Thank you. My name is Carson Gardner. I'm a second year resident with the San Francisco Orthopedic Residency Program. I began this research when I was a medical student at USC, and it was really made possible by the faculty there, including Dr. Gamert, who's speaking later this session. So my study is entitled, NCAA football players are at higher risk of upper extremity injury after concussion. I have no disclosures. So we know that athletes are at increased risk of lower extremity injury after a concussion. There's been a lot of research in the last 10 years or so that's demonstrated this. The first study was by Nordstrom et al. in 2014. They showed the phenomenon in Champions League soccer players. There's been a lot of studies since then. I cited a few here, including McPherson, who showed an increased risk, specifically in the ACL, as well as Houston and Harada, who showed a dose dependent relationship between number of concussions and risk of lower extremity injury after a concussion. But what about the upper extremities? At the time that we conducted this study, we were aware of no studies that investigated specifically upper extremity injury risk. However, recently in May this year, Roche and Associates published in the Orthopedic Journal of Sports Medicine, concussed athletes are at 1.84 times more likely to sustain upper extremity injury in the year after concussion versus a control group. So the purpose of our study was to investigate the influence of sport-related concussion on the risk of upper extremity injuries in NCAA football players. We identified 160 NCAA Division I football players from the same conference that had sustained a sport-related concussion. We followed them retrospectively for one year before their concussion and for one year after their concussion, beginning three months after the concussion. If athletes had multiple concussions, a non-sports-related concussion, or if they failed to return to play, they were excluded from the study. So we found that in the year after concussion, athletes were at 2.36 times higher risk of upper extremity injury than in the year before their concussion. The most concussed injury, or the most injured body part after concussion and before concussion was the shoulder. It also showed a significant, or a trend towards an increased injury risk. Interestingly, although it's underpowered, the hand, fingers, and thumb showed the greatest percent change in injury risk after concussion. So in terms of discussion for this, there's various explanations out there for why this risk increases, both in the lower extremities and the upper extremities. Concussion has been shown to alter balance, gait, landing biomechanics, and reaction time. There's also theorized papers out there talking about how athletes perceive and respond to their environments, and if there's any conscious or subconscious changes in the way that athletes play the sport. My hypothesis is that it's primarily the first bullet point there, that there's changes in balance, gait, biomechanics, and reaction time that lead to this higher risk of injury. So in conclusion, NCAA football players are at higher risk of upper extremity injury after concussion. These findings do correlate with a similar trend that's been demonstrated extensively in the lower extremities. And they also corroborate some recently published data by Roche and Associates. Here's my references. Thank you.

Carson Gardner

San Francisco Orthopedic Residency Program

upper extremity injury

NCAA football players

concussions