Monday, April 24, 2017

Does Concussion Increase Your Risk For ACL Injury - Part I

Back in 2012 and 2013, I was blessed to be a part of a research team that was performing movement assessments on female soccer players.  This study was designed to assess female soccer players for movement patterns which put them at risk for injury and also negatively impacted their athletic performance.  Initially we were performing these assessments on Division I soccer players.  Quickly we realized limiting ourselves to just Division I female athletes would limit the numbers of athletes in our study and limit the power of our data.  As such, we began to expand this study to include athletes from 11 years old to Division I athletes.

All of the athletes involved in this study fell under our IRB (Institutional Review Board) application and were all involved in organized soccer clubs (developmental leagues) and/or school sanctioned soccer.  During this study, we were collecting (in addition to other information) demographic data, orthopedic history and movement information from a standardized movement assessment.  As we started to assess these athletes, we quickly started to see three common trends, especially in our younger athletes.

  1. Younger athletes who had a history of concussion reported an increase number of non-contact lower kinetic chain injuries (ankle sprain/strains, knee injuries, etc.).  
  2. Athletes who had a history of concussion also performed very poorly on their single limb tests.
  3.  Athletes with a history of concussion also had increased number of losses of balance during the course of our assessment.
This made us hypothesize that athletes who have a history of concussion:
  1. Have an increase risk for LKC non-contact injuries.
  2. Have an increase risk for ACL injuries.
  3. Have a decrease in athletic performance.
As an examiner, this was clearly the case and these would be some strong assumptions based on what we are seeing, the science behind the rational and based on what we see clinically.  But as a scientist, sometimes we need a paper to show us that it may hurt when you pound your thumb with a hammer.  In other words, we need several research papers looking specifically at all the possible variables before we can come to this conclusion.  

What do you think?  Does previous concussion have an impact on athletic performance and injury risk.  Over the course of the next couple of weeks, we will start to dissect that question and look at the impact that concussion has on athletic performance. #ResearchThatWorks #ACLPlayItSafe

Dr. Nessler is a practicing physical therapist with over 20 years sports medicine clinical experience and a nationally recognized expert in the area of athletic movement assessment.  He is the developer of an athletic biomechanical analysis, is an author of a college textbook on this subject  and has performed >3000 athletic movement assessments.  He serves as the National Director of Sports Medicine Innovation for Select Medical, is Chairman of Medical Services for the International Obstacle Racing Federation and associate editor of the International Journal of Athletic Therapy and Training. 

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