The  American Journal of Sports Medicine recently published, “Concussion Increases Odds of Sustaining a Lower Extremity Musculoskeletal Injury After Return to Play Among Collegiate Athletes.”  Approximately one year prior to this article Medicine Science and Sports published, “Acute Lower Extremity Injury Rates Increase after Concussion in College Athletes.”  Both of the above studies found that their is an increased risk of a lower extremity musculoskeletal injury after a concussion.  A lower extremity injury can be considered anything from an ankle sprain, muscle pull, meniscus or knee. The risk is approximately 2 – 2 1/2 times greater than the controls in the studies who were without a history of being concussed.  This rise in incidence of injury was indicated to extend months post concussion regardless of whether playing football, soccer, hockey, softball, basketball, wrestling, or volleyball.

It is apparent that abnormalities in motor functioning after head trauma persist. These abnormalities are twice the norm.  In other words, it could be said that an athlete that has been concussed has a 100% greater chance of a lower extremity musculoskeletal injury after a concussion. Having a higher possibility is a signal to the coach that a particular athlete’s injury may not be attributed to atypical outcome of cause and effect and this significantly affects program design.  

In a recent paper featured in the 2016 edition of Sports Health “Full-Contact Practice and Injuries in College Football,” researchers looked at athletic injuries, and correlated them with the weekly exposures to full-contact practices, total practices, formal scrimmages, and games. The pre-season injury rate was much higher than in-season, and the game injury rate was over six times greater than the practice rate; which for most coaches is understood without substantiation from the literature. What is of concern, and backs up the aforementioned studies is –“Concussions constituted 14.5% of all injuries, and the incidence of concussions correlated with the incidence of all injuries.”

Strength training the head, neck and jaw is an important addition in every sport. Concussive forces must be lowered to protect each athlete. Having a strength component as an integral part of the athletic trainers and physicians return-to-play protocol is not just to protect the concussed individual against further head trauma, but to guard against all types of athletic injuries.