes. Although the underlying causes of movement differences following concussion are unknown, it is clear athletes often return to high-level sport activity following concussion while still demonstrating movement differences compared to their non-concussed counterparts. This begs the question: Are recently concussed individuals more likely to sustain acute lower extremity musculoskeletal injuries?

What did you do and what did you find in this study?

con2_robThe purpose of our study was to investigate acute lower extremity musculoskeletal injury rates following concussion. We did this by comparing pre- to post-concussion musculoskeletal injury rates in college athletes as well as comparing the musculoskeletal injury rates of concussed individuals to those who have not recently sustained a concussion. We found athletes experienced significantly higher musculoskeletal injury rates following concussion as compared to before the concussion. Additionally, the concussed individuals had higher musculoskeletal injury rates as compared to the matched control group.

How do these findings impact the public?

test_robOur findings demonstrate an increased rate of acute lower-extremity musculoskeletal injury following concussion. This is an important finding, as athletes in our study were not returned to their sport until they cleared a thorough, objective battery of post-concussion assessments. In other words, our concussed athletes were back to “normal” before they returned to full activity. Our findings add to a growing body of literature suggesting people do not move the same following brain injury. Unfortunately, the root cause of these movement differences remains unknown. Our future work will aim to explore sport specific movements such as jumping and cutting to determine if differences exist between concussed and non-concussed athletes. Additionally, we will investigate important neuromuscular control domains such as functional reaction time and proprioception in the context of sport-specific movement. Understanding the effect of concussion on these neuromuscular control domains may help inform the cause of movement differences after concussion as well as the increased musculoskeletal injury rates.