Concussion is not associated with elevated rates of lower-extremity musculoskeletal injuries in National Football League Players

Buckley, Thomas A.; Browne, Steven; Hunzinger, Katherine J.; Kaminski, Thomas W.; Swanik, C. Buz

doi:10.1080/00913847.2022.2080515

Cited by 5 publications

(4 citation statements)

References 49 publications

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“…In fact, a recent systematic review and bibliometric analysis identified an exponential increase in manuscripts using this methodology (Inclan et al 2023b ). One example is a recent research report that identified no increased risk of subsequent musculoskeletal injury after sustaining SRC in NFL players (Buckley et al 2022 ), which were in contrast to findings reported at other levels of participation (Lynall et al 2017 ; Nusbickel et al 2022 ; Herman et al 2017 ). Notably, those findings are based on a publicly available data source that only captured less than half of the medically documented SRCs based on the reported descriptives.…”

Section: Discussionmentioning

confidence: 90%

“…For example, in a recent study Bedard and Wyndham Lawrence ( 2021 ) described the epidemiology of injury using the NFL.com injury reports and suggested a decrease in SRC rates between the 2014 to 2015 seasons. Others used these publicly obtainable data sources to separately test the associations between SRC rates and introduction of Playing Rule Article 8 (Baker et al 2021 ), unconventional game schedules (i.e., Thursday game day, overseas play) (Teramoto et al 2017 ), and the association between in subsequent musculoskeletal injury after sustaining a SRC (Buckley et al 2022 ).…”

Section: Background/contextmentioning

confidence: 99%

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Publicly available data sources in sport-related concussion research: a caution for missing data

Bretzin,

D’Alonzo,

van der Mei

et al. 2024

Inj. Epidemiol.

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Background Researchers often use publicly available data sources to describe injuries occurring in professional athletes, developing and testing hypotheses regarding athletic-related injury. It is reasonable to question whether publicly available data sources accurately indicate athletic-related injuries resulting from professional sport participation. We compared sport-related concussion (SRC) clinical incidence using data from publicly available sources to a recent publication reporting SRC using electronic health records (EHR) from the National Football League (NFL). We hypothesize publicly available data sources will underrepresent SRC in the NFL. We obtained SRCs reported from two publicly available data sources (NFL.com, pro-football-reference.com) and data reported from the NFL’s published EHR. We computed SRC per 100 unique player signings from 2015–2019 and compared the clinical incidence from publicly available data sources to EHR rates using clinical incidence ratios (CIR) and 95% confidence intervals (CI). Findings From 2015–2019, SRC counts from published EHR record data ranged from 135–192 during the regular season, whereas SRC counts ranged from 102–194 and 69–202 depending on the publicly available data source. In NFL.com the SRC clinical incidence was significantly and progressively lower in 2017 (CIR: 0.73, 95% CI: 0.58–0.91), 2018 (CIR: 0.66, 95% CI: 0.50–0.87), and 2019 (CIR: 0.48, 95% CI: 0.35–0.64) relative to the gold-standard EHR. In the pro-football-reference.com data, the documented SRCs in publicly available data sources for other years were ~ 20–30% lower than the gold-standard EHR numbers (CIRs 0.70–0.81). Conclusions Publicly available data for SRCs per 100 unique player signings did not match published data from the NFL’s EHR and in several years were significantly lower. Researchers should use caution before using publicly available data sources for injury research.

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Section: Discussionmentioning

confidence: 90%

Section: Background/contextmentioning

confidence: 99%

Publicly available data sources in sport-related concussion research: a caution for missing data

Bretzin,

D’Alonzo,

van der Mei

et al. 2024

Inj. Epidemiol.

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“…Several previous studies have identified a shorter time to subsequent MSKI after concussion, 7,15 while others did not. 4 Similar to several previous studies, 4,8,36 our study assessed the subsequent MSKI incidence only for the remainder of the current season as opposed to longer time spans (1-2 years) in the other collegiate studies. 19,41,43 This is a common limitation to medical database evaluations and was also present in studies of postconcussion MSKI in high school athletes.…”

Section: Discussionmentioning

confidence: 90%

“…This is drastically different from previous studies that typically used a 1-year follow-up period, and a recent professional football analysis also failed to identify an elevated risk with a mean follow-up time of only 6 to 7 weeks. 8 Given that the postconcussion LEMSKI rate appears to increase over time, 43,51 this approach may account for the lack of differences in most of the analyses.…”

Section: Discussionmentioning

confidence: 99%

Lower Extremity Musculoskeletal Injuries After Concussion in Collegiate Student-Athletes

et al. 2023

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Background: An association has been identified between concussion and lower extremity musculoskeletal injury (LEMSKI) after return to sports participation. However, the collegiate student-athlete studies have relied on relatively small single-institution studies, which limits generalizability. Purpose: To assess odds of, and time to, LEMSKI after concussion in US collegiate athletes, using the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP). Study Design: Descriptive epidemiology study. Methods: Data from the NCAA ISP during the 2010-2011 through 2019-2020 athletic seasons were considered for analysis. Frequency distributions were examined for details related to the initial and subsequent injuries (injuries to bone, bursa, joint, ligament, muscle, or tendon). Multivariable logistic regression models and random-effects Poisson regression models examined odds of time loss (TL) and non–time loss (NTL) LEMSKI after concussion, as well as the time interval between initial concussion and subsequent LEMSKI in a single athletic season, or initial musculoskeletal injury (MSKI) and subsequent LEMSKI in a single athletic season. Analyses were performed separately for football and other sports. Results: A total of 31,637 initial injuries were recorded (football: 11,981; other sports: 19,656), which were followed by 0 or 1 injury in the same season. Overall, first injury type was not a significant predictor of subsequent LEMSKI, although certain contrasts yielded significant estimates. In football, the odds of NTL LEMSKI were higher after concussion than after upper extremity MSKI (UEMSKI; adjusted odds ratio [ORAdj], 1.59; 95% CI, 1.08-2.34). In football, the odds of TL LEMSKI were lower after concussion than after UEMSKI (ORAdj, 0.69; 95% CI, 0.50-0.97). No other significant effect estimates were observed for football or other sports. Conclusion: First injury type, either concussion or upper extremity, was not associated with an elevated risk of LEMSKI. Specifically, the results of this study did not identify an elevated odds of LEMSKI after a concussion. However, the authors observed greater odds of NTL LEMSKI and lower odds of TL LEMSKI in football.

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A controlled early-exercise rehabilitation program commencing within 48 hours of a Sports-Related Concussion improves recovery in UK student-athletes: A prospective cohort study

Glendon,

Blenkinsop,

Belli

et al. 2024

Journal of Science and Medicine in Sport

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Concussion is not associated with elevated rates of lower-extremity musculoskeletal injuries in National Football League Players

Cited by 5 publications

References 49 publications

Publicly available data sources in sport-related concussion research: a caution for missing data

Publicly available data sources in sport-related concussion research: a caution for missing data

Lower Extremity Musculoskeletal Injuries After Concussion in Collegiate Student-Athletes

A controlled early-exercise rehabilitation program commencing within 48 hours of a Sports-Related Concussion improves recovery in UK student-athletes: A prospective cohort study

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Concussion is not associated with elevated rates of lower-extremity musculoskeletal injuries in National Football League Players

Cited by 5 publications

References 49 publications

Publicly available data sources in sport-related concussion research: a caution for missing data

Publicly available data sources in sport-related concussion research: a caution for missing data

Lower Extremity Musculoskeletal Injuries After Concussion in Collegiate Student-Athletes

A controlled early-exercise rehabilitation program commencing within 48 hours of a Sports-Related Concussion improves recovery in UK student-athletes: A prospective cohort study

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Product

Resources

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A controlled early-exercise rehabilitation program commencing within 48 hours of a Sports-Related Concussion improves recovery in UK student-athletes: A prospective cohort study