Biomechanics of Sport Concussion: Quest for the Elusive Injury Threshold

Kevin M. Guskiewicz; Jason P. Mihalik

Disclosures

Exerc Sport Sci Rev. 2011;39(1):4-11. 

In This Article

Summary

Because of the varying magnitudes and locations of impacts resulting in concussion, as well as other factors such as the frequency of subconcussive impacts and number of prior concussions, it may be difficult to establish a threshold for concussive injury that can be applied to football and other helmeted contact sports, such as hockey and lacrosse. As reported previously in the literature, any proposed theoretical injury threshold should be interpreted with caution. Despite this, biomechanics research has still provided us with valuable information for improving safety in sports such as football and hockey. Our findings further substantiate the notion that concussions must be managed using a multifaceted approach (Fig. 3).

Figure 3.

Sport-related concussion represents a multifaceted clinical dilemma for the sports medicine professional. Beyond understanding the biomechanics (i.e., injury mechanism), clinicians must appreciate that concussion may result in cognitive deterioration, postural instability, and varied symptoms from one patient to the next.

The most important findings of these combined studies have been 1) that concussions can occur at lower impact magnitudes than previously thought; 2) that measures of linear acceleration appear equally important to cause concussion as angular acceleration; 3) that athletes can sustain a high number of head impacts in a season (many exceeding 80g-90g) and never sustain a diagnosed concussion; and 4) clinicians should not attempt to use impact magnitude or location to predict acute clinical outcomes of symptom severity, neuropsychological function, and balance. Our earlier studies, combined with those of several other studies on this topic, call for more research to be conducted to investigate how linear and rotational accelerations relate to measures of symptom severity, neurocognitive function, and postural stability in larger sample sizes across the entire recovery period. In addition, the role of this technology should be further investigated to identify its use for behavior modification and improved player mechanics.

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