New research is emerging to support the lasting effects a concussion could have on an athlete’s risk of injury following return to play. Clinicians should take an active role during the acute stage of the athlete’s recovery and incorporate balance exercises and exercises that include dual tasking into the athlete’s daily exercises. Should you treat an athlete with a lower extremity injury that had a concussion in the previous year, a clinician should assess the athlete’s dynamic balance, reaction time/responsiveness and dual task abilities to ensure efficient and proper care. Wilkerson G et al. Neuromechanical considerations for postconcussion musculoskeletal injury risk management.
It is recommended that following a concussion an athlete should have a period of relative rest for 24-48 hour, followed by gradual reintegration into normal daily activities. Acutely following a concussion, physiological changes and axonal shearing occurs in the brain causing concussive symptoms. Once the athlete’s physical symptoms have resolved, an athlete is cleared by a doctor to being their return to sport protocol. However, considering this research, medical professionals could be doing a disservice to the athlete by sending them to sport without first considering any persistent dysfunction in the athlete’s neurocognition. This research article supports that there is a statistically significant relationship between concussion and an increase risk of sustaining a lower extremity musculoskeletal injury upon return to play in these athletes. Therefore, dual task ability, dynamic balance and reaction time should be evaluated prior to returning the athlete to play. Additionally, if an athlete is being evaluated in the physical therapy clinic, the clinician should inquire about past concussions to determine if time would be better spent focusing on neuromuscular re-education rather than strength and power. Herman D. et al. Concussion may increase the risk of subsequent lower extremity musculoskeletal injury in collegiate athletes.