Descriptive Epidemiology of Musculoskeletal Injuries and Concussions in the National Football League, 2012-2014

Abstract

Background:The risk of all-cause injury and concussion associated with football is significant. The National Football League (NFL) has implemented changes to increase player safety warranting investigation into the incidence and patterns of injury.Purpose:To document the incidence and patterns of all-cause injury and concussions in the NFL.Study Design:Descriptive epidemiology study.Methods:Injury data were collected prospectively from official NFL injury reports over 2 regular seasons from 2012 to 2014, with identification of injury incidence rates and patterns. Concussion rate ratios were calculated using previously reported NFL rates.Results:A total of 4284 injuries were identified, including 301 concussions. The all-cause injury rate was 395.8 per 1000 athletes at risk (AAR) and concussion incidence was 27.8 per 1000 AAR. Only 2.3% of team games were injury free. Wide receivers, tight ends, and defensive backs had the highest incidence of injury and concussion. Concussion incidence was 1.61-fold higher in 2012 to 2014 compared with 2002 to 2007. The knee was injured most frequently, followed by the ankle, hamstring, shoulder, and head.Conclusion:The incidence of all-cause injury and concussion in the NFL is significant. Concussion injury rates are higher than previous reports, potentially reflecting an improvement in recognition and awareness. Injury prevention efforts should continue to reduce the prevalence of injury associated with football.

Utility of providing a concussion definition in the assessment of concussion history in former NFL players

“…professional football players often experience numerous concussions throughout their athletic career[1–4], and recurrent concussions may place this population at risk for later-life clinical impairment. A history of recurrent concussions has been linked with structural and functional brain changes, cognitive impairment, depression, and impulsivity in former National Football League (NFL) players[5–10].…”

Treating the Football Athlete

“…The majority of recent policy modifications and additions provide guidelines for the management of concussions and injuries to the head (Figure 3), which consist of roughly 7–10% of all football injuries 1,3,5 . Concussions pose significant challenges to medical staff, in that they do not present with consistent symptoms.…”

“…If an athlete [after prior diagnosis of concussion] comes in with a headache, the return-to-play time is extended another few days or another week. It is important to trust the information that you’re getting.” Studies evaluating the effectiveness of the 2010 policy and similar policies enacted throughout all levels of play have indicated a consistent increase of concussion incidence, which is likely a result of improved concussion reporting and policy introduction increasing concussion diagnosis 1,10,11 . Research exploring institutional and trainer compliance with concussion education programs have demonstrated that players are being provided with concussion information; however, player internalization of the information requires further exploration 12,13 .…”

“…It is undisputed that football is one of the most popular sports in the United States, with approximately 3 million youth, 1 million high school, and 100,000 college participants annually 1 . The sport is known for its competitive emphasis on physicality and toughness, which contributes to the creation of the nation’s most dynamic and specialized athletes.…”

“…The sport is known for its competitive emphasis on physicality and toughness, which contributes to the creation of the nation’s most dynamic and specialized athletes. However, sports medicine research has demonstrated that football has one of the highest risks of overall injury of all American sports, and that this risk increases with the level of competition 1–4 . Epidemiological studies evaluating injury rates at both collegiate and professional levels have shown that the majority of injuries are sustained as a result of high-energy player-to-player contact.…”