Injury Risk in Collegiate Football Players With Generalized Joint Hypermobility: A Prospective Cohort Study Over 2 Years

Richard W Nicolay; Matthew H Hartwell; Stephen D Bigach; Claire E Fernandez; Allison M Morgan; Charles J Cogan; Michael A Terry; Vehniah K Tjong

doi:10.1177/23259671231167117

Injury Risk in Collegiate Football Players With Generalized Joint Hypermobility: A Prospective Cohort Study Over 2 Years

Orthop J Sports Med. 2023 Jun 21;11(6):23259671231167117. doi: 10.1177/23259671231167117. eCollection 2023 Jun.

Authors

Richard W Nicolay¹, Matthew H Hartwell², Stephen D Bigach³, Claire E Fernandez³, Allison M Morgan⁴, Charles J Cogan², Michael A Terry³, Vehniah K Tjong³

Affiliations

¹ Illinois Bone & Joint Institute, Glenview, Illinois, USA.
² Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California, USA.
³ Department of Orthopaedic Surgery, Northwestern Memorial Hospital, Chicago, Illinois, USA.
⁴ Department of Orthopedic Surgery, New York University, New York, New York, USA.

Abstract

Background: Generalized joint hypermobility (GJH) has been identified as a risk factor for injury in various athletic patient populations.

Purpose: To evaluate GJH as a predisposing risk factor for injury in a population of National Collegiate Athletic Association (NCAA) Division I football players.

Study design: Cohort study; Level of evidence, 2.

Methods: The Beighton score was collected for 73 athletes during their preseason physical examinations in 2019. GJH was defined as a Beighton score ≥4. Athlete descriptive characteristics, including age, height, weight, and playing position, were recorded. The cohort was evaluated prospectively for 2 years, and the number of musculoskeletal issues, injuries, treatment episodes, days unavailable, and surgical procedures for each athlete during this period were recorded. These measures were compared between the GJH and no-GJH groups.

Results: The mean Beighton score was 1.4 ± 1.5 for the 73 players; 7 players (9.6%) had a Beighton score indicating GJH. During the 2-year evaluation, there were 438 musculoskeletal issues, including 289 injuries. The mean number of treatment episodes per athlete was 77 ± 71 (range, 0-340), and the mean number of days unavailable was 67 ± 92 days (range, 0-432 days). There were 23 athletes who required 25 operations, the most common procedure being arthroscopic shoulder stabilization (n = 6). The number of injuries per athlete was not significantly different between the GJH and no-GJH groups (3.0 ± 2.1 vs 4.1 ± 3.0; P = .13), nor were there any between-group differences in the number of treatments received (74.6 ± 81.9 vs 77.2 ± 71.5; P = .47), days unavailable (79.6 ± 124.5 vs 65.3 ± 89.3; P = .61), or rates of surgery (43% vs 30%; P = .67).

Conclusion: A preseason diagnosis of GJH did not place NCAA football players at a greater risk for injury during the 2-year study period. Based on the findings of this study, no specific preparticipation risk counseling or intervention is warranted for football players who are diagnosed with GJH as defined by the Beighton score.

Keywords: Beighton score; NCAA; athlete; collegiate; football; generalized joint hypermobility; injury; laxity.