Systematic review: no significant relationship between greater neck strength and lower risk of sports-related concussion––more research needed

By Sravya Valiveti. This article was initially published in the 8/24/23 edition of our Concussion Update newsletter; please consider subscribing.

Researchers Joel M. Garrett et al. conducted a systematic review to understand the relationship between neck strength and future incidence of a sports-related concussion in athletes participating in team sports. 

Their review, published in the Journal of Orthopaedic & Sports Physical Therapy, focused on studies of team sports and those that reported measures of neck strength and sports-related concussion incidence. The research team concluded that there was a small, nonsignificant relationship between greater neck strength and a lower risk of sustaining a sports-related concussion in athletes. Findings from the meta-analysis thus showed that there was very low certainty of evidence to draw a firm conclusion.

Eight studies involving 7625 participants met the primary criteria, and of those, five studies noted a relationship between greater neck strength or motor control and reduced concussion incidence. Measures such as risk of bias (using the Newcastle-Ottawa scale) and certainty of evidence (using the Grading of Recommendations, Assessment, Development, and Evaluation approach) were assessed to quantitatively and qualitatively summarize the findings. 

Pooled results from synthesized studies revealed that there was a small, non-significant relationship between both factors, and the research team noted considerable variability in these results due to “vastly different sample characteristics, including participant age, playing level, and sports” that resulted in this substantial heterogeneity. More research is needed to improve understanding of this potential association, considering the variability of results and participants.