Association Between Concussion and Lower Extremity Injuries in Collegiate Athletes

Background of Study: Females generally have a 6-8 times higher risk for lower extremity injury compared to male counterparts due to biomechanical differences and/or poor landing strategies. In recent years, a great deal of focus has been placed on prevention and reduction of non-contact lower extremity injuries. This has spurred the development of assessment methods to determine how athletes move and tools with which those motions are measured. Efforts have been made to measure and quantify movement strategies, which have given rise to multiple movement tests and measurement devices. One approach is the use of wearable technologies used in conjunction with a movement screening. Objective: Demonstrate a practical approach of using wearable technologies to guide training regimens in a population of female athletes that would be considered at risk for lower extremity injuries. Methods: A cohort of Division I female volleyball athletes were screened using wearable technology then assigned an intervention based on screening results. Comparisons were made between injury rates during the season when the intervention was applied compared to previous seasons. Results: All lower extremity injury rates were reduced after the intervention was applied. Conclusions: The use of wearable technology aids in quantifying movement to then assign a strategic intervention to reduce injuries in an at risk athletic population.

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A Comparison of Collegiate Women’s Court and Beach Volleyball Injury Data: A Three Year Retrospective analysis

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967119s00403 ◽

2019 ◽

Vol 7 (7_suppl5) ◽

pp. 2325967119S0040

Author(s):

Tristan Juhan ◽

Hyunwoo Paco Kang ◽

Andrew Homere ◽

Omid Jalali ◽

James E. Tibone ◽

...

Keyword(s):

Lower Extremity ◽

Injury Rate ◽

Collegiate Athletes ◽

Injury Patterns ◽

Back Injuries ◽

Injury Rates ◽

Lower Extremity Injuries ◽

Body Regions ◽

Volleyball Players ◽

Extremity Injuries

Objectives: NCAA Division I beach volleyball is a recently introduced sport that has been played for 3 seasons to date. Since the introduction of this new level of athletic participation for women’s’ beach volleyball, no study has been performed to compare the injury patterns between court and sand volleyball playing surfaces. The goal of this study is to compare the injury patterns and incidence in women’s collegiate court and beach volleyball in order to aid trainers, coaches and medical staff in effectively preparing and treating these collegiate athletes. Methods: A 3 year, retrospective review of all training room injury reports were analyzed for both beach and court volleyball from the 2015 through 2017 seasons. Non-athletic injuries or illness were excluded from analysis. Standardized injury rates for beach and court surfaces were calculated by normalizing the total number of injuries by the number of athletes and sets played. To compare the injury patterns among court versus beach volleyball players, injuries were categorized into one of six body regions (abdomen, lower extremity, upper extremity, thorax, head, and back). The proportion of injuries to each of these regions by playing surface was then calculated to compare injury patterns by playing surface. Chi-squared test and odds ratios were used to compare injury rates. Results: Between 2015 and 2017, 90 court volleyball injuries were recorded, while 49 beach volleyball injuries were recorded in the same time period. Court volleyball players had nearly quadruple the injury rate when compared to beach volleyball players, 0.039 and 0.010 injuries per athlete-set respectively (OR 4.05, 95%CI 2.85-5.76, p<0.0001). Court volleyball players suffered a higher proportion of lower extremity injuries when compared to beach volleyball players (51.5% vs. 12.8% respectively, p=0.004), and beach volleyball players suffered a significantly higher proportion of back injuries when compared to court volleyball players, (23.4% vs. 7.8% respectively, p=0.010). Conclusion: The data suggests a significantly higher incidence of injury for court volleyball players when normalized for gameplay exposure. There were, also significant differences in injury patterns with court volleyball players having a higher proportion of lower extremity injuries and beach volleyball having a higher proportion of back injuries. Recognizing these differences can aid in the establishment of preventative strength and conditioning programs as well as post training treatment protocols for these athletes which may increase both the individuals as well as the teams overall competitive success.

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Can Neurocognitive Function Predict Lower Extremity Injuries in Male Collegiate Athletes?

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17239061 ◽

2020 ◽

Vol 17 (23) ◽

pp. 9061

Author(s):

Sunghe Ha ◽

Hee Seong Jeong ◽

Sang-Kyoon Park ◽

Sae Yong Lee

Keyword(s):

Lower Extremity ◽

Scoring System ◽

Collegiate Athletes ◽

Balance Test ◽

Lower Extremity Injuries ◽

Limb Injuries ◽

Neurocognitive Evaluation ◽

Extremity Injuries ◽

Use Of Assessment ◽

The Relationship

The purpose of this study is to demonstrate whether neurocognitive evaluation can confirm the association between neurocognitive level and postural control and to analyze the relationship between neurocognitive level and acute musculoskeletal injury in male non-net sports athletes. Seventy-seven male non-net sports athletes participated in this study. The Standardized Assessment of Concussion (SAC), Landing Error Scoring System (LESS), Balance Error Scoring System (BESS), and Star Excursion Balance Test (SEBT) were used for testing; we collected data related to injury history for six months after testing. Pearson’s correlation analysis, logistic regression, and the independent sample t-test were used for statistical analysis. The correlation between SAC and SEBT results was weak to moderate (p < 0.05). Eleven of the seventy-seven participants experienced acute lower limb injuries. SAC, LESS, BESS, and SEBT results have no effect on the occurrence of acute lower extremity injuries (p > 0.05) and were not statistically different between the injured and non-injured groups (p > 0.05). Therefore, using the SAC score alone to determine the risk factor of lower extremity injuries, except in the use of assessment after a concussion, should be cautioned against.

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Judgment and Approach for Management of Severe Lower Extremity Injuries

Clinics in Plastic Surgery ◽

10.1016/s0094-1298(20)30851-8 ◽

1991 ◽

Vol 18 (3) ◽

pp. 525-543 ◽

Cited By ~ 2

Author(s):

Robert L. Walton ◽

Douglas M. Rothkopf

Keyword(s):

Lower Extremity ◽

Lower Extremity Injuries ◽

Extremity Injuries

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Concussion in National Football League Athletes Is Not Associated With Increased Risk of Acute, Noncontact Lower Extremity Musculoskeletal Injury

Orthopaedic Journal of Sports Medicine ◽

10.1177/23259671211003491 ◽

2021 ◽

Vol 9 (5) ◽

pp. 232596712110034

Author(s):

Toufic R. Jildeh ◽

Fabien Meta ◽

Jacob Young ◽

Brendan Page ◽

Kelechi R. Okoroha

Keyword(s):

Lower Extremity ◽

National Football League ◽

Field Performance ◽

Return To Play ◽

Lower Extremity Injury ◽

Extremity Injury ◽

Lower Extremity Injuries ◽

Increased Risk ◽

Extremity Injuries ◽

And Control

Background: Impaired neuromuscular function after concussion has recently been linked to increased risk of lower extremity injuries in athletes. Purpose: To determine if National Football League (NFL) athletes have an increased risk of sustaining an acute, noncontact lower extremity injury in the 90-day period after return to play (RTP) and whether on-field performance differs pre- and postconcussion. Study Design: Cohort study, Level of evidence, 3. Methods: NFL concussions in offensive players from the 2012-2013 to the 2016-2017 seasons were studied. Age, position, injury location/type, RTP, and athlete factors were noted. A 90-day RTP postconcussive period was analyzed for lower extremity injuries. Concussion and injury data were obtained from publicly available sources. Nonconcussed, offensive skill position NFL athletes from the same period were used as a control cohort, with the 2014 season as the reference season. Power rating performance metrics were calculated for ±1, ±2, and ±3 seasons pre- and postconcussion. Conditional logistic regression was used to determine associations between concussion and lower extremity injury as well as the relationship of concussions to on-field performance. Results: In total, 116 concussions were recorded in 108 NFL athletes during the study period. There was no statistically significant difference in the incidence of an acute, noncontact lower extremity injury between concussed and control athletes (8.5% vs 12.8%; P = .143), which correlates with an odds ratio of 0.573 (95% CI, 0.270-1.217). Days (66.4 ± 81.9 days vs 45.1 ± 69.2 days; P = .423) and games missed (3.67 ± 3.0 vs 2.9 ± 2.7 games; P = .470) were similar in concussed athletes and control athletes after a lower extremity injury. No significant changes in power ratings were noted in concussed athletes in the acute period (±1 season to injury) when comparing pre- and postconcussion. Conclusion: Concussed, NFL offensive athletes did not demonstrate increased odds of acute, noncontact, lower extremity injury in a 90-day RTP period when compared with nonconcussed controls. Immediate on-field performance of skill position players did not appear to be affected by concussion.

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EFFECTIVENESS OF PRE-SEASON PHYSICAL PERFORMANCE TESTS IN IDENTIFYING IN-SEASON LOWER EXTREMITY INJURIES IN ADOLESCENT GYMNASTS

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00141 ◽

2021 ◽

Vol 9 (7_suppl3) ◽

pp. 2325967121S0014

Author(s):

Danielle A Farzanegan ◽

Emily Francione ◽

Nicole Melfi

Keyword(s):

Lower Extremity ◽

Physical Performance ◽

Performance Tests ◽

Kinetic Chain ◽

Chi Square ◽

Balance Test ◽

Lower Extremity Injuries ◽

Common Location ◽

Acute Injuries ◽

Extremity Injuries

Background: Artistic competitive gymnastics results in a wide, unique spectrum of injuries. Due to the high number of injuries and the current lack of research related to pre-competitive testing in adolescent gymnasts, it is crucial to find a method to predict the likelihood of an athlete sustaining an in-season injury. Purpose: The purpose of this study was to 1) describe the frequency and type of pre-season and in-season injuries, 2) determine if there were differences in physical performance tests between those who had a lower extremity (LE) injury in-season and those who did not, and 3) determine if there were differences in age, level, sex, BMI, sport modifications, previous injury, and current injury between those who had a LE injury and those who didn’t. Methods: Thirty-seven adolescent gymnasts (average age: 12.81 years) were included with levels ranging from 5 (novice) to 10 (elite). Participants (15 males and 22 females) were surveyed for previous and current injury. The athletes completed a performance battery before the competition season including: Lower Quarter Y-Balance Test (LQYBT), Closed Kinetic Chain dorsiflexion (CKCDF), single hop (SH), triple hop (TH), and the Functional Movement Screen (FMS). Follow-up data was collected at the end of the competitive season for comparison. The data was analyzed using descriptive methods and comparative analyses including chi-square and independent t-tests with an alpha level set at .05. Results: Sixty-five percent reported an injury in the last year and seventy-eight percent reported pre-season injuries at testing day. The most common location for pre-season injury was the ankle/foot (24% and 31% respectively). There were no differences between injured and non-injured athletes when comparing asymmetries in CKCDF, LQYBT posteromedial or posterolateral reach, hop testing, or FMS. The LQYBT-anterior scores were significantly different at p=.049 between the injured versus uninjured groups, with 91% of the in-season injury group having a difference <4cm. Similarly, the LQYBT-composite score using a cut-off of 95% was significant at p=.043 with those >95% category being more likely to get injured. There were no significant differences in demographic information comparing injury occurrence. Conclusion: The tested physical performance battery may be useful in tracking gymnasts over time, but may not be beneficial in forecasting injuries in a sport with high percentages of acute injuries. The collected injury volume may not be reflective of a standard season as COVID-19 decreased the number of competitions. Additional research to identify athletes at risk for injury requires further investigation.

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Association Between Ball-Handling Versus Defending Actions and Acute Noncontact Lower Extremity Injuries in High School Basketball and Soccer

The American Journal of Sports Medicine ◽

10.1177/0363546514564541 ◽

2015 ◽

Vol 43 (4) ◽

pp. 802-807 ◽

Cited By ~ 9

Author(s):

Scott M. Monfort ◽

R. Dawn Comstock ◽

Christy L. Collins ◽

James A. Onate ◽

Thomas M. Best ◽

...

Keyword(s):

High School ◽

Lower Extremity ◽

Lower Extremity Injuries ◽

Extremity Injuries

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ORTHOPEDIC INJURIES IN ADOLESCENT GYMNASTS: A SYSTEMATIC REVIEW

Orthopaedic Journal of Sports Medicine ◽

10.1177/2325967121s00117 ◽

2021 ◽

Vol 9 (7_suppl3) ◽

pp. 2325967121S0011

Author(s):

Katie Kim ◽

Michael Saper

Keyword(s):

Lower Extremity ◽

Upper Extremity ◽

Weight Bearing ◽

The Body ◽

Adolescent And Young Adult ◽

Body Region ◽

Lower Extremity Injuries ◽

Common Location ◽

Orthopedic Injuries ◽

Extremity Injuries

Background: Gymnastics exposes the body to many different types of stressors ranging from repetitive motion, high impact loading, extreme weight bearing, and hyperextension. These stressors predispose the spine and upper and lower extremities to injury. In fact, among female sports, gymnastics has the highest rate of injury each year. Purpose: The purpose of this study was to systematically review the literature on location and types of orthopedic injuries in adolescent (≤20 years) gymnasts. Methods: The Pubmed, Medline, EMBASE, EBSCO (CINAHL) and Web of Science databases were systematically searched according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines to identify all studies reporting orthopedic injuries in adolescent and young adult gymnasts. All aspects of injuries were extracted and analyzed including location, type and rates of orthopedic injuries. Results: Screening yielded 22 eligible studies with a total of 427,225 patients. Twenty of 22 studies reported upper extremity injuries of which four specifically focused on wrist injuries. Eight studies reported lower extremity injuries. Nine studies reported back/spinal injuries. Seven studies investigated each body location of injury; one study reported the upper extremity as the most common location for injury and six studies reported the lower extremity as the most common location for injury. Of those seven studies, five (23%) reported sprains and strains as the most common injury. One study reported fractures as the most common injury. Conclusion: There is considerable variation in reported injury location. Some studies focused specifically on the spine/back or wrist. The type of gymnastics each patient participated in was also different, contributing to which area of the body was more heavily stressed, or lacking. Current literature lacks data to fully provide evidence regarding which body region is more frequently injured and the type of injury sustained.

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LOWER EXTREMITY INJURIES

Southern Medical Journal ◽

10.1097/00007611-199009001-00311 ◽

1990 ◽

Vol 83 (Supplement) ◽

pp. 2S-78

Author(s):

Shelby K. Brantley ◽

Suman K. Das

Keyword(s):

Lower Extremity ◽

Lower Extremity Injuries ◽

Extremity Injuries

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