The Effect of Concussion History on Lower Extremity Injury Risk in College Athletes: A Systematic Review and Meta-Analysis.
Ryan McCann, Eric Schussler, Jessica Martinez and 1 others
PMID 35949388WHAT IT FOUND
College athletes with a concussion history face a 58% greater risk of lower extremity injury than those without.
This risk is highest in the first 90 days after returning to play and does not appear significantly elevated at one year.
Key findings
01Athletes with a history of concussion had a pooled relative risk of 1.58 for sustaining a lower extremity musculoskeletal injury compared to those without.
02The risk of lower extremity injury was significantly elevated (RR = 2.20) within the first 90 days of return to play but was not significantly elevated (RR = 1.26) at one year.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The included studies had varying criteria for classifying lower extremity musculoskeletal injuries, which may have affected the reported injury risk. Not all studies examined both male and female athletes, making it difficult to determine if concussion affects injury risk differently by sex. The sample of studies was small (seven total, five in meta-analysis), and there was significant heterogeneity in injury tracking timelines. Matching controls by sport and position does not account for other potential confounding factors such as athlete behavior or personality traits. The mechanism behind the increased injury risk is not fully understood and may involve neuromuscular, neurocognitive, or sensory processing deficits that were not measured in the primary studies.
Declared interests
The authors report no conflicts of interest.
The easy way to misread this
Do not assume the increased injury risk persists indefinitely. The meta-analysis found the risk was significantly elevated only within the first 90 days of return to play; at one year, the risk was not statistically significantly different from controls.