No abstract

Level IV, cohort study.

Background: Lower extremity injuries are the most common injuries in professional sports and carry a high burden to players and teams in the National Football League (NFL). Injury prevention strategies can be refined by a foundational understanding of the occurrence and effect of these injuries on NFL players. Purpose: To determine the incidence of specific lower extremity injuries sustained by NFL players across 4 NFL seasons. Study Design: Descriptive epidemiology study. Methods: This retrospective, observational study included all time-loss lower extremity injuries that occurred during football-related activities during the 2015 through 2018 seasons. Injury data were collected prospectively through a leaguewide electronic health record (EHR) system and linked with NFL game statistics and player participation to calculate injury incidence per season and per 10,000 player-plays for lower extremity injuries overall and for specific injuries. Days lost due to injury were estimated through 2018 for injuries occurring in the 2015 to 2017 seasons. Results: An average of 2006 time-loss lower extremity injuries were reported each season over this 4-year study, representing a 1-season risk of 41% for an NFL player. Incidence was stable from 2015 to 2018, with an estimated total missed time burden each NFL season of approximately 56,700 player-days lost. Most (58.7%) of these injuries occurred during games, with an overall higher rate of injuries observed in preseason compared with regular season (11.5 vs 9.4 injuries per 10,000 player-plays in games). The knee was the most commonly injured lower extremity region (29.3% of lower body injuries), followed by the ankle (22.4%), thigh (17.2%), and foot (9.1%). Hamstring strains were the most common lower extremity injury, followed by lateral ankle sprains, adductor strains, high ankle sprains, and medial collateral ligament tears. Conclusion: Lower extremity injuries affect a high number of NFL players, and the incidence did not decrease over the 4 seasons studied. Prevention and rehabilitation protocols for these injuries should continue to be prioritized.

Modern synthetic turf is far different than when originally introduced. It requires routine maintenance, even at the level of local athletics. It is important for sports medicine personnel to be familiar with playing surface issues as they are often treating athletes at the time of injury and should maintain a level of awareness of contemporary research and practices regarding the relationships between synthetic turf and injury.

The purpose of this study was to assess patients' awareness of and attitudes toward physicians' receiving gifts from the pharmaceutical industry. The Alger County Community Health Study was a self-report survey targeting rural Alger County, Michigan. The survey (completion rate 10.1%) addressed issues on health, demographics, and patients' awareness of and attitudes toward gifts to physicians. Rates of awareness of gifts were: drug samples, 94 percent; ballpoint pens, 76.2 percent; medical books, 38 percent; conference/travel expenses, 34 percent; dinner out, 36.6 percent; spouse meal at dinner out, 23 percent; golf tournament fees, 19.0 percent. Rates of "approval" of physicians' accepting gifts were: drug samples, 69 percent; ballpoint pens, 54.2 percent; medical books, 49 percent; conference/travel expenses, 14 percent; dinner out, 12.1 percent; spouse meal at dinner out, 7 percent; golf tournament fees, 3.7 percent. Patients' approval of gifts seems to be related to the perceived value of the gift to patients as well as its monetary value. The patient population in the current study seems to be less approving of gifts to physicians than patients surveyed in the 1990s. Patients' opinions should be considered when establishing ethical guidelines and policies regulating physician-industry interaction.

Level II, prospective cohort study.

Level IV, case series.

No abstract