The relation between neck strength and psychological distress: Preliminary evidence from collegiate soccer athletes

Aim: To examine whether neck strength and symmetry are associated with psychological function in athletes with exposure to repetitive head impacts. Methods: Collegiate soccer (n = 29) and limited/noncontact (n = 63) athletes without a history of concussion completed the Brief Symptom Inventory 18 and assessments of isometric neck strength. Neck strength symmetry was calculated as the difference in strength between opposing muscle groups. Results: The results demonstrated that lower neck strength was associated with more symptoms of anxiety, whereas asymmetry in neck strength was associated with more symptoms of somatization and depression in soccer athletes only. Conclusion: These preliminary results suggest that greater neck strength/symmetry is related to better psychological function in athletes who have higher exposure to repetitive head impacts. Soccer athletes experience high exposure to repetitive head impacts, which have been associated with structural and functional brain changes as well as long-term alterations in psychological function. Past work suggests that greater neck strength and symmetry help to stabilize the head when impacted, potentially limiting the negative effects of repetitive head impacts on the brain. Therefore, the authors examined the relationship between neck strength/symmetry and psychological distress in soccer athletes and limited/noncontact athletes. The authors found that lower neck strength and greater neck strength asymmetry were associated with increased symptoms of psychological distress in soccer athletes only, suggesting that lower neck strength/symmetry may be related to poorer psychological function in athletes with higher exposure to repetitive head impacts.