Collegiate Student-athletes Research Articles

An exploratory study of factors influencing attitudes and behaviors toward LGBTQ athletes in China

This study examined the attitudes and behavior of collegiate student-athletes toward their LGBTQ counterparts in China. Utilizing a 15-item questionnaire derived from the tripartite model, findings from 191 participants were analyzed. Regression models showed that for negative behavior (use of homophobic language), the strongest predictors for males were team language norms (B = −0.67, t = −8.38, p < 0.001, R 2 = 0.45). For females, the strongest predictors were team language norms (B = −0.68, t = −6.8, p < 0.001), contact experiences (B = −0.41, t = −2.16, p < 0.05), and Affective Component of Attitude (ACA) (B = −0.26, t = −2.36, p < 0.05). For positive behavior (allyship), the significant predictor for males was ACA (B = 0.32, t = 3.56, p < 0.001). For females, the significant predictors were team language norms (B = 0.20, t = 2.22, p < 0.05) and ACA (B = 0.50, t = 5.56, p < 0.001). The findings highlight the importance of enhancing team norms and facilitating positive affective contact in sports settings to promote inclusive team behaviors.

Multifaceted concussion assessment battery: sensitivity at the expense of specificity?

ABSTRACT Objectives A multifaceted assessment battery is recommended for testing suspected concussed athletes; however, the individual tests have limitations and potentially may lead to false positive outcomes. Therefore, the purpose of this study was to psychometrically evaluate concussion assessment tools used for intercollegiate student-athletes, with a focus on the time interval between baseline and subsequent assessments. Methods 92 collegiate student-athletes matched between concussion (N = 46. F32/M14) and non-concussion (N = 46, 32F/14 M) completed the standard assessment of concussion, balance error scoring system, symptom questionnaire, and computerized neurocognitive tests at baseline and acutely (<48 hours) following a concussion. Test outcomes were compared between time points with three approaches, 1) vs baseline, 2) reliable change scores (RCI), and 3) vs American College of Rehabilitation Medicine (ACRM). Concussion assessment sensitivity, specificity, likelihood ratios, predictive values, and diagnostic odds ratio were calculated. A receiver operator characteristic compared area under the curve (AUC) for the overall battery as well as between academic years. Results The sensitivity of the battery was high (78.3 – 95.7%), but specificity was low to moderate (6.5 – 52.2%) with comparison to the RCI typically performing best. The three approaches yielded AUC values between 0.51 – 0.63 which is below the discriminatory threshold (0.70) with comparison to RCI performing best. By academic year, Juniors was the only year in which the ROC exceeded the threshold (0.75). The number of tests failed did not improve any AUC values (0.51 – 0.69) to exceed the threshold. Conclusions The outcomes of this study support the premise that concussion must be evaluated using a comprehensive clinical examination including a variety of assessments to evaluate each clinical domain. Clinicians need to recognize that the multifaceted assessment battery has high sensitivity, but the overall psychometrics do not exceed the threshold for group discrimination and caution must be used in their interpretation.

A Survey of US Collegiate Student-Athletes and Athletic Trainers on Sports-Related Concussion Knowledge and Reporting Habits.

To assess sports-related concussion (SRC) knowledge levels in US collegiate student-athletes (S-As) and athletic trainers (ATs) and identify factors that influence reporting of SRC by S-As. Cross-sectional, retrospective study. University training room/clinic visits. National Collegiate Athletics Association Division 1 S-As and ATs. A survey consisting of demographics, SRC knowledge, prior SRC history, and reporting habits. Sports-related concussion knowledge scores, SRC reporting habits. Response rates were 67% (350/520) for S-As and 100% (11/11) for ATs. S-As represented 21 sports (mean age 20.3 years, range 18-24, 54% male). Sports-related concussion knowledge scores were lower in male S-As (median 73%; interquartile range [IQR] 55%-85%) than in female S-As (79%; 55%-88%) (P < 0.05). Sports-related concussion knowledge scores differed between collision/contact (C/C) sport (79%; 67%-86%) and noncontact (NC) sport (73%; 55%-83%) S-As (P < 0.05). Twenty-nine percent (n = 102) of the S-As experienced a prior SRC, of which 67% (n = 68) reported their injury to a medical/authority figure. Male and C/C S-As were significantly less likely to report SRC than female, limited-contact, or NC sport S-As. Sports-related concussion knowledge scores were higher in ATs (97%; 89%-99%) than in S-As (76%; 55%-85%) (P < 0.001). S-As have variable levels of SRC knowledge, with female and C/C sport S-As scoring the highest. Most S-As with prior SRC reported these to a medical/authority figure, but male and C/C sport S-As were less likely to do so. As expected, ATs have higher SRC knowledge than S-As.

Sleep Disturbances and Risk of Sports Injury Among Collegiate Student-Athletes.

The purpose of this study was to examine the relationship between collegiate student-athletes' sleep and injury status. This study was a secondary analysis of observational survey data of student-athletes collected across 2 time periods, October 2020 and January 2021. Data were collected as part of an ongoing national (USA) longitudinal survey investigating student-athletes' well-being in the aftermath of the COVID-19 pandemic. Participants were made-up of a subsample of participants from the parent study. Data from 89 exact matched pairs (across 5 demographics) of injured and noninjured student-athletes (68.5% NCAA Division I, 82.0% women) were assessed. Student-athletes' sleep disturbance levels were the primary independent variable of interest. Analytic models also covaried for gender, racial, and ethnic identities, sport in-seasons, and previous injury status. Participant endorsed injury status was the main outcome measure of interest. Hypotheses were formulated during the data collection of the parent study. Student-athletes injured in January 2021 reported higher average sleep disturbances in both October 2020 and January 2021 than noninjured student-athletes but not student-athletes injured in October. In addition, October 2020 sleep disturbances were a significant predictor (P = 0.007) of injury, such that odds of student-athletes being injured increased 1.07 times for each unit increase in their sleep disturbances controlling for their identities, sport in-season, and previous injury status. Findings signal support for the screening and targeting of student-athletes' sleep problems to reduce potential occurrences of sports-related injuries in student-athletes.

Collegiate Student-Athletes' Use and Knowledge of Third-Party-Tested Nutritional Supplements: An Exploratory Study.

Nutritional supplement use in athletes is common, accompanied by potential doping risk. To determine athletes' nutritional supplement and third-party-tested (TPT) supplement use, supplement knowledge, and factors influencing their behavior. Cross-sectional study. National Collegiate Athletic Association Division I athletic departments. Student-athletes (n = 410, 53% female, age = 21.4 ± 1.6 years). Survey questions addressed topics including nutritional supplement knowledge and use, TPT supplement knowledge and use, and logo recognition, and data were stratified for sex differences. Athletes (91%) reported the use of supplements, but the total number of supplements used was lower in female (median = 7; interquartile range, 4-11) than in male (median = 9; interquartile range, 4-12) athletes, with U = 17 960 and P = .01. A total of 48% (n = 191, out of 402 responses) reported purchasing supplements outside of their athletic department, with significantly fewer female (40%, n = 84) than male (56%, n = 107) athletes reporting this behavior (χ2 = 11.20, P < .001). No association between TPT logo recognition and TPT use was seen (χ2 = 0.238, P = .63). Of all athletes using supplements, 38% (n = 140) reported "consistent TPT use," whereas female athletes (36%, n = 70) reported this less often than male athletes (41%, n = 70, χ2 = 0.952, P < .32). No sex differences were seen for receiving nutritional counseling (89%, P = .37) or low nutritional supplement knowledge (<50%, P = .38); however, males had 2.5 times greater odds at recognizing a TPT organization logo than females (odds ratio = 2.45; 95% CI, 1.58-3.79). Most athletes use nutritional supplements. Female athletes report slightly fewer supplements than male athletes, while also less frequently purchasing them outside their athletic department, potentially explaining the lower TPT logo recognition in female athletes.

Factor Structure and Measurement Invariance Across Sex of the Sport Concussion Assessment Tool Symptom Inventory.

Describe the factor structure of the 22-symptom Sport Concussion Assessment Tool (SCAT), using confirmatory factor analysis (CFA) for a priori hypothesized symptom domains. Prospective observational study. Collegiate student-athletes with concussion. Symptoms were collected via the SCAT symptom checklist. We created symptom domains based on previous literature, guided by clinical expertise. To determine which symptom grouping best represent the data, we used CFA and compared a single-domain model to 3- and 6-domains. We examined fit statistics to assess relative and absolute model fit. Motivated by differences in the prevalence of some individual symptoms by sex in our study, we also examined model invariance by sex to determine if symptoms were being measured as part of the same underlying construct(s). Among 1160 concussions (male, n = 667; female, n = 493) between 2015 and 2020, all 3 symptom structures seemed to fit the data well, with 3- and 6-domains fitting better than 1-domain. The 6-domain structure fit the data best with the following domains: headache, vestibulo-ocular, sensory, cognitive, sleep, and affective. All 3 structures showed configural and metric invariance by sex. We demonstrate that the SCAT symptom structure is best represented through 6 specific factors; however, the 3-factor model also demonstrated good fit. Key differences between the 3- and 6-domain models may make 1 model more appropriate than the other depending on the research question being addressed. Symptom structures were configurally and metrically invariant by sex, meaning that symptom measures represent symptom domain factors in the same way across sex.

Coaching Leadership Behaviours in Strength and Conditioning Coaching: Preferences of NCAA Division I and II Collegiate Student-Athletes Based on Level of Competition

Coaching Leadership Behaviours in Strength and Conditioning Coaching: Preferences of NCAA Division I and II Collegiate Student-Athletes Based on Level of Competition

The relationship between demographic factors, psychological distress, COVID worries, resilience, and athletic identity: A study of collegiate student-athletes

The COVID-19 pandemic provided athletes with an entirely new unforeseen circumstance, as many collegiate sport events and seasons were halted or canceled, forcing athletes into premature and non-normative retirement from sport. In the current study we analyzed the relationship between demographic factors, psychological distress, COVID worries, resilience, and athletic identity while controlling for student-athletes’ year of eligibility and NCAA division. Three-hundred and twenty-five student-athletes (232 females; 88 males; 5 non-binary) participated in the study by completing a demographic survey, the Athletic Identity Measurement Scale, the Brief Resilience Scale, the Depression Anxiety Stress Scale-21, and the COVID-specific worries questionnaire, which were administered electronically through a Qualtrics survey link. A stepwise hierarchical regression analysis revealed that (a) being either a senior (β = -0.15, p = .03) or a junior (β = -0.12, p = .01) was associated with lower levels of athletic identity; and (b) higher psychological distress scores were positively related to athletic identity (β = 0.14, p = .01). A path analysis revealed that resilience predicted psychological distress (β = -0.159, p = .01), which in turn predicted both COVID worries (β = 0.43, p < .01) and athletic identity (β = 0.12, p = .03).

Prior Concussion History and Clinical Recovery Following Sport-Related Concussion in College Athletes.

The aim of this study was to assess whether a history of prior concussions, and especially multiple prior concussions, is associated with clinical recovery following a subsequent sport-related concussion among collegiate student athletes. A naturalistic observational cohort study. Eleven National Collegiate Athletics Association Division III colleges. Collegiate athletes sustaining concussions from September 2014 through March 2020. Participants were divided into 3 groups, athletes with: (1) no prior concussion history, (2) one prior concussion, and (3) 2 or more prior concussions. Survival analyses were used to compare time to return to school and sports among athletes with a history of 0, 1, or ≥2 prior concussions. Among the 1132 college athletes, there were no statistically significant group differences between those with 0, 1, or ≥2 prior concussions in total time to return to school or sports. There was a statistically significant difference in the proportion of athletes with ≥2 prior concussions that had not fully returned to school, without accommodations, at 28 days (6.0%) compared to athletes with no prior concussions (2.2%; odds ratio = 2.80, 95% confidence interval 1.29-6.04). In summary, concussion history was not associated with time to return to sports following a subsequent sport-related concussion in these college athletes. On average, athletes with prior concussions did not take longer to return to school, although a slightly greater proportion of college athletes with ≥2 prior concussions had not fully returned to school, without accommodations, by 28 days following injury.

History Of Concussion Or ACL Injury Is Not Associated With Worse Health-Related Quality Of Life Scores In Collegiate Student-Athletes.

History Of Concussion Or ACL Injury Is Not Associated With Worse Health-Related Quality Of Life Scores In Collegiate Student-Athletes.

Comorbidity of concussion and depression alters brain functional connectivity in collegiate student-athletes

Depression and concussion are highly prevalent neuropsychological disorders that often occur simultaneously. However, due to the high degree of symptom overlap between the two events, including but not limited to headache, sleep disturbances, appetite changes, fatigue, and difficulty concentrating, they may be treated in isolation. Thus, clinical awareness of additive symptom load may be missed. This study measures neuropsychological and electroencephalography (EEG) alpha band coherence differences in collegiate student-athletes with history of comorbid depression and concussion, in comparison to those with a single morbidity and healthy controls (HC). 35 collegiate athletes completed neuropsychological screenings and EEG measures. Participants were grouped by concussion and depression history. Differences in alpha band coherence were calculated using two-way ANOVA with post hoc correction for multiple comparisons. Comorbid participants scored significantly worse on neuropsychological screening, BDI-FS, and PCSS than those with a single morbidity and HC. Two-way ANOVA by group revealed significant main effects of alpha band coherence for concussion, depression, and their interaction term. Post-hoc analysis showed that comorbid participants had more abnormal alpha band coherence than single morbidity, when compared to HC. Comorbidity of concussion and depression increased symptom reporting and revealed more altered alpha band coherence than single morbidity, compared to HC. The abnormalities of the comorbid group exclusively showed decreased alpha band coherence in comparison to healthy controls. The comorbidity of depression and SRC has a compounding effect on depression symptoms, post-concussion symptoms, and brain functional connectivity. This research demonstrates a promising objective measure in comorbid individuals, previously only measured via subjective symptom reporting.

Effects of Cohesion With Teammates on Division-I Student-Athletes’ Mental Health: An Application of the Human Need to Belong and Transactional Stress Frameworks

Collegiate student-athletes are experiencing an ongoing mental health epidemic, especially concerning anxiety and depression. This study builds upon the meta-theory of the human need to belong and the transactional theory of stress and coping by framing stress as a mediator for the benefits of cohesion between teammates on mental health. Data from 121 Division-I student-athletes demonstrated a fully mediated model whereby task cohesion indirectly benefited anxiety and depression through lower stress levels. Social cohesion, however, was not significantly associated with either stress or anxiety and depression. These findings underscore teammate relationships are appraised as social stimuli and that the lack of shared task approaches and understandings among teammates can be distressing and detract from general well-being. Coaches, athletic departments, and other academic stakeholders may use this information to guide their efforts to lower student-athlete stress through their social relationships with others. This aim can become an emphasis on pre-season training, team meetings, and athlete check-ins.

Off the Guardrails: Opportunities and Caveats for Name Image Likeness and the [Student] Athlete Influencer

The landscape of college athletics is undergoing a seismic shift with the advent of Name, Image, and Likeness (“NIL”) opportunities for student-athletes. In Off the Guardrails: Opportunities and Caveats for Name Image Likeness and the [Student] Athlete Influencer, Professor Maureen A. Weston examines the evolving terrain, tracing the journey from the National Collegiate Athletic Association’s (“NCAA’s”) rigid amateurism policies to the current era of NIL legislation and its implications. This Article navigates the complex intersection of athlete empowerment, entrepreneurial ventures, and regulatory challenges, shedding light on the multifaceted opportunities and risks for athletes in the burgeoning NIL market. Delving into the heart of the matter, Weston dissects the dynamics of NIL dealmaking, unveiling the potential windfalls and pitfalls awaiting collegiate student-athletes. From the allure of financial independence to the specter of predatory practices and regulatory ambiguities, the author uncovers the intricate tapestry of concerns surrounding the NIL framework. Drawing on insights from legal, regulatory, and ethical perspectives, Off the Guardrails offers a roadmap for those navigating this uncharted territory, exploring avenues for policy reform, regulatory harmonization, and athlete welfare safeguards in the quest for a balanced and equitable future for student-athlete influencers.

Migraine epidemiology in collegiate student-athletes: Findings from the Concussion Assessment, Research, and Education (CARE) Consortium.

This cross-sectional study evaluated de-identified data from the National Collegiate Athletic Association-Department of Defense Grand Alliance from 2014 to 2020 to determine the prevalence of migraine and migraine medication and to describe differences in migraine prevalence by sex, race, and sport. Epidemiological studies can help identify underdiagnosed and undertreated populations. Understanding migraine prevalence in collegiate student-athletes is essential for positive healthcare outcomes including development of prevention and treatment plans. From a concussion baseline assessment, participant's self-reported demographics (e.g., age, sex, sport), migraine diagnosis (i.e., yes/no), and migraine medication usage (e.g., yes/no, type) determined prevalence of migraine and medication use in collegiate student-athletes. Migraine was reported in 5.6% (2617/47,060; 95% confidence interval [CI] 5.4%-5.8%) of the student-athletes, with higher prevalence in females, 7.5% (1319/17,628; 95% CI 7.1%-7.9%), than males, 4.6% (1298/28,116; 95% CI 4.4%-4.9%). Medication usage was reported by 36.2% (947/2617; 95% CI 34.3%-38.0%) of individuals with migraine. Migraine reporting differed by race, with Caucasian reporting highest (5.9%; 1990/33,913; 95% CI 5.6%-6.1%) and Asian the lowest (2.7%; 55/2027; 95% CI 2.1%-3.5%). Women's sports, including golf, gymnastics, and lacrosse, and men's diving and squash had higher migraine reporting than other sports. Caucasian females reported higher rates than other groups and sport influenced rates of migraine diagnosis.

Suicide and suicidality among collegiate student-athletes: A scoping review

Objective: Participation in college athletics has traditionally been presumed to counter poor mental health outcomes including death by suicide. While previously reported incidents generally involve male football players, recent incidents suggest changing trends in frequency, sport, and sex. This research aims to summarize the breadth and limitations of existing research on death by suicide among U.S. collegiate student-athletes. Participants and Methods: This scoping review followed Joanna Briggs Institute guidance. A final sample of 19 research studies were identified through a comprehensive search including APA PsychINFO, PubMed, MEDLINE Complete, SPORTDiscus, and CINAHL databases and Gray Literature sources. Results: Most studied outcomes were suicidal ideation and attempt. Research on assessment of suicide prevention interventions for student-athletes is lacking. Conclusions: The paucity of research found on suicidal behaviors among collegiate student-athletes, including a lack of intervention research, in conjunction with recent trends suggest the need for a renewed focus on this topic.

Snooze it or Lose it: Understanding Sleep Disturbance and Injuries in Soccer and Basketball Student-Athletes.

To assess the sleep characteristics of collegiate soccer and basketball student-athletes and explore the associations between sleep and injury risk. Cohort study. NCAA D1 and NAIA Tier 1. One hundred eighty-one collegiate soccer and basketball student-athletes (42% female; mean age: 20.0 ± 1.7 years). Questionnaires were administered during the 2020/2021 and 2021/2022 preseason, collecting demographic, injury history, medical history, and sleep information, including sleep difficulty category scores of 0 to 4 (none), 5 to 7 (mild), and ≥8 (moderate/severe) and other sleep disturbance measures derived from the Athlete Sleep Screening Questionnaire (ASSQ), including insufficient sleep duration (<7 hours of sleep) and poor subjective sleep quality. All-complaint knee and ankle injuries. According to the ASSQ, 25.4% (95% confidence interval [CI], 17.9-34.3) of the student-athletes had mild sleep difficulty and 12.7% (95% CI, 7.3-20.1) had moderate/severe sleep difficulty. 36.1% (95% CI, 29.1-43.6) had insufficient sleep duration. 17.1% (95% CI, 11.7-23.7) were not satisfied with the quality of their sleep (poor sleep quality), and 13.8% (95% CI, 9.1-19.7) had an "eveningness" chronotype. Based on multivariable logistic regression models, student-athletes with poor sleep quality had significantly higher odds for injury (OR: 2.2, 95% CI, 1.04-4.79, P = 0.039). Clinically relevant dysfunctional sleep patterns are prevalent among collegiate soccer and basketball student-athletes. Poor sleep quality was significantly associated with injury risk among student-athletes. Findings suggest a substantial sleep problem in collegiate soccer and basketball student-athletes and warrant that student-athletes are regularly screened and timely interventions applied.

Association of Sport Helmet Status on Concussion Presentation and Recovery in Male Collegiate Student-Athletes.

Sporting helmets contain force attenuating materials which reduce traumatic head injury risk and may influence sport-related concussion (SRC) sequelae. The purpose of this study was to examine the association of sport helmet status with SRC-clinical presentation and recovery trajectories in men's collegiate athletes. Sport helmet status was based on the nature of sports being either helmeted/non-helmeted. 1070 SRCs in helmeted (HELM) sports (Men's-Football, Ice Hockey, and Lacrosse), and 399 SRCs in non-helmeted (NOHELM) sports (Men's-Basketball, Cheerleading, Cross Country/Track & Field, Diving, Gymnastics, Soccer, Swimming, Tennis, and Volleyball) were analyzed. Multivariable negative binomial regression models analyzed associations between sport helmet status and post-injury cognition, balance, and symptom severity, adjusting for covariate effects (SRC history, loss of consciousness, anterograde/retrograde amnesia, event type). Kaplan-Meier curves evaluated median days to: initiation of return to play (iRTP) protocol, and unrestricted RTP (URTP) by sport helmet status. Log-rank tests were used to evaluate differential iRTP/URTP between groups. Two independent multivariable Weibull accelerated failure time models were used to examine differential iRTP and URTP between groups, after adjusting for aforementioned covariates and symptom severity score. Overall, the median days to iRTP and URTP was 6.3 and 12.0, respectively, and was comparable across NOHELM- and HELM-SRCs. Post-injury symptom severity was lower (Score Ratio 0.90, 95%CI 0.82, 0.98), and cognitive test performance was higher (Score Ratio 1.03, 95%CI 1.02, 1.05) in NOHELM-compared to HELM-SRCs. Estimated time spent recovering to iRTP/URTP was comparable between sport helmet status groups. Findings suggest that the grouping of sports into helmeted and non-helmeted show slight differences in clinical presentation but not recovery.

Supporting Collegiate Students in the United States Through Athletic and Career Transitions

The purpose of this paper is to explore the athletic and career transitions that student-athletes navigate and to present examples of providing ongoing psychological support for student-athletes through these transitions. Guided by frameworks for understanding athlete change-events, a series of evidence-based propositions are presented to conceptualize how to understand and support collegiate student-athletes through transitions. A specific educational program is explained to provide an example of supporting student-athletes’ goal setting, identity, and life skills transfer during the transition out of college sports and college life. Future opportunities for supporting student-athlete transitions are then identified, along with reflections and lessons learned on how to provide ongoing psychological support to collegiate student-athletes.

Action Research on Collegiate Student-athlete and Student Peer Mentoring Program

PURPOSE The purpose of this study is to explore the effects of the student-athlete and student peer mentoring program as a collegiate class.METHODS The peer mentoring program, conducted at A University in the first semester of the 2023 school year, was evaluated using practical action research (Zuber-Skeritt, 1996).RESULTS In the introduction stage, ‘relative and absolute evaluation’, ‘member ratio’, and ‘definition of professor role’ were categorized as challenge issues. In the progress stage, ‘de-formalized lecture method’, ‘student athlete’s coaching experience’, and ‘student’s experience of football culture’ were discovered as possibilities, while ‘vacancy and absence of mentor-mentee’, ‘limited group activities and limitations of team sports’, and ‘lack of objective evaluation’ required improvement. At the end stage, student-athletes experienced changes in values such as self-identity, football, and human relationships, as well as quantitative and qualitative changes in sports participation.CONCLUSIONS This study confirmed the potential of the peer mentoring program as a collegiate class as well as its practical significance for guaranteeing student-athletes' learning rights and for forming sports culture on collegiate campuses.

Playing surface and sport contact status modulate time to lower extremity musculoskeletal injury at a greater level than concussion history among collegiate student-athletes

ObjectivesWhile previous investigations have demonstrated a positive correlation between previous concussion and risk of subsequent lower extremity musculoskeletal injury (LEMSKI), the effect of sport- and patient-specific factors on time to injury has not been thoroughly described. This study's main objective was to evaluate the relationship between prior concussion and time to LEMSKI among a population of collegiate student-athletes. Secondary objectives were to evaluate the relationship between playing surface, sport contact status, and biologic sex on time to LEMSKI. We hypothesized that those with previous concussions, those competing on synthetic surfaces, and those competing in collision sports would experience decreased latency to LEMSKI overall. MethodsA retrospective observational analysis of National Collegiate Athletic Association (NCAA) Division I student-athletes was conducted utilizing a mixed linear model analysis with contrasts. Inclusion criteria included participation in the Pac-12 Health Analytics Program with a documented LEMSKI between 2017 and 2020. Exclusion criteria included concurrent concussion and LEMSKI, injury resulting in serious morbidity or mortality, and incomplete medical record. Participants were classified by whether they sustained a concussion prior to LEMSKI in each athletic season. ResultsOf 1179 athletes included, 1140 had no previous concussion and 37 had a previous concussion. There was no observed effect of previous concussion (F ​= ​0.038; p ​= ​0.846) on time to LEMSKI overall. Student-athletes competing on constructed surfaces sustained a subsequent LEMSKI 14.5 days sooner (SE ​= ​5.255; p ​= ​0.045), and those competing on organic surfaces sustained a subsequent LEMSKI 23.5 days sooner (SE ​= ​4.018; p ​< ​0.001) in the season than those competing on synthetic surfaces. Contact sport student-athletes sustained a subsequent LEMSKI 52.1 days sooner than collision sport student-athletes (SE ​= ​5.248; p ​< ​0.001), and limited contact sport student-athletes sustained a subsequent LEMSKI 42.29 days sooner than collision sport student-athletes (SE ​= ​4.463; p ​< ​0.001). There was no observed effect of biologic sex (F ​= ​0.602; p ​= ​0.438) on time to LEMSKI overall. ConclusionThere was no observed impact of concussion on time on LEMSKI overall in this collegiate athletic population. Contact sports were associated with decreased time to LEMSK, while synthetic surfaces were associated with increased time to LEMSKI in this population. There was no observed impact of biologic sex on time to LEMSKI. Level of evidenceCase-control, level of evidence III.