Objective to understand if the rate of musculoskeletal (MSK) injury is elevated in world-class athletes during the first 100 days following a sports related concussion (SRC).

Design retrospective audit and analysis of the electronic medical records of UK Olympic World Class Programme (WCP) sports athletes.

Participants The health records of all 1,303 athletes from the 42 UK Sport-funded World Class Programmes (WCP) that were held in the English Institute of Sport (EIS) Performance Data Management System (PDMS) within the period 1^st January 2016 to 18^th May 2022 were included for analysis.

Main Results MSK injury comparator rate: 5062 injuries/15,653 periods of 100 days = 0.32 MSK injuries per 100 days. The post SRC injury rate: 86 injuries within 100 days/ 222 concussion diagnoses = 0.39 MSK injuries per 100 days post-concussion. The incidence rate ratio (IRR) is 1.19 (95% confidence interval of 0.97 – 1.48) with a number >1 indicating that there are more injuries post-SRC compared to the baseline comparator data. These findings equate to a 19.8% greater MSK injury incidence.

Conclusions Previous research in this area has been conducted in individual collegiate sports, not on athletes from Olympic world class programmes. Despite the differences in study population the findings presented align with previous research, demonstrating greater likelihood of any MSK injury following SRC when compared to other index MSK injuries. Identifying and addressing causal factors is required to tackle subsequent MSK injury burden following SRC.