Isometric Neck Strength Research Articles

Reliability of a Flight Helmet-Attached Force Gauge in Measuring Isometric Neck Muscle Strength

INTRODUCTION: Strong neck muscles may decrease the risk of flight-induced neck pain and possible disability among fast jet pilots. The purpose of this study was to examine the intra- and interrater reliability of a commercial force gauge attached to a pilot’s helmet for measuring isometric force production of the neck muscles. METHODS: A total of 41 subjects performed maximal isometric cervical flexion, extension, and lateral flexion in two measurement sessions for intrarater reliability, and 31 of these subjects participated in a third session for measuring interrater reliability. Delayed muscle soreness and neck pain were assessed using the Visual Analog Scale before and after each measurement session. The intraclass correlation coefficient (ICC) was used to compare values between the test and retest assessments. RESULTS: The overall interrater reliability was good (ICC 0.79–0.90), whereas the intrarater reliability varied from moderate to good (ICC 0.58–0.84). In both intra- and interrater reliability, the flexion test had good (ICC 0.84–0.89) reliability, while the lateral flexion test results had moderate to good (ICC 0.73–0.90) reliability. The extension test had the lowest reliability in both intra- (ICC 0.58) and interrater (ICC 0.79) tests. The average visual analog scale score (from 1–100 scale) prior to the second measurement session was 16 ± 18 in delayed muscle soreness and 0 ± 0 in neck pain. DISCUSSION: The present study demonstrated that the helmet-attached force gauge is a reliable, safe, and clinically applicable method to evaluate isometric neck strength in the flexion and lateral flexion directions. Honkanen T, Mattila V, Kinnunen O, Janhunen M, Sovelius R, Vaara JP, Kyröläinen H. Reliability of a flight helmet-attached force gauge in measuring isometric neck muscle strength. Aerosp Med Hum Perform. 2024; 95(10):788–793.

Between-Session Reliability of Field-Based Assessments of Isometric Neck Strength.

The reliability of the fixed-frame dynamometer for measuring isometric neck strength is established, but with limited field-based applications. This study aimed to establish the inter- and intra-session reliability of the peak force for neck flexors, extensors, and side flexors using the VALD ForceFrame and DynaMo and the force-time characteristics in the quadruped position (ForceFrame). Twenty-seven recreationally active males performed three repetitions of isometric neck flexion, extension, and side flexion over two sessions in random order using the VALD ForceFrame and DynaMo. Both devices demonstrated acceptable reliability, with the Forceframe ICC > 0.8 and CV% < 13.8% and the DynaMo ICC > 0.76 and CV% < 13.8%. No systematic or proportional differences were found using the Passing-Bablock procedure, and Bland-Altman analysis confirmed agreement across measures. Reliability was shown for right-side (ICC > 0.76) and left-side (ICC > 0.79) flexion and flexion (ICC > 0.75) across 50, 100, 150, and 200 ms. Statistical parametric mapping indicated no differences in ForceFrame-generated isometric force-time curves between sessions, though the CV was highest in the force development phase. The findings suggest that both tools can reliably assess neck strength, supporting their use in sports and clinical settings. However, assessment methods are not interchangeable, emphasising the need for standardised neck strength assessment approaches.

Evaluating a 14-week neck strengthening protocol for neuromuscular indicators associated with head and neck trauma

Increased neck strength has been linked to a potential decrease in traumatic brain injuries (TBI). The purpose was to determine the efficacy of a neck-strengthening protocol using a novel neck-strengthening device to increase isometric neck strength and rate of force development (RFD). Utilizing self-generated centripetal force, participants trained for 14 weeks. A linear mixed model was used to analyze the relationship between post-assessment measurements and pre-assessments measurements, while accounting for repeated measure random effect at the individual level, and a regular random error term. RFD values were 4.344 times higher in the clockwise direction and 5.978 times higher in the counterclockwise direction when comparing pre and post assessment measurements. Isometric neck strength increased significantly (p ​< ​0.05) in the cervical extension (p ​= ​0.010) and left lateral flexion (p ​= ​0.009) directions. The results can be used in strength training and clinical settings to potentially reduce the incidence of TBI.

Risk Reduction of Concussion in Athletes: Do Neck Size or Neck Strength Make a Difference?

Medical provider's ability to detect, diagnose, and treat sport-related concussion has greatly improved in recent years. Although more is known about the biomechanical forces involved in concussion, it is still uncertain whether there are preventative measures athletes can take to prevent a sport-related concussion from occurring. The objective of this review was to determine if either neck size or neck strength is related to a decreased risk of sustaining a sport-related concussion. A literature review was conducted on Google Scholar and Ovid MEDLINE for pertinent articles. Findings indicate that isometric neck strength, but not neck size, has been shown to be a predictor for sport-related concussion prevention. Formal neck strengthening programs are feasible and lead to decreased sport-related concussion risk. Additionally, there may be greater opportunity to increase neck strength in amateur athletes compared to professional. In conclusion, cervical strengthening programs have been shown to be feasible and beneficial for athletes to decrease their risk of sustaining a sport-related concussion, though the optimal duration, intensity, and frequency has yet to be determined.

The effect of ball pressure and maximal isometric neck strength on head acceleration during purposeful heading in adult football players during heading drills

ObjectiveThis randomised repeated measures study explored the effect of ball pressure and maximal isometric neck strength on head acceleration during purposeful heading in adult football players during heading drills within a laboratory environment. MethodsRecreational football players (n ​= ​17) attended one familiarisation session to determine baseline maximal isometric neck strength, followed by two experimental sessions where they randomly trialled two conditions (>72-h apart). The first condition included 20 rotational headers with a match-ball at low-pressure (58.6 ​kPa; 8.5 psi) and the second included 20 rotational headers with a match-ball at high-pressure (103.4 ​kPa; 15.0 psi) whilst instrumented with an inertial measurement unit. ResultsA statistically significant difference between conditions for both peak linear head acceleration (F ​= ​15.2; p= ​ < ​ 0.001) and peak angular head velocity (F ​= ​5.71; p ​= ​0.018) during purposeful heading. The low-pressure ball condition demonstrated a 12 ​% reduction in peak linear acceleration and 6 ​% reduction in peak angular velocity when compared with high-pressure ball condition. Additionally, neck strength significantly predicted head acceleration during purposeful heading (p ​ = ​ <0.05). ConclusionThese findings suggest that lower ball pressure and higher neck strength can lower head acceleration during heading in adult football players during heading drills within a laboratory environment.

Evaluating Neck-Strengthening Protocols to Reduce the Incidence of Traumatic Brain Injury: Traditional vs. Nontraditional Neck-Strengthening Techniques.

Schroeder, LH, McDaniel, AT, Wang, Y, Dickens, GM, Pantani, V, and Kubinak, H. Evaluating neck-strengthening protocols to reduce the incidence of traumatic brain injury: traditional vs. nontraditional neck-strengthening techniques. J Strength Cond Res 38(7): 1266-1274, 2024-A common cause of traumatic brain injuries (TBIs) is the head's kinematic response to rapid movement, which can be reduced with dynamic neck strengthening. This study aimed to determine the most effective neck-strengthening program by comparing a traditional and nontraditional program. Isometric neck strength was assessed in 32 subjects randomly assigned to one of the traditional and nontraditional neck-strengthening programs. The nontraditional program used a novel neck-strengthening device. After weeks 6 and 10 of training, isometric neck strength was reassessed. With the collected data, linear mixed models were established to compare the changes in neck strength between the 2 groups during the 10-week training period. Statistical analysis results suggest that, for both cervical extension (CE) and cervical flexion (CF), subjects in the novel neck-strengthening device group had a significantly higher gain of strength during the 10 weeks than the traditional group. With test statistics of -2.691 and -3.203 and corresponding 2-sided p -value of 0.01289 and 0.003889, respectively, we conclude that there is a statistically significant difference in the linear slopes of increase for both CE and CF between the 2 groups. As to left cervical lateral flexion and right cervical lateral flexion, the novel neck strength group had increased strength gains compared with the traditional group. However, the increase was not enough to demonstrate significant findings. Results were considered significant at p < 0.05. The results of this study show that the novel neck-strengthening device may be an effective mechanism for preventing mild TBIs.

To make or to break in isometric neck strength testing?

To make or to break in isometric neck strength testing?

Intra and Inter-Rater Reliability of a Novel Isometric Test of Neck Strength.

There is no single, universally accepted method of measuring isometric neck strength to inform exercise prescription and injury risk prediction. This study aimed to establish the inter- and intra-rater reliability of a commercially available fixed frame dynamometer in measuring peak isometric neck strength. A convenience sample of male (n = 16) and female (n = 20) university students performed maximal isometric contractions for flexion (Flex), extension (Ext), left- (LSF) and right-side flexion (RSF) in a quadruped position over three sessions. The intra-rater reliability results were good-to-excellent for both males (ICC = 0.83-0.90) and females (ICC = 0.86-0.94) and acceptable (CV &lt; 15%) across all directions for both males and females. The inter-rater reliability results were excellent (ICC = 0.96-0.97) and acceptable (CV &lt; 11.1%) across all directions. Findings demonstrated a significant effect for sex (p ≤ 0.05): males were stronger in all four directions, and a significant effect for direction (p ≤ 0.05): Ext tested stronger (193 N) than Flex (176 N), LSF (130 N) and RSF (125 N). The findings show that the VALD fixed frame dynamometer can reliably assess isometric neck strength and can provides reference values for healthy males and females.

The implementation of a neck strengthening exercise program in elite rugby union: A team case study over one season

ObjectivesTo investigate the effect of a neck strengthening program on maximal isometric neck strength and incidence of head and neck injuries including concussion, and to evaluate the acceptability and feasibility of the program within one professional men's rugby union team over one season. DesignPre- and post-intervention study. MethodsA phased neck strengthening program was implemented in one rugby union team (n = 26 Forward Group; n = 13 Back Group) throughout the 2020 Super Rugby season, with maximal isometric neck strength measured at each training phase. Strength changes were analysed using one-way, repeated measures analysis of variance and paired samples t-test. Injury data from 2019 to 2020 were compared using incidence rate ratios (IRR). Player and staff surveys, reported as percentage of agreement, assessed program acceptability and feasibility. ResultsForward Group's neck flexors (p < 0.001), left-lateral flexors (p = 0.04) and flexor/extensor ratio (p < 0.001) and Back Group's neck flexors (p = 0.01) significantly improved across the season, with uncertain evidence to support the reduction of head and neck injuries (IRR:0.86 (0.23–2.56) and concussion (IRR:0.63 (0.06–3.34) between seasons. Survey responses revealed high percentages of agreement for the program's acceptability and feasibility. ConclusionsTargeted sport-specific neck exercises have the potential to increase the maximal isometric neck strength of professional rugby players and may assist in reducing head and neck injuries including concussion.

Reliability of Repeated Isometric Neck Strength in Rugby Union Players Using a Load Cell Device.

Concussion is the most common injury in professional Rugby Union (RU) players, with increasing incidence and severity each year. Strengthening the neck is an intervention used to decrease concussion incidence and severity, which can only be proven effective if strength neck measures are reliable. We conducted a repeated-measures reliability study with 23 male RU players. Neck strength was assessed seated in a ‘make’ test fashion in flexion, extension, and bilateral-side flexion. Flexion-to-extension and left-to-right side ratios were also computed. Three testing sessions were undertaken over three consecutive weeks. Intrasession and intersession reliabilities were assessed using typical errors, coefficient of variations (CV), and intraclass correlation coefficients (ICC). Intrasession reliability demonstrated good-to-excellent relative (ICC > 0.75) and good absolute (CV ≤ 20%) reliability in all directions (ICC = 0.86–0.95, CV = 6.4–8.8%), whereas intersession reliability showed fair relative (ICC: 0.40 to 0.75) and acceptable absolute (CV ≤ 20%) reliability for mean and maximal values (ICC = 0.51–0.69, CV = 14.5–19.8%). Intrasession reliability for flexion-to-extension ratio was good (relative, ICC = 0.86) and acceptable (absolute, CV = 11.5%) and was fair (relative, ICC = 0.75) and acceptable (absolute, CV = 11.5%) for left-to-right ratio. Intersession ratios from mean and maximal values were fair (relative, ICC = 0.52–0.55) but not always acceptable (absolute, CV = 16.8–24%). Assessing isometric neck strength with a head harness and a cable with a load cell device seated in semi-professional RU players is feasible and demonstrates good-to-excellent intrasession and fair intersession reliability. We provide data from RU players to inform practice and assist standardisation of testing methods.

Neck strength and concussion prevalence in football and rugby athletes

ObjectivesTo determine the maximal isometric neck strength of male and female rugby and football (soccer) athletes, and to investigate the relationship between neck strength and sport played, sex, age, anthropometric measurements and concussion history. DesignCross-sectional observational study. MethodsIn total, 358 (70% male) healthy football and rugby playing adolescents and adults participated. Isometric neck strength and anthropometry measurements were collected, as well as completion of a sociodemographic survey. The mean (standard deviation) of all measurements for each age group was calculated and compared between sports and sexes, with correlation analyses performed to determine associations between all variables. ResultsIn general, rugby athletes had stronger neck musculature compared to football athletes, and males had stronger neck musculature compared to age-matched females, with these strength differences becoming increasingly significant with age (p < 0.05). The athletes with stronger neck muscles were older, taller, heavier, had higher bilateral grip strength and larger neck girth compared to those with weaker neck muscles (p < 0.05). Male rugby athletes who self-reported higher rates of a previous concussion had lower neck flexor/extensor strength ratio (p < 0.01). In 11–12-year-old male footballers, increased heading was associated with increased self-reported previous concussion (p < 0.01). ConclusionsThese normative neck strength data can form important reference values for rugby and football athletes from adolescence into adulthood. Male rugby athletes with a previous history of concussion demonstrated strength imbalances of their neck musculature (lower flexor/extensor ratio), with this finding having potentially important implications for training protocols and injury prevention initiatives.

Sex differences in neck strength and head impact kinematics in university rugby union players

ABSTRACT Globally, over three million women participate in rugby union, yet injury prevention and training strategies are predominantly based on androcentric data. These strategies may have limited generalisability to females, given the cervical spine is more susceptible to whiplash and less adept at resisting inertial loading. A total of 53 university rugby union players (25 female, 28 male, 20.7 ± 1.8 years) had their isometric neck strength measured. Bespoke instrumented mouthguards were used to record the magnitude of head impact events in six female and seven male competitive matches. Mean female maximal isometric neck strength was 47% lower than male. Independent samples Mann–Whitney U tests showed no significant differences for peak linear head acceleration (female: median 11.7 g, IQR 7.9 g; male: median 12.5 g, IQR 7.0 g p=.23) or peak rotational head acceleration (female: median 800.2 rad·s−2, IQR 677.7 rad·s−2; male: median 849.4 rad·s−2, IQR 479.8 rad·s−2; p=.76), despite the mean male body mass being 24% greater than female. Coded video analysis revealed substantial differences in head-impact mechanisms; uncontrolled whiplash dominated >50% of all recorded female impact events and <0.5% in males. Direct head-to-ground impacts comprised 26.1% of female and 9.7% of male impacts, with whiplash occurring in 78.0% and 0.5%, respectively. Overall, the data provided in this study do not support the generalisation of male-derived training and injury-prevention data to female rugby athletes. These results suggest a considerable research effort is required to identify specific weakness of female rugby players and derive appropriate training, injury prevention and return to play protocols. Highlights Video analysis revealed substantial differences in head-impact mechanisms, with uncontrolled whiplash dominating >50% of all recorded female impact events but rarely in males. Isometric neck strength was 47% lower in female players than males. Direct head-to-ground impacts accounted for 26.1% and 9.7% of female and male impacts, with whiplash occurring in 78.0% and 0.5%, respectively.

An isometric neck strengthening program does not improve neck strength in elite women's football-code athletes: A randomised controlled trial

ObjectivesThe purpose of this study was to investigate the effectiveness of an isometric neck strengthening program to improve isometric neck strength in elite women's football-code athletes. DesignRandomised controlled trial. MethodsElite female soccer (n = 10) and Australian football (n = 30) players were randomised into either a control (n = 20) or experimental (n = 20) group for a 12-week intervention study during their respective seasons. While both groups undertook their prescribed strength and conditioning programs, the experimental group also performed isometric neck strengthening exercises three times per week prior to training. Isometric neck strength of the extensors, flexors, lateral flexors, and rotators were assessed pre, mid (Week 7), and post (Week 13) intervention with a hand-held dynamometer during early to mid-competition season. A mixed design analysis of variance was performed for statistical analysis. ResultsNo significant group-by-time interactions in isometric neck strength were observed. All strength variables displayed a significant change over time throughout the 12-week period (p < 0.05). No significant between group differences in isometric neck strength variables were observed except for lateral left flexion (F(1, 38) =5.064, p = 0.030, η2p = 0.117). ConclusionsThe addition of isometric neck strengthening exercises did not improve neck strength beyond a standard strength and conditioning program for elite women's football-code athletes. While this specific program may not improve neck strength in elite women's football-code athletes, further investigation is needed to determine whether sport-specific neck strength exercises may improve neck strength or if lower-level competition athletes may still benefit from an isometric neck strengthening program.

The Effect of the FIFA 11 + with Added Neck Exercises on Maximal Isometric Neck Strength and Peak Head Impact Magnitude During Heading: A Pilot Study.

BackgroundHigher neck strength has been postulated to reduce head impact magnitude during purposeful heading in football.ObjectivesThis pilot trial explored the effect of a neck exercise programme on (1) neck strength and (2) head impact magnitude during heading in male and female adolescent football players.MethodsBoys and girls (aged 12–17 years) were randomised by team to the intervention (5 weeks of supervised neuromuscular neck exercises integrated into part 2 of the FIFA 11 + , completed three times per week) or the control group (usual part 2 of the FIFA 11 + , no neck exercises). Outcomes included isometric neck strength and head impact magnitude (peak linear acceleration and peak angular velocity) during standardised heading from a throw-in (at baseline and 6 weeks) plus completion of an evaluation survey by intervention players and coaches.ResultsIn total, 52 players (n = 31 intervention; n = 21 control) completed the study. Mixed-model analysis of variance (ANOVA) revealed significant differences in neck strength variables (p < 0.001), peak linear acceleration (p = 0.04) and peak angular velocity (p = 0.04) between the intervention and control groups over time. Intervention players demonstrated increases in mean composite neck strength (53.8% intervention vs 15.6% control) as well as decreases in mean peak linear head acceleration during heading (− 11.8% vs − 5.0%) from baseline to follow-up. Reduction in peak angular velocity was more pronounced in girls (− 27.7%) than boys (− 11.5%) in the intervention group. The addition of neck exercises into part 2 of the FIFA 11 + was feasible and accepted by players and coaches.ConclusionOn average, players who completed neck exercises demonstrated an increase in isometric neck strength and a decrease in head impact magnitude during heading. These exercises were easily incorporated into usual training.Australian New Zealand Clinical Trials Registry (no: ACTRN12619001375145).Supplementary InformationThe online version contains supplementary material available at 10.1007/s40279-021-01564-0.

Eight Weeks of Self-Resisted Neck Strength Training Improves Neck Strength in Age-Grade Rugby Union Players: A Pilot Randomized Controlled Trial.

Greater neck strength is associated with fewer head and neck injuries. Neck-strengthening programs are commonly burdensome, requiring specialist equipment or significant time commitment, which are barriers to implementation. Completing a neck-strengthening program will increase isometric neck strength in age-group rugby players. A pilot randomized controlled exercise intervention study. Level 2. Twenty-eight U18 (under 18) male regional age-group rugby union players were randomized (intervention n =15/control n = 13). An 8-week exercise program was supervised during preseason at the regional training center. Control players continued their "normal practice," which did not include neck-specific strengthening exercises. The 3-times weekly trainer-led intervention program involved a series of 15-second self-resisted contractions, where players pushed maximally against their own head, in forward, backward, left, and right directions. Peak isometric neck strength (force N) into neck flexion, extension, and left and right side flexion was measured using a handheld dynamometer. Postintervention between-group mean differences (MDs) in isometric neck strength change were adjusted for baseline strength and favored the intervention for total neck strength (effect size [ES] = 1.2, MD ± 95% CI = 155.9 ± 101.9 N, P = 0.004) and for neck strength into extension (ES = 1.0, MD ± 95% CI = 59.9 ± 45.4 N, P = 0.01), left side flexion (ES = 0.7, MD ± 95% CI = 27.5 ± 26.9 N, P = 0.05), and right side flexion (ES = 1.3, MD ± 95% CI = 50.5 ± 34.4 N, P = 0.006). This resource-efficient neck-strengthening program has few barriers to implementation and provides a clear benefit in U18 players' neck strength. While the present study focused on adolescent rugby players, the program may be appropriate across all sports where head and neck injuries are of concern and resources are limited. Greater neck strength is associated with fewer head and neck injuries, including concussion. Performing this neck exercise program independently, or as part of a whole-body program like Activate, an interactive guide for players and coaches, could contribute to lower sports-related head and neck injuries.

The relation between neck strength and psychological distress: preliminary evidence from collegiate soccer athletes.

Aim:To examine whether neck strength and symmetry are associated with psychological function in athletes with exposure to repetitive head impacts.Methods:Collegiate soccer (n = 29) and limited/noncontact (n = 63) athletes without a history of concussion completed the Brief Symptom Inventory 18 and assessments of isometric neck strength. Neck strength symmetry was calculated as the difference in strength between opposing muscle groups.Results:The results demonstrated that lower neck strength was associated with more symptoms of anxiety, whereas asymmetry in neck strength was associated with more symptoms of somatization and depression in soccer athletes only.Conclusion:These preliminary results suggest that greater neck strength/symmetry is related to better psychological function in athletes who have higher exposure to repetitive head impacts.

The concurrent validity and intrarater reliability of a hand-held dynamometer for the assessment of neck strength in semi-professional rugby union players

ObjectivesThe main objective of this study was to determine the concurrent validity between a hand-held (HHD) and mounted hand-held dynamometer (MHHD) for assessing isometric neck strength. DesignObservational design. SettingSemiprofessional rugby club. ParticipantsNineteen semi-professional rugby players (age = 26 ± 5 years, stature = 186.5 ± 6.5 cm, body mass = 98.7 ± 12.8 kg). Main outcome measuresConcurrent validity (limits of agreement, correlation) between HHD and MHHD, the intrarater reliability (intra-class correlation, ICC) and comparison between playing positions. ResultsAbsolute peak and mean peak force were systematically lower when using the HHD compared to MHHD, with the mean bias ranging from −1.8 to −3.8 kgf (P < 0.05). Differences were not evident for flexion when applying the correction equations (−0.5 to 2.1 kgf, P > 0.05) but remained for extension. Correlations between methods were large-to-very large; the ICCs for both methods were good (ICC = 0.72–0.89), with no difference between positions (P < 0.05). ConclusionThe concurrent validity of HHD was considered acceptable when compared to the MHHD and the correction equation applied. Both methods are reliable and useful for assessing neck strength in rugby players, though, caution is needed when determining strength during neck extension.

A Systematic Review of Strength and Conditioning Protocols for Improving Neck Strength and Reducing Concussion Incidence and Impact Injury Risk in Collision Sports; Is There Evidence?

The objective of this systematic literature review was to evaluate the evidence regarding the development of neck strength in reducing concussion and cervical spine injuries in adult amateur and professional sport populations. PubMed, CINAHL, Science Direct, and Web of Science databases were searched systematically. The criteria for inclusion in the review were as follows: (1) a human adult (≥18 or above); (2) involved in amateur, semi-professional, or professional sports; (3) sports included involved collisions with other humans, apparatus or the environment; (4) interventions included pre- and post-neck muscle strength measures or neck stability measures; (5) outcomes included effects on increasing neck strength in participants and/or injury incidence. Database searches identified 2462 articles. Following title, abstract, and full paper screening, three papers were eligible for inclusion. All of the papers reported information from male participants, two were focused on rugby union, and one on American football. Two of the included studies found a significant improvement in isometric neck strength following intervention. None of the studies reported any impact of neck strengthening exercises on cervical spine injuries. This review has shown that there is currently a lack of evidence to support the use of neck strengthening interventions in reducing impact injury risk in adult populations who participate in sport.

The reliability of isometric neck strength assessments in trained individuals

The Journal of Sport and Exercise Science™ ISSN 2703-240X Our Journal: Aims and Scope The Journal of Sport and Exercise Science™ (JSES) is a peer-reviewed online journal that publishes original research articles, reviews, invited commentaries, and letters to the editor, in the broad context of sport and exercise science. This includes, but is not limited to, […]

Relation between Isometric Neck Strength and White Matter Organization in Collegiate Athletes.

Soccer athletes frequently experience repetitive head impacts (RHI) during games and practices, which may affect neural integrity over time and lead to altered brain structure. Neck strength is hypothesized to limit the transfer of force to the brain and decrease the effect of RHI on brain structure. The goal of our work was to examine whether greater neck strength is associated with more intact white matter organization (WMO) in collegiate athletes exposed to RHI. Collegiate soccer (n = 17) and limited/non-contact sport (n = 39) athletes were assessed prior to their athletic seasons. Participants completed neck strength assessments using handheld dynamometry in six test positions and diffusion tensor imaging. Fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were calculated for 20 white matter (WM) regions. A multi-variate approach was used to examine the relationship between neck strength and diffusion measures in soccer and limited/non-contact athletes. Neck strength was positively associated with FA and negatively associated with RD across several WM regions in soccer players only. Neck strength was not significantly associated with MD or AD in either group. Greater neck strength was related to more intact WMO in athletes with high exposure to RHI, particularly in regions prone to damage from brain trauma such as the basal ganglia, superior longitudinal fasciculus, and frontoparietal WM. Future studies should examine neck strength as a factor to moderate neural outcomes in athletes with exposure to RHI.