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Updated: May 4, 2026

A Multi-Modal Approach to Assessing Recovery in Youth Athletes Following Concussion
Published on: September 25, 2014
Diagnosed concussion is associated with increased risk for upper extremity injury in community rugby players in males
Katherine J Hunzinger1,2, Katelyn M Costantini3, C Buz Swanik4,5
1Department of Exercise Science, Thomas Jefferson University, Philadelphia, PA, USA.
Objectives:
To cross-sectionally determine 1) the association between lifetime diagnosed concussion and upper extremity musculoskeletal injury (UE-MSI) amongst a novel cohort of community rugby union players and 2) the sex-specific risk of UE-MSI given concussion history among these rugby players.
Methods:
A total of 1,037 (31.0% female, 31.6 + 11.3 years) rugby players completed an online survey to determine lifetime history of diagnosed concussion (yes; no) and UE-MSI (yes; no). A chi-squared test of association was performed between concussion and any UE-MSI; odds ratio risk was also determined. Analyses were repeated by sex (male; female) and with specific UE-MSI (e.g. sprains, broken bones, dislocations).
Results:
There was a significant association between concussion and any UE-MSI for this cohort (χ(1) = 10.802, p = 0.001, OR = 1.70 [95%CI: 1.23-2.32]). There was a significant association between concussion and any UE-MSI among males for (χ(1) = 13.612, p < 0.001, OR = 2.20 [95%CI: 1.4-3.3]) but not among females (χ(1) = 0.735, p = 0.391, OR = 1.20 [95%CI: 0.8-2.0]).
Conclusions:
Community rugby players with a history of diagnosed concussion are at 1.7× increased odds for history of any UE-MSI compared to rugby players who are concussion naïve; sex-specific analyses revealed only increased risk among males. Sports medicine professionals and rugby stakeholders should view concussions as a risk factor and utilize established injury prevention programs to help reduce future UE-MSI in athletes.

