A Systematic Review of Strength and Conditioning Protocols for Improving Neck Strength and Reducing Concussion Incidence and Impact Injury Risk in Collision Sports; Is There Evidence?

The objective of this systematic literature review was to evaluate the evidence regarding the development of neck strength in reducing concussion and cervical spine injuries in adult amateur and professional sport populations. PubMed, CINAHL, Science Direct, and Web of Science databases were searched systematically. The criteria for inclusion in the review were as follows: (1) a human adult (≥18 or above); (2) involved in amateur, semi-professional, or professional sports; (3) sports included involved collisions with other humans, apparatus or the environment; (4) interventions included pre- and post-neck muscle strength measures or neck stability measures; (5) outcomes included effects on increasing neck strength in participants and/or injury incidence. Database searches identified 2462 articles. Following title, abstract, and full paper screening, three papers were eligible for inclusion. All of the papers reported information from male participants, two were focused on rugby union, and one on American football. Two of the included studies found a significant improvement in isometric neck strength following intervention. None of the studies reported any impact of neck strengthening exercises on cervical spine injuries. This review has shown that there is currently a lack of evidence to support the use of neck strengthening interventions in reducing impact injury risk in adult populations who participate in sport.