In this episode of Behind the Breakthroughs: Off the Field, Melissa sits down with Dr. April McPherson, an associate research scientist at the Emory Sports Performance and Research Center. Dr. McPherson shares her journey from being a student athlete and biomedical engineer to researching the fascinating, yet often overlooked, link between previous concussions and the increased risk of future lower-extremity injuries.
Articles mentioned in this episode:
Herman, D. C., & Barth, J. T. (2016). Drop-Jump Landing Varies With Baseline Neurocognition: Implications for Anterior Cruciate Ligament Injury Risk and Prevention. The American journal of sports medicine, 44(9), 2347–2353. https://doi.org/10.1177/0363546516657338
McPherson, A. L., Zuleger, T. M., Barber Foss, K. D., Warren, S. M., Hogg, J. A., Diekfuss, J. A., & Myer, G. D. (2024). Does Neuromuscular Training Reduce the Risk of Lower-Extremity Musculoskeletal Injury in High School Female Athletes With a History of Sport-Related Concussion?. Journal of sport rehabilitation, 33(7), 506–514. https://doi.org/10.1123/jsr.2023-0403
Melissa: Welcome to Behind the Breakthroughs. I'm Melissa Deuber from the Woodruff Health Sciences Center Library. In each edition, we take a closer look at the research shaping health, healing, and human performance at Emory. Today's episode is part of the Off the Field series, where we explore how science moves from the lab to everyday life. I'm joined by Dr. April McPherson to talk about their work, the questions that drive it, and what it could make possible. Let's get started. So first off, tell me a little bit about yourself and how you got into researching the topic that you do.
Dr. McPherson: Absolutely, thank you for having me today. I'm an associate research scientist at Emory Sports Performance and Research Center. My background is biomedical engineering and physiology. I've had a couple of stints outside of academia, one being at the US Olympic and Paralympic Training Center in Colorado Springs, before coming back into the academic world with Dr. Meyer.
This has kind of been a perfect culmination of what my graduate school work was focused on: the history of brain injury, specifically concussion, and its future risk of a lower extremity injury. And with the technology we have here at Emory SPARC, we're perfectly positioned to continue investigating that. And that was what this paper was about. This was actually a secondary analysis to a larger clinical trial that investigated ACL injury risk factors in high school female soccer, basketball, and volleyball athletes. But for this particular analysis and this paper, we wanted to know: does neuromuscular training, a specific injury prevention training style, reduce the risk of a lower extremity injury in those high school female athletes who report having had a previous concussion before the training program started?
Melissa: So, if you had to explain what question you were trying to answer to maybe a friend or a family member who doesn't work in science, what would you say?
Dr. McPherson: So, when we hear concussion, especially in the media, the frenzy around them, we're typically thinking of headaches, maybe dizziness, instability when that football player gets up off of the field. But in the last decade or so, the science is actually pretty clear that there appears to be a higher risk—up to three times the risk—of a future leg injury for up to three years after that concussion compared to, maybe, a teammate who hasn't had a history of concussion.
But what the science isn't clear on is the "why" behind that increased risk. So, while we at SPARC and others across the country and the world are trying to figure out that why, at the same time we're trying to figure out how can we reduce that risk of injury? We know people are going to keep playing, we know concussions are going to happen; how can we change current care to hopefully reduce that risk of injury?
Melissa: So what made you curious about this concept of predicting injuries instead of just treating them after they happen?
Dr. McPherson: For me personally, that curiosity in injury prevention stemmed from being an athlete myself while also studying biomedical engineering in undergrad. I realized I could combine my passion with my career. Reducing the risk of injury is important to me because I had friends and teammates whose careers ended because of injury; mine almost ended because of an injury.
And specifically, the curiosity between concussion and knee injury stems back to grad school. I read a paper by Dr. Herman out of the University of Florida who was looking at how a healthy athlete's landing strategies were associated with their baseline neurocognitive performance, which is kind of the standard of care for concussion prevention and rehabilitation. And that was kind of a lightbulb moment of: how can we use existing injury prevention strategies and tools and apply those to different populations, such as those who have had a concussion?
Melissa: So, how could preventing these injuries as opposed to just reacting to them change the experience of athletes or just active people in general?
Dr. McPherson: So, instead of that reactive and rehabilitative medicine after an injury, we have the knowledge to shift focus to proactive assessments and training. But the missing piece is resources and implementation of it at scale to have a measurable and noticeable effect on preventing injuries.
I think improving injury education, implementing targeted training strategies, removing the fear and stigma around injury reporting, especially concussions, and ideally preventing injuries in the first place keeps athletes healthier and active longer. Not to mention the cost associated with reactive healthcare, from surgeries, doctor's appointments, rehab, time lost from school or work; the list keeps going. So, sports and fitness, in my opinion, should be a lifelong experience, so if we can prevent severe ones like an ACL injury in childhood, that should have a lasting effect through adulthood and through the lifespan.
Melissa: Great. And to wrap up, what's one thing that you wish the general public understood better about how injury research actually helps people?
Dr. McPherson: I think one of the things I hear often is: we're not trying to be the bad guys and say, "Don't do this, don't do that". We're trying to say: we know you're going to keep playing, let's make it safer. What we learn from our studies doesn't have to, and I don't think should, be confined to just this paper that we published or just to inform the next clinical trial. Although we do have really fancy and fun equipment and tools here in our lab, a lot of the principles and applications that we learn in research can actually be applied pretty easily and pretty simply without a lot of tech or a lot of investment to have a major impact on athlete safety, injury risk, and ultimately their performance. So, I think the greatest success we can have is if we never see you in one of our trials, because that means you didn't get hurt.
Melissa: That's a great point. So, thank you for joining us for this episode of Behind the Breakthroughs: Off the Field. I hope today's conversation offered a clearer look at the curiosity, care, and science behind the work happening at Emory. If you enjoyed this episode, feel free to explore the rest of the series, where each researcher brings a new perspective on injury prevention and human performance. Thanks for listening, and we'll see you next time.