How to reduce your risk of another injury after a concussion

Concussions are common, especially in athletes.

The common theme here is that when your brain experiences a large force, then a concussion is the result. Shortly after this force is experienced, you’ll feel those not-so-fun symptoms like headaches, dizziness, nausea, fatigue, and sensitivity to light and sound.

Symptoms can, unfortunately, persist for some people.

— Read more about concussions in this article by Sport Medicine Physician, Dr. Andy Reed —

Concussion and future injury risk

Although they may seem unrelated, there is a connection between a concussion and experiencing a future musculoskeletal (bone, joint, tendon, ligament) injury. As it turns out, you are potentially 2 times more likely to sustain an musculoskeletal (MSK) injury after a concussion. This risk for MSK injuries can increase even more after having sustained multiple concussions. 

One theory as to why this may occur is thought to be due to lingering symptoms related to how well you can focus. It is thought that these focus-related impairments could lead to a decreased reaction time in a situation where an injury may occur. For example, imagine you’re skiing and hit a patch of ice, and have to react quickly to stop yourself from falling. Your reaction time to avoid a crash could be decreased after a concussion. There are other theories about why MSK injury risk is higher after a concussion, but no concrete evidence exists at this time.

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How to reduce your risk

Similar to a lot of MSK injuries, those that are sustained after a concussion have the potential to be preventable.

Neuromuscular and ‘dual task’ training are two ways that have the potential to be effective in helping prevent further injuries after a concussion.

Neuromuscular training is a type of training that works both your brain (neuro) and your body (muscular). By refining the neural pathways that your brain uses to activate your muscles through specific movements, you can train effectively. This includes types of movements that are based on strength, technique, balance, and power-type (plyometric) movements.

The one key difference between neuromuscular training and traditional strength training is that neuromuscular training considers the information about where your body is in your environment, called proprioception. This information is carried by proprioceptors, which are small nerve cells that cover your entire body. They tell your brain the location of your limbs relative to each other and give you a sense of touch. The brain will then use this information to help plan movements based on the environment that you’re in.

There are a variety of exercises that this includes, but a few examples are tuck jumps, walking lunges, and lateral jumps and holds (skaters).

Along with this, using a ‘dual task‘, where 2 different tasks are performed at once, can aid the effectiveness of neuromuscular training. A few good examples of this would be walking and doing a memory recall activity or hopping on one foot and naming animals.

The combination of these 2 types of training appears to have a significant effect on preventing a subsequent MSK injury.

In a recent study, neuromuscular training combined with dual tasks were shown to be potentially effective in reducing post-concussion injury risk.

In this study, participants that followed a neuromuscular training + dual task program twice a week for 8 weeks, had 3 times fewer injuries in the next year compared to those that didn’t follow the program.

Additionally, the same participants in the neuromuscular training group were found to be 50% less likely to sustain any injury that would prevent them attending an upcoming practice, game, or training session.

Despite these findings, the study only included 27 participants, which decreases how accurate the evidence is. More research will be required to determine how effective this method of training truly is. 

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Contributing Expert

Spencer Lawley, BSc. Honours, Kinesiology Co-Op, University of Waterloo

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