Research Reports - Association between concussion and lower extremity injuries in collegiate athletes

Sports Health. 2016 Sep 1. pii: 1941738116666509. [Epub ahead of print]

Gilbert FC(1), Burdette GT(2), Joyner AB(3), Llewellyn TA(4), Buckley TA(5).

BACKGROUND: Concussions have been associated with elevated musculoskeletal injury
risk; however, the influence of unreported and unrecognized concussions has not
been investigated.
HYPOTHESIS: The purpose of this study was to examine the association between
concussion and lower extremity musculoskeletal injury rates across a diverse
array of sports among collegiate student-athletes at the conclusion of their
athletic career. The hypothesis was that there will be a positive association
between athletes who reported a history of concussions and higher rates of lower
extremity injuries.
STUDY DESIGN: Cross-sectional study.
LEVEL OF EVIDENCE: Level 3.
METHODS: Student-athletes (N = 335; 62.1% women; mean age, 21.2 ± 1.4 years) from
13 sports completed a reliable injury history questionnaire. Respondents
indicated the total number of reported, unreported, and potentially unrecognized
concussions as well as lower extremity injuries including ankle sprains, knee
injuries, and muscle strains. Chi-square analyses were performed to identify the
association between concussion and lower extremity injuries.
RESULTS: There were significant associations between concussion and lateral ankle
sprain (P = 0.012), knee injury (P = 0.002), and lower extremity muscle strain (P
= 0.031). There were also significant associations between reported concussions
and knee injury (P = 0.003), unreported concussions and knee injury (P = 0.002),
and unrecognized concussions and lateral ankle sprain (P = 0.001) and lower
extremity muscle strains (P = 0.006), with odds ratios ranging from 1.6 to 2.9.
CONCLUSION: There was a positive association between concussion history and lower
extremity injuries (odds ratios, 1.6-2.9 elevated risk) among student-athletes at
the conclusion of their intercollegiate athletic careers.
CLINICAL RELEVANCE: Clinicians should be aware of these elevated risks when
making return-to-participation decisions and should incorporate injury prevention
protocols. 

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