Females have a Higher Post-Concussion Subsequent Injury Rate than Male Collegiate Athletes

Abstract

ObjectiveThe purpose of this study is to compare post-concussion lower extremity musculoskeletal (MSK) injury between sexes.BackgroundEmerging evidence suggests that there is an elevated risk of lower extremity MSK injury in the year following concussion. Indeed, we have previously reported a 1.6 –2.9 times elevated risk of lower extremity injury across a diverse population of collegiate student athletes at the conclusion of their athletic careers. However, there are recent and important calls to investigate the role of gender in concussion research and collegiate female student-athletes have elevated risks of specific injuries.Design/MethodsWe recruited 335 student-athletes (62.1% female, mean age, 21.2 ± 1.4 years old) across 13 sports from 17 NCAA member institutions. Participants self-reported concussions under three categories: 1) selfreported concussions, 2) acknowledged unreported concussions (e.g., “hidden”), 3) unrecognized concussions (e.g., memory loss following a head impact). The lower extremity MSK injuries were self-reported 1) lateral ankle sprains, 2) knee sprains, or 3) lower extremity muscle strain. Chi-square analyses identified the association between each of the concussion variables and lower extremity MSK between self-reported sexes.ResultsFor females, there was a significant association between 1) reported concussions and knee injuries (p = 0.018, OR = 2.22, 95% CI: 1.18 – 4.21), 2) unreported concussions and knee injuries (p = 0.005, OR = 3.73, 95% CI: 1.51 – 9.22), 3) unrecognized concussions and lateral ankle sprains (p = 0.007, OR = 2.61, 95% CI: 1.32 – 5.15). For males, there was only a significant association between unrecognized concussions and muscle strains (p = 0.020, odds ratio = 2.39, 95% CI: 1.16 – 4.92).ConclusionsThe results of this study suggest females are at higher risk of post-concussion subsequent MSK injury over the course of their collegiate athletic career. Consistent with recent concussion related findings, these results may highlight a gender difference in concussion response and suggests future studies continue to differentiate gender during analysis.