Collegiate Football Athletes Research Articles

ACL Injury in Collegiate Football Athletes: Impact on Draft Status and Professional Performance

Objectives:Shoulder injuries remain among the most common traumatic injuries in high-level football players. However, there remains a paucity of information available on the impact of shoulder on d...

Shoulder Injuries in Collegiate Football Athletes: Impact on Draft Status and Professional Performance

Objectives:Shoulder injuries remain among the most common traumatic injuries in high-level football players. However, there remains a paucity of information available on the impact of shoulder on draft prospect and professional performance. The purpose of this study is to define the epidemiology of shoulder injuries in NFL athletes, and to determine the impact of associated injuries on draft status and performance in the NFL.Methods:All NFL-caliber athletes who attended the NFL Scouting Combine between 2009 and 2015 were analyzed for history of shoulder injury. The impact of shoulder injury on NFL draft pick status and NFL performance, including games started, games played, and position-specific performance outcomes, were analyzed, and compared to control Combine athletes, which were defined as athletes with no history of shoulder injury in college, no surgical history, and no history of missing > 2 total games in college.Results:A total of 1143/2198 (52%) at the Combine had a history of shoulder injury, including 527 acromioclavicular joint (ACJ) injuries (46%), 90 posterior labrum injuries (8%), 77 anterior labrum injuries (7%), 69 clavicle injuries (6%), 42 rotator cuff injuries (4%), 14 superior labrum anterior to posterior (SLAP) lesions (1%), 14 sternoclavicular joint injuries (1%), and 16 biceps injuries (1%). In addition, 267 athletes (23%) had “complex” injuries, indicating multiple sites about the shoulder, while 207 athletes (18%) had shoulder injuries designated as “other.” Combine athletes with shoulder injuries were more likely to go undrafted compared to controls (34% undrafted, vs. 27.3% for controls), and had a higher undrafted rate with biceps (43.8%), SLAP (42.9%), ACJ (35.9%), ACJ (35.6%), labrum (33%), and complex injuries (35.6%) Similarly, of the drafted athletes, those with shoulder injuries were more likely to have a higher (worse) overall draft pick compared to controls. In general, athletes with shoulder injuries played and started fewer games in their first two seasons in the NFL than controls (played: 23.7±7.7, started 11.1±10.5), with sternoclavicular injuries associated with the lowest numbers of games played (17±8.5) and started (10.3±11.2).Conclusion:History of shoulder injury in NFL-caliber players is associated with reduced overall draft rates, higher (worse) overall draft pick, and reduced performance in the NFL compared to control athletes without shoulder injury. Overall, ACJ injuries are the most prevalent of shoulder injuries among NFL-caliber athletes. Additional analysis is warranted to determine the overall impact of specific types of shoulder injuries, as well as shoulder surgery, on position-specific performance and career longevity.

Epidemiological Patterns of Initial and Subsequent Injuries in Collegiate Football Athletes

Background: A body of epidemiological studies has examined football injuries and associated risk factors among collegiate athletes. However, few existing studies specifically analyzed injury risk in terms of initial or subsequent injuries. Purpose: To determine athlete-exposures (AEs) and rates of initial and subsequent injury among collegiate football athletes. Study Design: Descriptive epidemiological study. Methods: Injury and exposure data collected from collegiate football players from two Division I universities (2007-2011) were analyzed. Rate of initial injury was calculated as the number of initial injuries divided by the total number of AEs for initial injuries, while the rate for subsequent injury was calculated as the number of subsequent injuries divided by the total number of AEs for subsequent injury. Poisson regression was used to determine injury rate ratio (subsequent vs initial injury), with adjustment for other covariates. Results: The total AEs during the study period were 67,564, resulting in an overall injury rate of 35.2 per 10,000 AEs. Rates for initial and subsequent injuries were 31.7 and 45.3 per 10,000 AEs, respectively, with a rate ratio (RR) of 1.4 for rate of subsequent injury vs rate of initial injury (95% CI, 1.1-1.9). Rate of injury appeared to increase with each successive injury. RR during games was 1.8 (95% CI, 1.1-3.0). The rate of subsequent injuries to the head, neck, and face was 10.9 per 10,000 AEs, nearly double the rate of initial injuries to the same sites (RR = 2.0; 95% CI, 1.1-3.5). For wide receivers, the rate of subsequent injuries was 2.2 times the rate of initial injuries (95% CI, 1.3-3.8), and for defensive linemen, the rate of subsequent injuries was 2.1 times the rate of initial injuries (95% CI, 1.1-3.9). Conclusion: The method used in this study allows for a more accurate determination of injury risk among football players who have already been injured at least once. Further research is warranted to better identify which specific factors contribute to this increased risk for subsequent injury.

Evaluation of Shoulder-Stabilizing Braces: Can We Prevent Shoulder Labrum Injury in Collegiate Offensive Linemen?

Background:Shoulder injuries remain one of the most common injuries among collegiate football athletes. Offensive linemen in particular are prone to posterior labral pathology.Purpose:To evaluate the efficacy of shoulder bracing in collegiate offensive linemen with respect to injury prevention, severity, and lost playing time.Study Design:Cohort study; Level of evidence, 3.Methods:Offensive linemen at a single collegiate institution wore bilateral shoulder-stabilizing braces for every contact practice and game beginning in the spring of 2013. Between spring of 2007 and fall of 2012, offensive linemen did not wear any shoulder braces. Player injury data were collected for all contact practices and games throughout these time periods to highlight differences with brace use.Results:Forty-five offensive linemen (90 shoulders) participated in spring and fall college football seasons between 2007 and 2015. There were 145 complete offensive linemen seasons over the course of the study. Offensive linemen not wearing shoulder braces completed 87 seasons; offensive linemen wearing shoulder braces completed 58 seasons. Posterior labral tear injury rates were calculated for players who wore the shoulder braces (0.71 per 1000 athlete-exposures) compared with shoulders of players who did not wear the braces (1.90 per 1000 athlete-exposures). The risk ratio was 0.46 (95% CI, 0.16-1.30; P = .14). Mean time (contact practices and games) missed due to injury was significant, favoring less time missed by players who used braces (8.7 vs 36.60 contact practices and games missed due to injury; P = .0019). No significant difference in shoulder labral tears requiring surgery was found for brace use compared with no brace use.Conclusion:Shoulder-stabilizing braces were shown not to prevent posterior labral tears among collegiate offensive lineman, although they were associated with less time lost to injury. The results of this study have clinical significance, indicating that wearing a shoulder brace provides a protective factor for offensive linemen.

Abnormalities in Functional Connectivity in Collegiate Football Athletes with and without a Concussion History: Implications and Role of Neuroactive Kynurenine Pathway Metabolites.

There is a great need to identify potential long-term consequences of contact sport exposure and to identify molecular pathways that may be associated with these changes. We tested the hypothesis that football players with (Ath-mTBI) (n = 25) and without a concussion history (Ath) (n = 24) have altered resting state functional connectivity in regions with previously documented structural changes relative to healthy controls without football or concussion history (HC) (n = 27). As a secondary aim, we tested the hypothesis that group differences in functional connectivity are moderated by the relative ratio of neuroprotective to neurotoxic metabolites of the kynurenine pathway. Ath-mTBI had significantly increased connectivity of motor cortex to the supplementary motor area relative to Ath and HC. In contrast, both Ath-mTBI and Ath had increased connectivity between the left orbital frontal cortex and the right lateral frontal cortex, and between the left cornu ammonis areas 2 and 3/dentate gyrus (CA2-3/DG) of the hippocampus and the middle and posterior cingulate cortices, relative to HC. The relationship between the ratio of plasma concentrations of kynurenic acid to quinolinic acid (KYNA/QUIN) and left pregenual anterior cingulate cortex connectivity to multiple regions as well as KYNA/QUIN and right CA2-3/DG connectivity to multiple regions differed significantly according to football and concussion history. The results suggest that football exposure with and without concussion history can have a significant effect on intrinsic brain connectivity and implicate the kynurenine metabolic pathway as one potential moderator of functional connectivity dependent on football exposure and concussion history.

Effects of Excessive Body Weight on Wingate Test Performance

Resistance loading is important to correct power determinations using the Wingate power output test. In football linemen who have very heavy body weights, much of which can be fat mass, the standard loading of 7.5% may result in a resistance too heavy for them to complete the test adequately. PURPOSE: The purpose of this study was to determine if excessive body weight will result in peak power output (PPO) and fatigue index (FI) not being accurately assessed at the standard resistance of 7.5% on the Wingate test. METHODS: Eleven division three collegiate football athletes (mean ± SD: age, 19.09 ± 0.54 yrs; height, 188.19 ± 3.51 cm; weight, 131.50 ± 14.33 kg; percent fat, 31.58 ± 4.29 %) participated in the current study. All subjects performed three, 30 second Wingate tests at the following resistances, 5.5%, 6.5%, and 7.5% in a randomized order to assess PPO and FI. Each Wingate test was performed on different days with at least four days’ rest between trials. RESULTS: PPO and FI were significantly different between the three resistance groups (p ≤ 0.05). The 5.5% resistance setting produced the lowest PPO (1038.3 ± 82.3 Watts) and fatigue index (15.29 ± 3.66 W/S). The 7.5% resistance setting had the highest PPO (1413.10 ± 125.64 Watts) and fatigue index (25.97 ± 5.27 W/S). At the 6.5% resistance setting, data were between the two other groups and different from the other groups. CONCLUSION: In conclusion, excessive body weight individuals should perform the standard resistance of 7.5% on the Wingate test instead of lower resistances to obtain a true peak power output and fatigue index.

Predictors Of Grit Levels In An NCAA Division II College Football Team

Grit is defined as an individual’s perseverance and desire to achieve long-term goals. Grit has been demonstrated to be a predictive factor for academic achievement in youth settings but few studies have assessed grit in college athletic populations. PURPOSE: To investigate potential factors predicting grit in collegiate football athletes. METHODS: Athletes with ages ranging from 18 to 22 years (M = 19.40, SD = 1.29) from one NCAA Division II football team [(N = 88; freshmen (43%); sophomores (19%); juniors (21%); seniors (17%)] completed five self-reported measures at one time point: the Short Grit Scale (GRIT-S), the Sport Motivation Scale II (SMS II), the Short Self-Compassion Scale (SSCS), the Objectified Body Consciousness Scale (OBCS) and a demographics questionnaire. The 12-item GRIT-S was used to measure grit, the 18-item SMS II scale was used to assess six factors of athletes’ motivation within their given sport (intrinsic regulation, four types of extrinsic regulation and amotivation), the 12-item SSCS was used to measure levels of self-compassion, and the 8-item Control Beliefs subscale of the OBCS was used assess the degree to which individuals believe that they are responsible for their appearance and that they can control their appearance with enough effort. A multiple regression analysis was conducted and an alpha level of 0.05 was set for statistical significance. RESULTS: Results revealed that three factors statistically significantly predicted grit (R2=.35, F(3,84) = 15.14, p < .001): control beliefs (β = .38, p < .001), intrinsic regulation (β = .28, p = .006) and self-compassion (β = .21, p = .033). CONCLUSIONS: Results indicated that three predictor variables explained 35% of the variance for grit in this population of collegiate football players. Those working diligently through failures, adversities and plateaus while maintaining a fervent level of interest to achieve success possess more “grittiness.” It is gleaned from this study that one’s degree of control over beliefs about one’s appearance, level of intrinsic regulation (internal satisfaction and enjoyment of competing) and self-compassion levels greatly influence grit. Further research is needed to better understand grit in a national sample of college athletic teams that may provide more generalizable results.

Assessment of an Educational Intervention on Blood Pressure Knowledge and Risk Factor Practices in Collegiate Football Athletes

Hypertension is a serious health problem affecting approximately one‐third of the adult population in the US. While athletes work to maintain high levels of fitness, they too, are affected by this disease. American–style football is the most popular sport in which adolescents within the US participate. This translates into many individuals pursuing collegiate football activities. Few studies have examined blood pressure and football relationships. However, an increase in blood pressure was observed within the first season of playing football, with a diagnosis of hypertension in &gt;10% of individuals assessed. Interestingly, some training‐related behaviors associated with athletes’ regimens to enhance performance such as intense resistance training, a relative lack of aerobic exercise, and weight gain have been suggested to play a role in professional football players’ diagnoses of hypertension and left ventricular hypertrophy, as well as premature CVD‐related mortality. Lifestyle choices have been identified that increase the risk for hypertension. Education of college‐age athletes regarding these risk factors has the potential to result in better blood pressure control. Sixty‐six college‐aged football athletes were queried on blood pressure knowledge and diagnostic criteria along with selected dietary habits and training activities via a pre‐test. An educational intervention in the form of a Fact Sheet was delivered via paper copy (most preferred method) and e‐mail per the preferences expressed by the athletes. A post‐test was delivered to assess changes in knowledge of hypertension and change in hypertension‐related dietary practices. Pretest results indicated variability in the knowledge of the collegiate football athletes regarding hypertension and a need for educational intervention. The pretest and post‐test results will provide evidence of the effectiveness of the intervention.Support or Funding InformationNA

Smaller Dentate Gyrus and CA2 and CA3 Volumes Are Associated with Kynurenine Metabolites in Collegiate Football Athletes.

An imbalance in kynurenine pathway metabolism is hypothesized to be associated with dysregulated glutamatergic neurotransmission, which has been proposed as a mechanism underlying the hippocampal volume loss observed in a variety of neurological disorders. Pre-clinical models suggest that the CA2-3 and dentate gyrus hippocampal subfields are particularly susceptible to excitotoxicity after experimental traumatic brain injury. We tested the hypothesis that smaller hippocampal volumes in collegiate football athletes with (n = 25) and without (n = 24) a concussion history would be most evident in the dentate gyrus and CA2-3 subfields relative to nonfootball healthy controls (n = 27). Further, we investigated whether the concentration of peripheral levels of kynurenine metabolites are altered in football athletes. Football athletes with and without a self-reported concussion history had smaller dentate gyrus (p < 0.05, p < 0.10) and CA2-3 volumes (p's < 0.05) relative to healthy controls. Football athletes with and without a concussion history had a trend toward lower (p < 0.10) and significantly lower (p < 0.05) kynurenine levels compared with healthy controls, while athletes with a concussion history had greater levels of quinolinic acid compared with athletes without a concussion history (p < 0.05). Finally, plasma levels of 3-hydroxykynurenine inversely correlated with bilateral hippocampal volumes in football athletes with a concussion history (p < 0.01), and left hippocampal volume was correlated with the ratio of kynurenic acid to quinolinic acid in football athletes without a concussion history (p < 0.05). Our results raise the possibility that abnormalities of the kynurenine metabolic pathway constitute a mechanism for hippocampal volume differences in the context of sports-related brain injury.

Thinner Cortex in Collegiate Football Players With, but not Without, a Self-Reported History of Concussion.

Emerging evidence suggests that a history of sports-related concussions can lead to long-term neuroanatomical changes. The extent to which similar changes are present in young athletes is undetermined at this time. Here, we tested the hypothesis that collegiate football athletes with (n = 25) and without (n = 24) a self-reported history of concussion would have cortical thickness differences and altered white matter integrity relative to healthy controls (n = 27) in fronto-temporal regions that appear particularly susceptible to traumatic brain injury. Freesurfer software was used to estimate cortical thickness, fractional anisotropy was calculated in a priori white matter tracts, and behavior was assessed using a concussion behavioral battery. Groups did not differ in self-reported symptoms (p > 0.10) or cognitive performance (p > 0.10). Healthy controls reported significantly higher happiness levels than both football groups (all p < 0.01). Contrary to our hypothesis, no differences in fractional anisotropy were observed between our groups (p > 0.10). However, football athletes with a history of concussion had significantly thinner cortex in the left anterior cingulate cortex, orbital frontal cortex, and medial superior frontal cortex relative to healthy controls (p = 0.02, d = -0.69). Further, football athletes with a history of concussion had significantly thinner cortex in the right central sulcus and precentral gyrus relative to football athletes without a history of concussion (p = 0.03, d = -0.71). No differences were observed between football athletes without a history of concussion and healthy controls. These results suggest that previous concussions, but not necessarily football exposure, may be associated with cortical thickness differences in collegiate football athletes.

Exertional Heat Illnesses and Environmental Conditions During High School Football Practices

Background: Guidelines for preventing exertional heat illnesses (EHIs) during extreme heat stress should be specific to regional environments, age, and sport and should be based on evidence of reducing the risk. Each year in the United States, over 1 million high school football players practice in the August heat; however, no published data describe the incidence of EHIs in these athletes. Purpose: To describe the environmental conditions and incidence of EHIs during high school football practices over a 3-month period. Study Design: Descriptive epidemiology study. Methods: For a 3-month period (August-October), athletic trainers at 12 high schools in North Central Florida recorded the practice time and length, environmental conditions (wet-bulb globe temperature), and incidences of EHIs in varsity football athletes. Results: Athletes suffered 57 total EHIs during 29,759 athlete-exposures (AEs) for the 3-month data collection period (rate = 1.92/1000 AEs). August accounted for the majority of all EHIs, with 82.5% (47/57) and the highest rate (4.35/1000 AEs). Of total heat illnesses, heat cramps accounted for 70.2% (40/57), heat exhaustion 22.8% (13/57), and heat syncope 7.0% (4/57). The odds ratio indicated that athletes in August practices that lasted longer than the recommended 3 hours were 9.84 times more likely to suffer a heat illness than those in practices lasting ≤3 hours. Conclusion: The highest rate of EHIs was during August. Practices in August that exceeded the recommended 3 hours were associated with a greater risk of heat illnesses. The overall rate of EHIs was lower for the high school football athletes observed in the study compared with that reported for collegiate football athletes in the region. The low rates of EHIs recorded suggest that the prevention guidelines employed by sports medicine teams are appropriate for the region and population. Clinical Relevance: Team physicians and athletic trainers should employ evidence-based, region- and population-specific EHI prevention guidelines. Sports medicine teams, coaches, and athletes should be aware of the increased risk of EHIs during August practices and the risk of prolonged practices during August.

The Influence of Social Status and Power on the Sexual Behavior of Male Collegiate Football Athletes

The purpose of this study was to explore the perceived influence that status and social power have on the sexual behavior of 15 male football players at a Southeastern university. Participants were individually interviewed and findings revealed four major themes concerning college football players: (a) they have a polarizing image among women, (b) their status influences their self-perception and behavior, (c) women are attracted to their status, and (d) they believed women perceived benefits in having sex with them. Understanding the lived experience of college football athletes can aid in further studies of their behaviors as well as the development of programs and services focused on at-risk behavior prevention.

The Relationship between Self-Ratings of Aggression and Insular Cortical Thickness in Collegiate Football Athletes

The Relationship between Self-Ratings of Aggression and Insular Cortical Thickness in Collegiate Football Athletes

Groin Injury in a Collegiate Football Athlete

HISTORY: A 19-year-old Division 1 Collegiate football player presented to the Emergency Department four days following injury to his right groin during football practice. He complained of severe right groin pain accompanied by fatigue, fevers, nausea, and diarrhea. He was admitted to the hospital for pain control and MRI evaluation of psoas injury. On hospital day 1 he developed oliguria with acute kidney injury and rhabdomyolysis. Within hours he became febrile, tachypnic, and tachycardic and was transferred to the medical intensive care unit for sepsis and acute kidney injury. PHYSICAL EXAMINATION: T 101.3, HR 134, RR 40, BP 105/53 Ill-appearing male in moderate respiratory distress. Cardiovascular: Tachycardic with regular rhythm, new systolic murmur, grade 2/6 at the left upper sternal border, distal pulses 2+ and equal bilaterally. Respiratory: Tachypneic, clear to auscultation bilaterally. Abdomen: soft, tender to palpation right lower quadrant, no guarding or rebound. Extremities: No obvious deformities, significant pain with extension of right hip and knee. Skin: flushed. Neuro: alert and oriented to person, place, and time. DIFFERENTIAL DIAGNOSIS: Right psoas abscess Pyomyositis Appendicitis TEST AND RESULTS: Laboratory studies: Creatinine2.8 CPK1530 Procalcitonin57 Lactic acid3.1 CT Abd/Pelvis: Right iliopsoas muscle injury Possible acute avulsion fracture Soft tissue stranding suggestive of possible superinfection Normal appendix MRI: 14.2 x 5.7 x 5.3 cm abscess located in the right iliopsoas and distal myotendinous junction FINAL WORKING DIAGNOSIS: Myonecrosis of the right iliopsoas TREATMENT AND OUTCOMES: 1. Anterior thigh incision and debridement of necrotic right iliopsoas muscle with delayed primary closure 2. Targeted antibiotic therapy 3. Rehabilitation started 6 weeks post-injury 4. Returned to sport without limitation four months post-injury

Groin Injury in a Collegiate Football Athlete

Groin Injury in a Collegiate Football Athlete

Recovery of cerebral blood flow following sports-related concussion.

Animal models suggest that reduced cerebral blood flow (CBF) is one of the most enduring physiological deficits following concussion. Despite this, longitudinal studies documenting serial changes in regional CBF following human concussion have yet to be performed. To longitudinally assess the recovery of CBF in a carefully selected sample of collegiate athletes and compare time course of CBF recovery with that of cognitive and behavioral symptoms. A cohort of collegiate football athletes (N = 44) participated in this mixed longitudinal and cross-sectional study at a private research institute specializing in neuroimaging between March 2012 and December 2013. Serial imaging occurred approximately 1 day, 1 week, and 1 month postconcussion for a subset of participants (n = 17). All athletes reported no premorbid mood disorders, anxiety disorders, substance abuse, or alcohol abuse. Arterial spin labeling magnetic resonance imaging was used to collect voxelwise relative CBF at each visit. Neuropsychiatric evaluations and a brief cognitive screen were also performed at all 3 points. Clinicians trained in sports medicine provided an independent measure of real-world concussion outcome (ie, number of days withheld from competition). The results indicated both cognitive (simple reaction time) and neuropsychiatric symptoms at 1 day postinjury that resolved at either 1 week (cognitive; P < .005) or 1 month (neuropsychiatric; P < .005) postinjury. Imaging data suggested both cross-sectional (ie, healthy vs concussed athletes; P < .05) and longitudinal (1 day and 1 week vs 1 month postinjury; P < .001) evidence of CBF recovery in the right insular and superior temporal cortex. Importantly, CBF in the dorsal midinsular cortex was both decreased at 1 month postconcussion in slower-to-recover athletes (t11 = 3.45; P = .005) and was inversely related to the magnitude of initial psychiatric symptoms (Hamilton Depression Scale: r = -0.64, P = .02; Hamilton Anxiety Scale: r = -0.56, P = .046), suggesting a potential prognostic indication for CBF as a biomarker. To our knowledge, these results provide the first prospective evidence of reduced CBF in human concussion and subsequent recovery. The resolution of CBF abnormalities closely mirrors previous reports from the animal literature and show real-world validity for predicting outcome following concussion.

Common Shoulder Injuries in American Football Athletes.

American football is a collision sport played by athletes at high speeds. Despite the padding and conditioning in these athletes, the shoulder is a vulnerable joint, and injuries to the shoulder girdle are common at all levels of competitive football. Some of the most common injuries in these athletes include anterior and posterior glenohumeral instability, acromioclavicular pathology (including separation, osteolysis, and osteoarthritis), rotator cuff pathology (including contusions, partial thickness, and full thickness tears), and pectoralis major and minor tears. In this article, we will review the epidemiology and clinical and radiographic workup of these injuries. We also will evaluate the effectiveness of surgical and nonsurgical management specifically related to high school, collegiate, and professional football athletes.

Allometric scaling of strength scores in NCAA division I-A football athletes.

This study examined population-specific allometric exponents to control for the effect of body mass (BM) on bench press, clean, and squat strength measures among Division I-A collegiate football athletes. One repetition maximum data were obtained from a university pre-season football strength assessment (bench press, n = 207; clean, n = 88; and squat n = 86) and categorized into 3 groups by positions (line, linebacker, and skill). Regression diagnostics and correlations of scaled strength data to BM were used to assess the efficacy of the allometric scaling model and contrasted with that of ratio scaling and theoretically based allometric exponents of 0.67 and 0.33. The log-linear regression models yielded the following exponents (b): b = 0.559, 0.287, and 0.496 for bench press, clean, and squat, respectively. Correlations between bench press, clean, and squat to BM were r = -0.024, -0.047, and -0.018, respectively, suggesting that the derived allometric exponents were effective in partialling out the effect of BM on these lifts and removing between-group differences. Conversely, unscaled, ratio-scaled, and allometrically scaled (b = 0.67 or 0.33) data resulted in significant differences between groups. It is suggested that the exponents derived in the present study be used for allometrically scaling strength measures in National Collegiate Athletic Association Division I-A football athletes. Use of the normative percentile rank scores provide coaches and trainers with a valid means of judging the effectiveness of their training programs by allowing comparisons between individuals without the confounding influence of BM.

Return to Football and Long-Term Clinical Outcomes After Thumb Ulnar Collateral Ligament Suture Anchor Repair in Collegiate Athletes

To evaluate return to play after complete thumb ulnar collateral ligament (UCL) injury treated with suture anchor repair for both skill position and non-skill position collegiate football athletes and report minimum 2-year clinical outcomes in this population. For this retrospective study, inclusion criteria were complete rupture of the thumb UCL and suture anchor repair in a collegiate football athlete performed by a single surgeon who used an identical technique for all patients. Data collection included chart review, determination of return to play, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) outcomes. A total of 18 collegiate football athletes were identified, all of whom were evaluated for follow-up by telephone, e-mail, or regular mail at an average 6-year follow-up. Nine were skill position players; the remaining 9 played in nonskill positions. All players returned to at least the same level of play. The average QuickDASH score for the entire cohort was 1 out of 100; QuickDASH work score, 0 out of 100; and sport score, 1 out of 100. Average time to surgery for skill position players was 12 days compared with 43 for non-skill position players. Average return to play for skill position players was 7 weeks postoperatively compared with 4 weeks for non-skill position players. There was no difference in average QuickDASH overall scores or subgroup scores between cohorts. Collegiate football athletes treated for thumb UCL injuries with suture anchor repair had quick return to play, reliable return to the same level of activity, and excellent long-term clinical outcomes. Skill position players had surgery sooner after injury and returned to play later than non-skill position players, with no differences in final level of play or clinical outcomes. Management of thumb UCL injuries in collegiate football athletes can be safely and effectively tailored according to the demands of the player's football position. Therapeutic IV.

Rates and Determinants of Return to Play After Anterior Cruciate Ligament Reconstruction in NCAA Division 1 College Football Athletes: A Study of the ACC, SEC, and PAC-12 Conferences.

Background:For competitive athletes, return to play (RTP) and return to preinjury levels of performance after anterior cruciate ligament (ACL) reconstruction are the main goals of surgery. Although outcomes of ACL surgery are well studied, details on factors influencing RTP in elite college football players have not been evaluated thoroughly.Purpose:To determine the rate of RTP following ACL surgery among National Collegiate Athletic Association (NCAA) Division 1 collegiate football athletes and to examine variables that may affect these rates. The hypothesis was that the RTP rate in this cohort will be influenced by factors reflecting skill and accomplishment; that is, athletes higher on the depth chart, those on scholarship, and those later in their careers will have higher RTP rates. It was also predicted that graft type and concomitant procedures may have an effect on RTP rates.Study Design:Case series; Level of evidence, 4.Methods:Using athlete- and surgery-specific data from participating institutions in 3 major Division 1 college football conferences, information on athletes who had ACL reconstruction from 2004 through 2010 was collected. Statistical analyses were performed to determine the RTP rate as a function of the variables, such as depth chart position, in the data collected.Results:Of the 184-player cohort, 82% of the athletes, including 94% of starters, were able to RTP. Rates were greater among athletes higher on the depth chart (P = .004) and on scholarship (P = .008). Year of eligibility also affected RTP rates (P = .047), which increased from the redshirt and freshman year to the sophomore and junior years, but then decreased slightly into the senior and fifth-year senior seasons. The use of an autograft versus allograft was associated with increased RTP (P = .045). There was no significant difference (P = .18) between players who underwent an isolated ACL reconstruction versus those who underwent additional procedures.Conclusion:More than 80% of football players at the Division 1 level were able to RTP following ACL reconstruction. Factors representative of a player’s skill were associated with higher rates of RTP. Surgery-specific variables, in general, had no effect on RTP, except for the use of autograft, which was associated with a greater RTP rate.