scholarly journals Lower Extremity Musculoskeletal Injury Is Associated with Increased Risk of Concussion in High School Athletes

2020 ◽  
Vol 8 (7_suppl6) ◽  
pp. 2325967120S0039
Author(s):  
Adam Lutz ◽  
Charles Thigpen ◽  
R. Gil Gilliland ◽  
John Thorpe ◽  
Michael Kissenberth ◽  
...  
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Female Athletes ◽  
High School Athletes ◽  
Time Loss ◽  
Male Athletes ◽  
Lower Extremity Injuries ◽  
Increased Risk ◽  
Extremity Injuries ◽  
Combined Injuries

Objectives: Previous research indicates that concussion increases the risk of lower extremity injuries (LE) after return to sport. However, no study has examined the risk of precedent lower extremity injuries and their relationship to the development of a sport related concussion (SRC). To determine if the risk of combined injuries (LE injury-SRC) is elevated in high school athletes accounting for athlete sport and gender. Methods: 33,386 high school athletes were monitored over 4 seasons. 4223 LE injuries and 1132 concussions were reported. Injured athletes were identified by their school athletic trainer (AT) time-loss injury during a team-sponsored practice or game. ATs documented the date, mechanism, and sport of injury. Injured athletes were referred to a board-certified sports medicine physician for diagnoses and follow up care. Cumulative injury rates were calculated with 95% confidence intervals. Rate ratios were used to compare frequency of SRC after RTS following a LE injury. Comparisons were made overall cohort between those participating athletes with and without isolated and combined injuries as well as by gender. (α=0.05). Results: A cumulative incidence for athletes sustaining an isolated SRC was 2.3/100 athletes (95% CI= 2.1-2.5) and for isolated LE injury was 11.5/100 (95% CI=11.2-11.9) athletes. Athletes presenting with a LE injury had an increased risk (RR= 4.7; 95% CI = 4.2-5.2) of sustaining a subsequent SRC within 1 year when compared to athletes that did not suffer precedent LE injuries. Male athletes presenting with a LE injury had an increased risk (RR= 4.9; 95% CI = 4.2-5.7) of sustaining a subsequent SRC within 1 year when compared to male athletes that did not suffer precedent LE injuries. Female athletes presenting with a LE injury had an increased risk (RR= 4.4; 95% CI = 3.6-5.2) of sustaining a subsequent SRC within 1 year when compared to female athletes that did not suffer precedent LE injuries. In football, presenting with a LE injury had an increased risk (RR= 5.8; 95% CI = 4.5-7.4) of sustaining a subsequent SRC within 1 year when compared to football athletes that did not suffer precedent LE injuries. Conclusion: Our results are the first to show that high school athletes who suffer a time-loss LE injury are at 4.4-5.8 times increased risk to suffer a sports related concussion within the next year. Additional studies are warranted to confirm these findings.

scholarly journals Lower Extremity Musculoskeletal Injury Risk After Concussion Recovery in High School Athletes

2017 ◽  
Vol 52 (11) ◽  
pp. 1028-1034 ◽  
Author(s):  
Robert C. Lynall ◽  
Timothy C. Mauntel ◽  
Ryan T. Pohlig ◽  
Zachary Y. Kerr ◽  
Thomas P. Dompier ◽  
...  
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Musculoskeletal Injury ◽  
Lower Extremity Injury ◽  
Extremity Injury ◽  
High School Athletes ◽  
Time Loss ◽  
Lower Extremity Injuries ◽  
Subsequent Time ◽  
Extremity Injuries

Context:  Although an association between concussion and musculoskeletal injury has been described in collegiate and professional athletes, no researchers have investigated an association in younger athletes. Objective:  To determine if concussion in high school athletes increased the risk for lower extremity musculoskeletal injury after return to activity. Design:  Observational cohort study. Setting:  One hundred ninety-six high schools across 26 states. Patients or Other Participants:  We used data from the National Athletic Treatment, Injury and Outcomes Network surveillance system. Athletic trainers provided information about sport-related concussions and musculoskeletal injuries in athletes in 27 sports, along with missed activity time due to these injuries. Main Outcome Measure(s):  Three general estimating equations were modeled to predict the odds of sustaining (1) any lower extremity injury, (2) a time-loss lower extremity injury, or (3) a non–time-loss lower extremity injury after concussion. Predictors were the total number of previous injuries, number of previous concussions, number of previous lower extremity injuries, number of previous upper extremity injuries, and sport contact classification. Results:  The initial dataset contained data from 18 216 athletes (females = 39%, n = 6887) and 46 217 injuries. Lower extremity injuries accounted for most injuries (56.3%), and concussions for 4.3% of total injuries. For every previous concussion, the odds of sustaining a subsequent time-loss lower extremity injury increased 34% (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.13, 1.60). The number of previous concussions had no effect on the odds of sustaining any subsequent lower extremity injury (OR = 0.97; 95% CI = 0.89, 1.05) or a non–time-loss injury (OR = 1.01; 95% CI = 0.92, 1.10). Conclusions:  Among high school athletes, concussion increased the odds of sustaining subsequent time-loss lower extremity injuries but not non–time-loss injuries. By definition, time-loss injuries may be considered more severe than non–time-loss injuries. The exact mechanism underlying the increased risk of lower extremity injury after concussion remains elusive and should be further explored in future research.

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

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.

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

2015 ◽  
Vol 43 (4) ◽  
pp. 802-807 ◽  
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

A Prospective Study on the Effect of Sport Specialization on Lower Extremity Injury Rates in High School Athletes

2017 ◽  
Vol 45 (12) ◽  
pp. 2706-2712 ◽  
Author(s):  
Timothy A. McGuine ◽  
Eric G. Post ◽  
Scott J. Hetzel ◽  
M. Alison Brooks ◽  
Stephanie Trigsted ◽  
...  
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Sport Participation ◽  
Large Population ◽  
Lower Extremity Injury ◽  
High School Athletes ◽  
Adolescent Athletes ◽  
School Year ◽  
Increased Risk ◽  
Interscholastic Athletes

Background: Sport specialization is associated with an increased risk of musculoskeletal lower extremity injuries (LEIs) in adolescent athletes presenting in clinical settings. However, sport specialization and the incidence of LEIs have not been investigated prospectively in a large population of adolescent athletes. Purpose: To determine if sport specialization was associated with an increased risk of LEIs in high school athletes. Study Design: Cohort study; Level of evidence, 2. Methods: Participants (interscholastic athletes in grades 9-12) were recruited from 29 Wisconsin high schools during the 2015-2016 school year. Participants completed a questionnaire identifying their sport participation and history of LEIs. Sport specialization of low, moderate, or high was determined using a previously published 3-point scale. Athletic trainers reported all LEIs that occurred during the school year. Analyses included group proportions, odds ratios (ORs) and 95% CIs, and days lost due to injury (median and interquartile range [IQR]). Multivariate Cox proportional hazard ratios (HRs) with 95% CIs were calculated to investigate the association between the incidence of LEIs and sport specialization level. Results: A total of 1544 participants (50.5% female; mean age, 16.1 ± 1.1 years) enrolled in the study, competed in 2843 athletic seasons, and participated in 167,349 athlete-exposures. Sport specialization was classified as low (59.5%), moderate (27.1%), or high (13.4%). Two hundred thirty-five participants (15.2%) sustained a total of 276 LEIs that caused them to miss a median of 7.0 days (IQR, 2.0-22.8). Injuries occurred most often to the ankle (34.4%), knee (25.0%), and upper leg (12.7%) and included ligament sprains (40.9%), muscle/tendon strains (25.4%), and tendinitis/tenosynovitis (19.6%). The incidence of LEIs for moderate participants was higher than for low participants (HR, 1.51 [95% CI, 1.04-2.20]; P = .03). The incidence of LEIs for high participants was higher than for low participants (HR, 1.85 [95% CI, 1.12-3.06]; P = .02). Conclusion: Athletes with moderate or high sport specialization were more likely to sustain an LEI than athletes with low specialization. Sports medicine providers need to educate coaches, parents, and interscholastic athletes regarding the increased risk of LEIs for athletes who specialize in a single sport.

scholarly journals Association of Competition Volume, Club Sports, and Sport Specialization With Sex and Lower Extremity Injury History in High School Athletes

2017 ◽  
Vol 9 (6) ◽  
pp. 518-523 ◽  
Author(s):  
Eric G. Post ◽  
David R. Bell ◽  
Stephanie M. Trigsted ◽  
Adam Y. Pfaller ◽  
Scott J. Hetzel ◽  
...  
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Sport Participation ◽  
Lower Extremity Injury ◽  
Extremity Injury ◽  
High School Athletes ◽  
Level Of Evidence ◽  
Increased Risk ◽  
History Of ◽  
Club Sport

Background: High school athletes are increasingly encouraged to participate in 1 sport year-round to increase their sport skills. However, no study has examined the association of competition volume, club sport participation, and sport specialization with sex and lower extremity injury (LEI) in a large sample of high school athletes. Hypothesis: Increased competition volume, participating on a club team outside of school sports, and high levels of specialization will all be associated with a history of LEI. Girls will be more likely to engage in higher competition volume, participate on a club team, and be classified as highly specialized. Study Design: Cross-sectional study. Level of Evidence: Level 3. Methods: High school athletes completed a questionnaire prior to the start of their competitive season regarding their sport participation and previous injury history. Multivariable logistic regression analyses were used to investigate associations of competition volume, club sport participation, and sport specialization with history of LEI, adjusting for sex. Results: A cohort of 1544 high school athletes (780 girls; grades 9-12) from 29 high schools completed the questionnaire. Girls were more likely to participate at high competition volume (23.2% vs 11.0%, χ2 = 84.7, P < 0.001), participate on a club team (61.2% vs 37.2%, χ2 = 88.3, P < 0.001), and be highly specialized (16.4% vs 10.4%, χ2 = 19.7, P < 0.001). Athletes with high competition volume, who participated in a club sport, or who were highly specialized had greater odds of reporting a previous LEI than those with low competition volume (odds ratio [OR], 2.08; 95% CI, 1.55-2.80; P < 0.001), no club sport participation (OR, 1.50; 95% CI, 1.20-1.88; P < 0.001), or low specialization (OR, 2.58; 95% CI, 1.88-3.54; P < 0.001), even after adjusting for sex. Conclusion: Participating in high sport volume, on a club team, or being highly specialized was associated with history of LEI. Girls were more likely to participate at high volumes, be active on club teams, or be highly specialized, potentially placing them at increased risk of injury. Clinical Relevance: Youth athletes, parents, and clinicians should be aware of the potential risks of intense, year-round participation in organized sports.

scholarly journals Early sports specialisation and the incidence of lower extremity injuries in youth athletes: current concepts

2021 ◽  
pp. jisakos-2019-000288
Author(s):  
Richard N Puzzitiello ◽  
Coleen F Rizzo ◽  
Kirsten D Garvey ◽  
Elizabeth G Matzkin ◽  
Matthew J Salzler
Keyword(s):  
Lower Extremity ◽  
Injury Risk ◽  
Lower Extremity Injury ◽  
Medical Community ◽  
Repetitive Movement ◽  
Lower Extremity Injuries ◽  
Increased Risk ◽  
Athletic Success ◽  
Youth Athlete ◽  
Extremity Injuries

Year-round intensive, single-sport training beginning at an young age is an increasingly common trend in the youth athlete population. Early sport specialisation may be ineffective for long-term athletic success and contribute to an increased risk of physical injury and burn-out. The medical community has noted that repetitive movement patterns may occur in non-diversified activity and this may contribute to overuse injury in young athletes. Studies have begun to identify an association between early sport specialisation and lower extremity injuries in the youth athlete population that is independent of training volume. Recent literature has suggested that sport diversification, not specialisation, is a better path for athletic success and minimised lower extremity injury risk.

scholarly journals High School Basketball Coach And Player Perspectives About Warm Up Routines And Lower Extremity Injuries

2020 ◽  
Vol 52 (7S) ◽  
pp. 1017-1018
Author(s):  
Corrine Munoz-Plaza ◽  
Dana Pounds ◽  
Anna Davis ◽  
Stacy Park ◽  
Robert Sallis ◽  
...  
Keyword(s):  
High School ◽  
Lower Extremity ◽  
Warm Up ◽  
Lower Extremity Injuries ◽  
Extremity Injuries

Incidence of Lower Extremity Injury in the National Football League: 2015 to 2018

2020 ◽  
Vol 48 (9) ◽  
pp. 2287-2294 ◽  
Author(s):  
Christina D. Mack ◽  
Richard W. Kent ◽  
Michael J. Coughlin ◽  
Kristin Y. Shiue ◽  
Leigh J. Weiss ◽  
...  
Keyword(s):  
Lower Extremity ◽  
National Football League ◽  
Lower Extremity Injury ◽  
Injury Incidence ◽  
Ankle Sprains ◽  
Extremity Injury ◽  
Time Loss ◽  
Lower Extremity Injuries ◽  
Time Burden ◽  
Extremity Injuries

Background: Lower extremity injuries are the most common injuries in professional sports and carry a high burden to players and teams in the National Football League (NFL). Injury prevention strategies can be refined by a foundational understanding of the occurrence and effect of these injuries on NFL players. Purpose: To determine the incidence of specific lower extremity injuries sustained by NFL players across 4 NFL seasons. Study Design: Descriptive epidemiology study. Methods: This retrospective, observational study included all time-loss lower extremity injuries that occurred during football-related activities during the 2015 through 2018 seasons. Injury data were collected prospectively through a leaguewide electronic health record (EHR) system and linked with NFL game statistics and player participation to calculate injury incidence per season and per 10,000 player-plays for lower extremity injuries overall and for specific injuries. Days lost due to injury were estimated through 2018 for injuries occurring in the 2015 to 2017 seasons. Results: An average of 2006 time-loss lower extremity injuries were reported each season over this 4-year study, representing a 1-season risk of 41% for an NFL player. Incidence was stable from 2015 to 2018, with an estimated total missed time burden each NFL season of approximately 56,700 player-days lost. Most (58.7%) of these injuries occurred during games, with an overall higher rate of injuries observed in preseason compared with regular season (11.5 vs 9.4 injuries per 10,000 player-plays in games). The knee was the most commonly injured lower extremity region (29.3% of lower body injuries), followed by the ankle (22.4%), thigh (17.2%), and foot (9.1%). Hamstring strains were the most common lower extremity injury, followed by lateral ankle sprains, adductor strains, high ankle sprains, and medial collateral ligament tears. Conclusion: Lower extremity injuries affect a high number of NFL players, and the incidence did not decrease over the 4 seasons studied. Prevention and rehabilitation protocols for these injuries should continue to be prioritized.

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