Collegiate Football Players Research Articles

Baseline, retest, and post-injury profiles of auditory neural function in collegiate football players

Objectives Recent retrospective studies report differences in auditory neurophysiology between concussed athletes and uninjured controls using the frequency-following response (FFR). Adopting a prospective design in college football players, we compared FFRs before and after a concussion and evaluated test-retest reliability in non-concussed teammates. Design Testing took place in a locker room. We analysed the FFR to the fundamental frequency (F0) (FFR-F0) of a speech stimulus, previously identified as a potential concussion biomarker. Baseline FFRs were obtained during the football pre-season. In athletes diagnosed with concussions during the season, FFRs were measured days after injury and compared to pre-season baseline. In uninjured controls, comparisons were made between pre- and post-season. Study Sample Participants were Tulane University football athletes (n = 65). Results In concussed athletes, there was a significant group-level decrease in FFR-F0 from baseline (26% decrease on average). By contrast, the control group’s change from baseline was not statistically significant, and comparisons of pre- and post-season had good repeatability (intraclass correlation coefficient = 0.75). Conclusions Results converge with previous work to evince suppressed neural function to the FFR-F0 following concussion. This preliminary study paves the way for larger-scale clinical evaluation of the specificity and reliability of the FFR as a concussion diagnostic. Highlights This prospective study reveals suppressed neural responses to sound in concussed athletes compared to baseline. Neural responses to sound show good repeatability in uninjured athletes tested in a locker-room setting. Results support the feasibility of recording frequency-following responses in non-laboratory conditions.

Alterations to the Gut Microbiome after Sport-Related Concussion in a Collegiate Football Players Cohort

Alterations to the Gut Microbiome after Sport-Related Concussion in a Collegiate Football Players Cohort

Peroneal reaction time delayed but dynamic single-legged stability retained in collegiate footballers during a simulated prolonged football protocol

ABSTRACT Delayed peroneal reaction time and impaired single-legged dynamic stability were risk factors of lateral ankle sprain (LAS), yet no study explored the change of them during a football match. The aim is to explore the change of peroneal reaction time and single-legged dynamic stability during a football simulation protocol. Twelve collegiate football players voluntarily completed a 105-min football match simulation protocol in which peroneal reaction time, root-mean-square of mediolateral ground reaction force in first 0.4 s (RMS ML 0.4), and the mean mediolateral ground reaction force in the late stage (late dynamic MLGRF), were measured for both legs at 15-min intervals during the protocol. Peroneal reaction time was tested using an electromyography (EMG) system. The ground reaction force variables were measured from GRF data after a single-legged drop-jump landing. Repeated measures one-way MANOVA was conducted to evaluate variables over time and leg dominance. Statistical significance was set at p < 0.05 level. Peroneal reaction time significantly increased for both legs at 45 minutes and after 60 minutes. RMS ML 0.4 of both legs and late dynamic MLGRF for dominant leg remained unchanged throughout the protocol and late dynamic MLGRF for non-dominant leg significantly reduced at the 90th minute.

Distal MCL Grade III Injuries in Collegiate Football Players: Operative Management, Rehabilitation, and Return to Play.

Abstract

Recurrent Instability and Surgery Are Common After Nonoperative Treatment of Posterior Glenohumeral Instability in NCAA Division I FBS Football Players.

In-season return to play after anterior glenohumeral instability is associated with high rates of recurrent instability and the need for surgical stabilization. We are not aware of previous studies that have investigated in-season return to play after posterior glenohumeral instability; furthermore, as posterior shoulder instability in collision athletes occurs frequently, understanding the expected outcome of in-season athletes may improve the ability of physicians to provide athletes with a better understanding of the expected outcome of their injury and their ability to return to sport. (1) What proportion of athletes returned to play during the season after posterior instability in collegiate football players? (2) How much time did athletes lose to injury, what proportion of athletes opted to undergo surgery, and what proportion of athletes experienced recurrent instability after a posterior instability episode during a collegiate football season? A multicenter, prospective, observational study of National Collegiate Athletic Association (NCAA) Division 1 Football Bowl Subdivision athletes was performed at three US Military Service Academies. Ten athletes who sustained a posterior instability event during the regular football season and who pursued a course of nonoperative treatment were identified and prospectively observed through the subsequent season. All athletes in the observed cohort attempted an initial course of nonoperative treatment during the season. All athletes sustained subluxation events initially identified through history and physical examination at the time of injury. None of the athletes sustained a dislocation event requiring a manual reduction. Intraarticular pathology consisting of posterior labral pathology was further subsequently identified in all subjects via MRI arthrogram. Return to play was the primary outcome of interest. Time lost to injury, surgical intervention, and subsequent instability were secondary outcomes. Of the 10 athletes who opted for a trial of initial nonoperative management, seven athletes were able to return to play during the same season. Although these seven athletes returned within 1 week of their injury (median of 1 day), 5 of 7 athletes sustained recurrent subluxation events with a median (range) of four subluxation events per athlete (0 to 8) during the remainder of the season. Seven athletes were treated surgically after the completion of their season, four of whom returned to football. This study suggests that although collegiate football players are able to return to in-season sport after a posterior glenohumeral instability event, they will likely sustain multiple recurrent instability events and undergo surgery after the season is completed. The results of this study can help guide in-season management of posterior shoulder instability by allowing more appropriate postinjury counseling and decision making through the identification of those athletes who may require additional attention from medical staff during the season and possible modifications to training regimens to minimize long-term disability. Further prospective studies involving a larger cohort over several seasons should be performed through collaborative studies across the NCAA that better assess function and injury risk factors before beginning collegiate athletics. This would better characterize the natural history and associated functional limitations that athletes may encounter during their collegiate careers. Level IV, prognostic study.

Associations Of Concussion And Playing History With Clinical Outcomes In Young College Football Alumni

The effects of concussion history (CH) and years of playing football on cognitive function and mood-related symptoms in former football players is unclear. Most former player studies include mid-to-late life individuals, and little is known about younger cohorts. PURPOSE: Assess the influence of CH and years played on cognitive function, mood-related symptoms, and life satisfaction in former football players. METHODS: Former collegiate football players (n = 58; age 37.9 + 1.5 years; BMI 31.3 + 5.0 kg/m2) from 16 schools completed a health survey and subsequent in-person evaluation 15 yrs post-college football. Outcomes included cognitive tests: Symbol Digit Modalities Test (SDMT), Controlled Oral Word Association Test (COWAT), revised Hopkins Verbal Learning Test (HVLTr), and Trails A (TMTA) and B (TMTB); and self-reported outcomes: NeuroQOL Cognition Short Form (NQC), Beck Depression (BDI-II) and Anxiety (BAI-II) inventories, and Satisfaction with Life Scale (SWLS). Current symptom severity (SS) was reported on the Graded Symptom Checklist alongside typical hours slept per night. CH was split into tertiles: 0-1, 3-6, or 7+ prior concussions. Multivariable linear regression models were used to assess the influence of CH and years played on each outcome with BMI, sleep, and SS as covariates. RESULTS: Model predictors and adjusted R2 values are in Table 1. Higher SS was associated with worse outcomes on most measures. Worse SDMT scores were partially explained by greater CH and years played. In addition to SS, greater CH related to better COWAT performance; those with more sleep had longer TMTA times; and those with lower BMI and more sleep had higher SWLS. CONCLUSIONS: Our data show no clear influence of CH or years played on cognitive function, mood-related symptoms, or life satisfaction. In our relatively young sample, SS at the time of testing was associated with worse outcomes. Continued longitudinal analyses may explain age related changes on these outcomes.

Effects Of Vitamin C Enriched Hydrolyzed Collagen On Explosive Performance

The stiffness of a tendon is determined by the amount and cross-linking of collagen within the tissue. Acute exercise and possibly vitamin C-enriched collagen supplementation have been shown to increase collagen synthesis as well as the expression of the primary enzyme involved in collagen cross-linking (lysyl oxidase). The result may be a denser and stiffer tissue. Stiffness is directly related to force transfer. Whether this nutritional supplementation can further augment response to training, in particular rate of force development (RFD), and translate to improved explosive performance compared to training alone is unknown. PURPOSE: To determine if nutritional supplementation with vitamin C-enriched collagen improves RFD compared to placebo (PLA) with an explosive power-based training regime. METHODS: Healthy male collegiate football players (18-25 years) were enrolled in a 3-week double-blinded, parallel design study. Athletes were randomly assigned to the intervention group (COLL; 15g hydrolyzed collagen with 50mg vitamin C) or placebo group (PLA; 15g rice four). Supplements were ingested 60min prior to training 5 days per week and with breakfast on rest days. Athletes completed the same training program and progression. RFD was measured from the best of three maximal isometric squats, countermovement jumps and squat jumps (Kistler, Novi, MI) performed at the same time on each testing day (baseline and after 1,2 and 3 weeks of training). Two-way ANOVA (nutrition intervention and time) was used to compare RFD between groups. RESULTS: At time of analysis there were no significant difference for maximal RFD in the maximal isometric squat between the interventions. RFD data from CMJ and SJ are yet to be determined. CONCLUSION: Supplementation with vitamin C-enriched collagen prior to training throughout a 3-week explosive power-based training program does not improve maximal RFD compared to exercise alone. More comprehensive analysis of all RFD parameters is required to fully interpret results from this study and will be completed prior to abstract presentation.

Division 1 Football Players And Metabolic Syndrome Risk Factors: A Three Year Observational Study

Professional football players, especially linemen are at increased risk for early Metabolic Syndrome (MetS) leading to cardiovascular disease and death. There are no longitudinal studies examining MetS to determine if risk factors are present during college and if the risk factors change over time. PURPOSE: The purpose of this longitudinal study was to follow MetS risk factors in Division 1-FCS players over three years. MetS is defined by the NCEP ATP III standards. METHODS: Players were tested in the fall prior to the start of each season. Of the 39 players tested the first fall, eight players completed all tests every year of the study. Testing included waist circumference (WC), systolic blood pressure (SBP), diastolic blood pressure (DBP), fasting blood glucose (BG), high density lipoprotein (HDL), and triglycerides (TG). Descriptive statistics and comparisons were analyzed. A repeated measures ANOVA was used to compare the means of each dependent variable across the three years. A Bonferroni correction was used to adjust for multiple comparisons. RESULTS: One participant met the criteria for MetS during all three years with the same risk factors, low HDL, elevated TG and WC. Another participant met the MetS criteria during the second year (low HDL, elevated TG and WC), but not during the first and third years. Both players were offensive linemen. There were no significant differences in SBP, DBP, BG, or HDL across the three years. There was a significant difference in TG over time (F [1.122, 7.852] = 6.355, p = .034). Pairwise comparisons indicated a significant difference between year one-two, one-three, and two-three (p = .001, p = .001, p = .05; respectively). CONCLUSIONS: These findings suggest that nonskilled football positions have a higher incidence of MetS risk factors. Additionally, TG varied across the three years, indicating that nutrition may be a primary influencing factor as players maintain fitness training year-round. A primary limitation of this study was the small sample size based on players completing testing all three years. Pre-season evaluation for early detection of MetS with follow up for early intervention is recommended. Further research should explore the nutrition practices of collegiate football players.

A-23 Mental Health Outcomes of Elite Athletes Following Sport Related Concussion

Abstract Objective Investigation of anxiety and depression symptoms at baseline and following sport related concussion in a population of professional and collegiate football players. Method A quasi-experimental prospective longitudinal design was implemented. Participants included 198 Canadian Football League and University of Alberta varsity football players at baseline. Additionally, this study tracked 13 concussed athletes, 12 orthopaedic control athletes, and 15 healthy control athletes over approximately a 2 month period. Statistical analysis included an ANOVA and repeated measures ANOVA to identify differences in mental health at baseline as well as after injury at 3 time points (24-48 hours post injury, asymptomatic, and 1 month post return to play). Results At baseline, players who had a history of 1 or more concussions reported a greater number of anxiety and depression symptoms in comparison to players who did not have a history of concussion (F(2, 197) = 66.75, (p =.000)). At the group level, there were no differences in anxiety and depression symptoms between players who sustained a concussion, orthoepic injury, or no injury across the four time points measured (depression (F(3, 58) = 1.05, (p =.404); anxiety (F(3, 58) = 1.65, (p =.151)). However, individuals who sustained a concussion displayed significant changes in symptoms of anxiety (F(3, 12) = 9.004, (p =.000)) and depression (F(3, 12) = 11.396, (p =.000)) over time. Specifically, concussed players reported an increase in anxiety related symptoms between baseline report and 24-48 hours post injury (p = .042), a decrease between 24-48 hours and 1 month post return to play (p = .002) and a decrease between asymptomatic and 1 month post return to play (p = .036) time points. Additionally, players who sustained a concussion reported a significant increase in depressive symptoms between 24-48 hours post injury and 1 month post return to play (p = .029) and a decrease between asymptomatic and 1 month post return to play (p = .014) time points. This change over time was not found in the orthopaedic injury (depression (F(3, 11) = 2.467, (p =.14); anxiety (F(3, 11) = 2.242, (p =.15)) or healthy control groups (depression; (F(3, 14) = 2.177, (p =.17); anxiety; F(3, 14) = 1.435, (p =.30)). Conclusions Results from this study suggest that a history of concussion impacts baseline self-report of anxiety and depression symptoms. Furthermore, players who sustained a concussion experienced subtle increases in anxiety and depressive symptoms in the short term and not in the long term. Players with who sustained an orthopaedic injury and healthy players did not show these changes in anxiety and depression symptom report. It appears that in this small sample concussion produced unique outcomes related to mental health functioning in the short term.

Editors' note: Acute elevation of serum inflammatory markers predicts symptom recovery after concussion

In the article “Acute elevation of serum inflammatory markers predicts symptom recovery after concussion,” Drs. Nitta et al. studied serum inflammatory markers in 41 high school and collegiate football players with sports-related concussion (SRC) and 43 matched control athletes, and they collected symptom severity scores at a preinjury baseline and at several time points up to 45 days postconcussion. They found that interleukin-6 (IL-6) and IL-1RA were significantly elevated in SRC at 6 hours vs preinjury and other postinjury visits. These inflammatory markers discriminated concussed from control athletes at that time point, with IL-6 levels at 6 hours also being significantly associated with symptom duration. In response, Dr. Sethi asks whether the levels of serum inflammatory markers correlated with the severity of the concussion and whether the normalization of such markers correlated with symptom resolution. He notes that an ideal SRC marker would not only accurately identify a concussed athlete but also help guide return-to-play decisions. Responding to these comments, Drs. Meier and Nitta note that no concussed athletes reported loss of consciousness in their sample and only 2 reported posttraumatic amnesia; therefore, they could not relate the markers to such gradations of severity. They indicate that levels of IL-1RA and IL-6 returned to baseline levels by the 24–48 hours visit despite symptom severity scores remaining elevated and thus appeared to show prognostic promise only when collected within 6 hours postinjury. This discussion highlights enduring challenges in the search for clinically relevant biomarkers for SRC, and it is likely that a panel of markers will be needed to make various predictions following SRC. In the article “Acute elevation of serum inflammatory markers predicts symptom recovery after concussion,” Drs. Nitta et al. studied serum inflammatory markers in 41 high school and collegiate football players with sports-related concussion (SRC) and 43 matched control athletes, and they collected symptom severity scores at a preinjury baseline and at several time points up to 45 days postconcussion. They found that interleukin-6 (IL-6) and IL-1RA were significantly elevated in SRC at 6 hours vs preinjury and other postinjury visits. These inflammatory markers discriminated concussed from control athletes at that time point, with IL-6 levels at 6 hours also being significantly associated with symptom duration. In response, Dr. Sethi asks whether the levels of serum inflammatory markers correlated with the severity of the concussion and whether the normalization of such markers correlated with symptom resolution. He notes that an ideal SRC marker would not only accurately identify a concussed athlete but also help guide return-to-play decisions. Responding to these comments, Drs. Meier and Nitta note that no concussed athletes reported loss of consciousness in their sample and only 2 reported posttraumatic amnesia; therefore, they could not relate the markers to such gradations of severity. They indicate that levels of IL-1RA and IL-6 returned to baseline levels by the 24–48 hours visit despite symptom severity scores remaining elevated and thus appeared to show prognostic promise only when collected within 6 hours postinjury. This discussion highlights enduring challenges in the search for clinically relevant biomarkers for SRC, and it is likely that a panel of markers will be needed to make various predictions following SRC.

A risk as an infection route: Nasal colonization of methicillin-resistant Staphylococcus aureus USA300 clone among contact sport athletes in Japan

Panton-Valentine leukocidin (PVL)-positive USA300 clone is a highly pathogenic and global epidemic community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) clone. Athletes are particularly vulnerable to CA-MRSA infection because of the frequency of skin trauma, close-contact situations, and sharing of equipment that is customary in the athletic setting. We experienced a case of Japanese collegiate football player with septic pulmonary emboli secondary to infectious iliofemoral deep venous thrombosis caused by the USA300 clone. Here, we screened the nasal carriage of USA300 clone colonization among asymptomatic teammate of the patient to elucidate the infection route. Among 69 nasal samples, CA-MRSA strains were found in 5.8% (four samples). Molecular epidemiological analyses showed that three of the CA-MRSA strains were USA300 clone. Furthermore, pulsed-field gel electrophoresis revealed that all nasal USA300 clones showed 100% identity with the USA300 clone isolated from their teammate with critical infection. Our findings indicate that nasal colonization of the PVL-positive CA-MRSA, especially USA300 clone, pose a threat among contact sport athletes in Japan likewise other countries. An immediate infection control strategy for contact sport athletes is necessary to prevent outbreaks of PVL-positive CA-MRSA infections.

Accuracy of the Region of Limb Stability in Predicting Risk for Lower Limb Injury.

This study aimed to determine whether a measure of lower limb segment stability derived from body-worn inertial measurement units can predict risk for lower limb musculoskeletal injury in Division I Collegiate Football Players (D1CFP). The region of limb stability (ROLS) values were collected in a cohort of D1CFP during preseason. ROLS is a measure of knee joint stability, defined by thigh and shank excursion (cm) in the anterior-posterior and medial-lateral direction during single limb stance. The ROLS symmetry index (SI) (%) is the ratio between lower limb ROLS values where 100% suggests absolute symmetry. One-hundred and four D1CFP participated in this study and were divided into two groups: 1) no previous lower limb injury or no in-season injury (n = 70, "noninjured group") and 2) no previous lower limb injury, but in-season injury requiring surgery (n = 34, "injured group" group). The mean ± SD ROLS SI was 82.86% ± 14.75% and 65.58% ± 16.46% for the noninjured and injured group, respectively. Significant differences in ROLS SI were found between groups (P < 0.001). The ROLS SI demonstrated an area under the curve of 0.8 (P < 0.001; 95% confidence interval = 0.71-0.88) with an SE of 0.04, indicating that the ROLS SI has good predictive accuracy in detecting those healthy D1CFP at risk for lower limb injury resulting in surgery. The ROLS SI was found to have good predictive accuracy in detecting individuals at risk for injury that were healthy and asymptomatic during preseason testing. Increase in thigh and shank excursions and/or decrease in SI between lower limbs may be a predictor of risk for future injury.

Grip strength and North American collegiate football performance indicators

Football athletes are often tested in their ability to display high levels of strength and power to determine their sporting prowess. One indicator of total body strength in the general population is handgrip strength (HGS) which has also been used to stratify level of success in a variety of sports. It is of interest to determine what relationship HGS has with other indicators of football performance. This study examined the correlation between HGS as it relates to indicators of football sport performance: vertical jump (VJ), 18.3 meter sprint (13.8MS), and one-repetition maximum back squat (1-RM BSQ) among North American collegiate football players. Sixteen (n=16) male participants from a NCAA Division II football program (age: 21.3±1.7 years, height: 183.6±9.1 cm, mass: 99.6±17.7 kg) were assessed for HGS, VJ, 18.3MS, and 1-RM BSQ. Athletes performed a dynamic warm-up followed by two trials of each assessment: HGS, VJ, and 18.3MS. A recent 1-RM BSQ as recorded by the college’s strength and conditioning staff was used as the measure of BSQ strength. Pearson correlation coefficients (r) were determined for HGS and football performance tests as well as HGS to body mass ratio and football performance tests. Moderate correlations were found between HGS and VJ, as well as HGS and 18.3MS (r=-0.41, and r=0.49; respectively). HGS to body mass (HGS/BM) ratio also demonstrated moderate correlations with VJ (r=0.50) and 18.3MS times (r=-0.41). No significant correlation was found between HGS and 1-RM BSQ (r=0.09) or HGS/BM with 1-RM BSQ/BM (r=-0.13). Within the parameters of this study, HGS as it relates to an athlete’s body mass has a moderate relationship with performance in the VJ and the 13.8MS.

Using Variance to Explore the Diagnostic Utility of Baseline Concussion Testing.

The Graded Symptom Checklist (GSC), Standardized Assessment of Concussion (SAC), Balance Error Scoring System (BESS), and King-Devick Test (KDT) are considered important components of concussion assessment. Whether baseline testing improves the diagnostic utility of these tests remains unclear. We performed an observational cohort study to investigate the within-subject and between-subjects variability of these tests over repeated assessments during two football seasons to examine whether baseline testing reduces variability in test performance. Thirty-five male collegiate football players completed weekly clinical concussion assessments over two seasons. Within-subject (week-to-week) and between-subjects (player-to-player) variability for each test were compared using a bootstrap analysis. Within-subject and between-subjects proportions of overall variance for each test score were calculated. Mixed-model analyses were used to quantify practice effects resulting from repeated testing. For the GSC and BESS, within-subject and between-subjects variability did not significantly differ. For the KDT, the proportion of within-subject variance (20.2%) was significantly less than the between-subjects variance (79.8%). For SAC, however, the proportion of within-subject variance (66.8%) was significantly greater than the between-subjects variance (33.8%). A small, but significant, practice effect was observed for the BESS and KDT tests. When athletes are evaluated during a football season for concussion using the GSC, SAC, and BESS, comparing their scores to baseline performance is likely no more beneficial than comparing them to normative population data for identifying neurological changes associated with concussion. For the KDT, comparison to baseline testing is likely beneficial because of significantly higher between-subjects variability.

Prospective study of the effects of sport-related concussion on serum kynurenine pathway metabolites

Reports of neurodegenerative and psychiatric disease in former athletes have increased public concern about the acute and chronic effects of sport-related concussions (SRC). The biological factors underlying individual differences in the psychiatric sequalae of SRC and their role in potential long-term negative outcomes have not been determined. One understudied biological consequence of the known inflammatory response to concussion is the activation of a key immunoregulatory pathway, the kynurenine pathway (KP). Activation of the KP produces several neuroactive metabolites that have been associated with psychiatric and neurodegenerative diseases. We tested the hypothesis that SRC results in an elevation of serum KP metabolites with neurotoxic properties (quinolinic acid [QuinA], 3-hydroxykynurenine [3HK]) together with a reduction in the neuroprotective metabolite kynurenic acid (KynA), and that these metabolites would predict post-concussion psychological symptoms. Additionally, because brain injury is thought to prime the immune system, a secondary goal was to test the hypothesis that athletes with acute SRC and a history of prior SRC would have elevated neurotoxic relative to neuroprotective KP metabolites compared to athletes that were concussed for the first time. High school and collegiate football players (N = 1136) were enrolled at a preseason baseline visit that included clinical testing and blood specimen collection. Athletes that suffered a SRC (N = 59) completed follow-up visits within 6-hours (early-acute), at 24–48 h (late-acute) and at 8, 15, and 45 days post-injury. Uninjured contact sport (CC; N = 54) and non-contact sport athletes completed similar visits and served as controls (NCC; N = 30). SRC athletes had significantly elevated psychological symptoms, assessed using the Brief Symptom Inventory-18 (BSI), acutely following injury relative to both control groups. There was a group-by-visit interaction on the ratio of KynA to 3HK in serum, a neuroprotective index, with elevated KynA/3HK in athletes with SRC at the early-acute visit relative to later visits. Importantly, athletes with greater elevation in this neuroprotective index at the early-acute visit reported fewer depressive symptoms at the late-acute visit. Finally, SRC athletes with prior concussion had significantly lower serum KynA/QuinA at all visits compared to SRC athletes with no prior concussion, an effect driven by elevated QuinA in SRC athletes with prior concussion. These results suggest that early-acute activation of the KynA branch of the KP may protect against the development of depressive symptoms following concussion. Furthermore, they highlight the potential of serum QuinA as a biomarker for repetitive head injury and provide insight into possible mechanisms linking prior concussion with subsequent injury.

Y-Balance Test Performance Does Not Determine Non-Contact Lower Quadrant Injury in Collegiate American Football Players.

Collegiate American football has a high rate of injury. The Lower Quarter Y-Balance Test (YBT-LQ), a dynamic assessment of lower extremity strength, mobility, and balance, has been purported to identify athletes at risk for injury in different sports including football. Previous studies examining the association between YBT-LQ and injury have reported varied findings; therefore, the purpose of this study was to assess if preseason YBT-LQ performance predicted whether football players would sustain a non-contact lower extremity or low back (lower quarter (LQ)) injury during the season. Fifty-nine male collegiate American football players (age 20.8 ± 1.3 y, height 1.8 ± 0.1 m, body mass 94.6 ± 14.2 kg) completed a survey of training and injury history and had their YBT-LQ performance assessed at the start of the season. Athletic training staff tracked the occurrence of non-contact LQ injuries during the season. There were no significant relationships found between preseason YBT-LQ values and incidence of non-contact LQ injury in this population of collegiate American football players. This study is consistent with recent reports that have not found a significant association between preseason YBT-LQ values and LQ injury. These results suggest that, in isolation, the YBT-LQ may have limited utility as a screening test for non-contact injury in collegiate football players.

Estimated Age of First Exposure to Contact Sports and Neurocognitive, Psychological, and Physical Outcomes in Healthy NCAA Collegiate Athletes: A Cohort Study.

Collegiate football players who started playing tackle football before age 12years did not show worse neuropsychological test performance than those who started playing tackle football after age 12years. It is unknown if beginning other contact sports, such as lacrosse, at a younger age is associated with worse neurocognitive performance, greater psychological distress, or worse postural stability in collegiate student athletes. The purpose of this study was to examine the association between estimated age of first exposure (eAFE) to repetitive head impacts (RHI) and these outcome measures in collegiate student athletes. 1891 female and 4448 male collision/contact (i.e., football, ice hockey, lacrosse, wrestling, soccer) and non-contact (i.e., golf, rifle, rowing/crew, swimming, tennis) sport athletes completed baseline testing, including the Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), Brief Symptom Inventory 18 (BSI-18), and Balance Error Scoring System (BESS). For women, the eAFE-by-sport interaction was associated with ImPACT Verbal Memory and Visual Memory, whereby earlier eAFE to contact sports was associated with higher composite scores (B = - 0.397, B = - 0.485, respectively). For men, the eAFE-by-sport interaction was associated with BSI-18 Depression and Global Severity Index and symptom severity scores, whereby earlier eAFE to football was associated with lower psychological distress and symptom severity [Depression, Exp(B) = 1.057; Global Severity Index, Exp(B) = 1.047; Symptom Severity, Exp(B) = 1.046]. Parameter estimates were small suggesting these results may have minimal practical relevance. Findings suggest that RHI during early adolescence is unrelated to brain health as measured by these specific outcome measures in collegiate student athletes.

Comparison of Core Stability and Hip Muscular Strength in Selected Collegiate Football Players with and without Patellofemoral Pain Syndrome (PFPS)

Comparison of Core Stability and Hip Muscular Strength in Selected Collegiate Football Players with and without Patellofemoral Pain Syndrome (PFPS)

Examination of Sleep and Injury Among College Football Athletes.

Burke, TM, Lisman, PJ, Maguire, K, Skeiky, L, Choynowski, JJ, CapaldiII, VF, Wilder, JN, Brager, AJ, and Dobrosielski, DA. Examination of sleep and injury among college football athletes. J Strength Cond Res 34(3): 609-616, 2020-The purpose of this study was to characterize subjective sleep metrics in collegiate football players at the start of the season, determine the relationship between preseason subjective sleep measures and in-season objective sleep characteristics, and examine the association between subjective and objective sleep metrics and incidence of time-loss injury during the competitive season. Ninety-four Division I football players completed 5 validated sleep-related questionnaires to assess sleep quality, insomnia severity, daytime sleepiness, sleep apnea risk, and circadian preference before the start of the season. Clinical thresholds for sleep questionnaires were used to determine risk of sleep disorders. Continuous wrist actigraphy was collected throughout the season to generalize sleep behaviors. Time-loss injury incidence data were recorded and used for analysis. Results indicated that 67.4% (60 of 89) of athletes scored above clinical threshold in at least 1 questionnaire to indicate sleep disorder risk. At the start of the season, players subjectively reported an average sleep duration of 7:16 ± 1:18 hours:minutes, which was in contrast to the 6:04 ± 0:41 hours:minutes measured through actigraphy during the season. Logistic regression models adjusted for age and body mass index revealed no significant associations between injury and subjective (odds ratio [OR] = 1.00; 95% confidence interval [CI] = 0.99-1.01) and objective (OR = 1.01; 95% CI = 0.99-1.02) sleep duration or measures attained from sleep questionnaires (ORs ranged from 1.01 to 2.87). Sleep metrics (quantity and quality) were not associated with increased risk of injury in this cohort of collegiate football players.

Multiple flexor tendon pulley ruptures in a division 1 collegiate football player.

Injuries to the hand and digits are common in football players. To our knowledge, there have been no reports on multiple flexor pulley ruptures in football players treated non-operatively through splinting and taping techniques. A 22-year old collegiate defensive lineman sustained an injury resulting in complete disruption of the annular 2, 3, 4, and cruciate 1 and 2 pulleys. The patient was successfully treated with serial custom splints for 12 weeks. Our splinting and taping techniques and timing of these have not been previously described. This case illustrates a successful treatment option in football players with multiple flexor pulley ruptures.