Evaluation of Musculoskeletal Re-Injury Occurrence in Previously Concussed National Football League Athletes

Introduction: Increased risk of musculoskeletal (MSK) injury post-concussion has been reported in collegiate athletes, yet it is unknown if professional football athletes are at the same risk of secondary injury. The objective of this study was to determine if the risk of MSK injury in National Football League (NFL) athletes increases after concussion. Methods: NFL injury reports from 2013 to 2017 were collected from public websites. Concussed athletes (n=91) were equally matched to a non-injured control and an athlete with an incident of musculoskeletal (MSK) injury. Results: Following their return to sport, concussed athletes were 2.35 times more likely to have a subsequent MSK injury relative to non-injured controls (95% CI: 2.35 [1.25, 4.44], P = 0.01), but were no more likely than athletes with an incident MSK injury ( P = 0.55). Likewise, athletes with an incident MSK injury were no more likely to have a subsequent MSK injury than controls ( P = 0.08). Discussion: Increased odds of MSK injury in the 12-week period following a concussion in professional football athletes warrants future research on the acute effects of concussion and the relationship to MSK injury risk. Keywords: mild traumatic brain injury, musculoskeletal injury, return to play, NFL, professional American football