May132019
Concussion Injuries
A study of more than 300 collegiate athletes show a significant association for the women between reported, unreported, and “any” concussions and knee injuries, and between unrecognized concussions and lateral ankle sprains. The men only show a significant association between unrecognized concussion and any type of lower extremity injury. The results suggest that “females are at higher risk of post-concussion subsequent MSK injury over the course of their collegiate athletic career,” investigators note.

Incomplete neurological recovery

They hypothesize that the sex differences be due to incomplete neurological recovery or possibly because of persistent deficits in postural control. Is there something occurring in this population whereby they’re seeing these dual-task postural challenges predisposing a person to a secondary injury?” Buckley speculated. “It also raises the question: can we look to rehabilitate or do secondary prevention strategies, or primary prevention of secondary injuries in this population?”

This is a topic that has really capture the attention of the sports medicine world, session co-moderator Tad D. Seifert, MD, director of the Sports Neurology Program at Norton Healthcare, Louisville, Kentucky, told after the presentation. Not only what seems to be an increase risk of lower extremity risk after a concussion; but now having evidence that further suggests that that risk is even higher in females is really interesting, they said.

It now begs the question of whether we need to somehow incorporate more of a definitive functional musculoskeletal screening process during the formal return-to-play progression. Seifert note that another big question is around; so how well clinicians are assessing clinical recovery and clinical aptitude, “not only from a neurologic standpoint; but also looking at musculoskeletal wellness and health, which are indirectly relate to neurocircuitry after a head trauma.

Strength component at play

Ask what they thought the underlying mechanism was for the sex differences find in the study; so certainly can’t answer that right now; but speculate that there might be a hormonal influence or strength component at play. Is it skeletal makeup differences? They don’t know but they think this is one of the pressing questions now as concussion research continues to evolve.

They note that replication is need in further studies before clinical guidance can release on this issue. But having said that, they don’t think this is something we can ignore. They, as neurologists, sometimes forget the whole body approach. They’re so worried about the central nervous system and the peripheral nervous system; so that we don’t think about other potential consequences of an injury such as concussion,” Seifert said.
“However, the evidence now clearly suggests” an association between concussion; also increase lower extremity MSK injury; so they added. So they think we have to incorporate sports medicine as a whole when they’re dealing with this type of specialize patient. It’s not just looking at the brain component; but also looking at orthopedic risk factors; so cardiovascular risk factors, and all things that can influence risk of injury of all types down the road.