Another aspect of concussions in elite athletes: An increased risk for subsequent traumatic injuries.

Gusten Nyberg Läkarstudent Hälsouniversitetet, Linköping

Jack Lysholm Professor Umeå

Yelverton Tegner Universitetslektor Luleå

Bakgrund

Concussion is a common injury among ice hockey players, with an incidence of up to 160/1000 player hours. In the Swedish Elite Ice Hockey League (Elitserien) all concussions have been treated in a uniform way since over 20 years. Before 2005 a concussion was graded on a three graded scale depending on severity. 2005 a new treatment model was adopted where the concussed athlete had at least 6 days before returning to play (RTP). After a concussion balance and neurocognitive function can be affected up to 30 and 14 days respectively. Our hypothesis is that if athletes return to play before being fully recovered they are at an increased risk for subsequent traumatic injuries.

Metod

All injuries and absence have been collected prospectively from one Elite Ice Hockey Club in Elitserien. Data from the seasons 1984-85 until 2008-09 have been used. All injuries occurring 7, 21 and 42 days after RTP from a concussion have been compared with new injuries after knee distortions or knee medial collateral ligament injuries.

Resultat

Within 7 days the players who had sustained a concussion were more likely to suffer a new injury compared to the players returning after knee injury (p<0,05). No differences were found when analyzing injuries after 21 and 42 days. In the concussed group, players who rested 0-3 days suffered more injuries after 7 days, 21 days and 42 days (p<0,05) compared to those who rested 4-7 days. There were no significant differences in the knee injury-group due to length of absence. There was also a trend that the concussed group suffered more serious injuries (measured in days absent) compared to control (p = 0.139, 0.075 and 0.084 for 7, 21 and 42 days). The concussed athletes had a higher proportion of serious injuries (absence >28) within 42 days when compared with all other injuries in the database (p<0,01).

Sammanfattning

Our results indicate that rehabilitation of concussed athletes should consider the risk of subsequent injuries, and not only the treatment of the actual concussions. Balance and neurocognitive testing before RTP may play a role in the assessment of the athletes’ recovery.