Risks After Concussion

Athletes who sustain a sport-related concussion face a significantly higher risk of musculoskeletal injuries. In fact, 67% higher incidence rate compared to non-concussed athletes. This persists across sexes, with both male and female athletes showing similar increased odds. The risk is particularly in the lower extremities, with collegiate athletes having returned to play from concussion experiencing more than triple the odds of a lower extremity injury within 90 days and still elevated risk up to a year afterward. Multiple concussions amplify this risk pattern: athletes with three or more concussions had odds of lower extremity injury nearly three times greater than those without concussions. These findings show that just because concussion symptoms go away, it doesn’t mean the body has fully healed. Some problems with movement and coordination can still be there, which may increase the chance of getting hurt again even after being cleared to play.

Recovering from a concussion involves more than just resting until symptoms go away. A gradual progression of exercises helps retrain balance, coordination, and reaction time. Starting with light aerobic activities like walking or cycling can promote healing without worsening symptoms. Then, balance exercises and visual tracking drills help restore control and eye coordination. Finally, combining movement with cognitive tasks prepares you for the fast-paced demands of your sport as well as neck strengthening.

Emerging research suggests that persistent motor-control impairments—not detectable through standard symptom-based return-to-play protocols—may pose a hidden threat for athletes post-concussion. Impaired motor function can present as altered muscle activation, reduced force production, compromised balance, and inefficient movement patterns, particularly under dual-task or fatigue conditions. These deficits are thought to elevate musculoskeletal injury risk by interfering with the body’s ability to respond dynamically to the demands of sport. Rehabilitation strategies that specifically assess and address motor-control deficits throughout the return-to-play continuum may therefore be critical for reducing injury risk and ensuring athletes are fully prepared to handle sport demands safely.