Prevalence of Shoulder Labral Injury in Collegiate Football Players at the National Football League Scouting Combine

Abstract

Background:Labral tears confirmed by magnetic resonance imaging (MRI) are a relatively common injury among collegiate athletes and can influence a player’s ability to compete at the professional level.Purpose:To determine the prevalence of MRI-confirmed shoulder labral injuries in collegiate football players entering the National Football League (NFL) Combine and to further describe these injuries by tear location, player position, history of surgical intervention, and associated concomitant shoulder injuries.Study Design:Descriptive epidemiology study.Methods:Data from 2009 to 2015 were retrospectively collected through review of the injury data registry available to the medical and training staff of all NFL teams following the completion of the NFL Combine. After players with potential labral tears were identified through history and examination, their MRIs were reviewed by 2 fellowship-trained orthopaedic sports medicine surgeons. Players diagnosed with a labral tear confirmed by MRI were separated for further analysis.Results:A total of 2285 players were analyzed for the presence of labral tears at the NFL Combine. Overall, 377 shoulders (in 340/2285 players; 14.9%) demonstrated MRI evidence of labral tear; whereas linebackers had the highest rate of labral tear (19.2%), linemen had significantly higher risk for labral injury in at least 1 shoulder (odds ratio, 1.31; 95% CI, 1.02-1.67; P = .029) compared with nonlinemen. Of the 377 shoulders analyzed, 115 (30.5%) exhibited an anterior labral tear, 131 (34.7%) had a posterior labral tear, and 131 (34.7%) had combined anterior and posterior tears. One hundred twenty (31.8%) shoulders had superior labral anterior-posterior (SLAP) tears. A total of 203 (53.8%) shoulders demonstrated evidence of previous surgical intervention on imaging.Conclusion:Injury involving the labrum is relatively common among participants at the NFL Combine, especially linebackers and linemen. Further investigation is necessary to determine the impact these injuries have on player draft position and NFL performance.

Effect of Posterior Glenoid Labral Tears at the NFL Combine on Future NFL Performance

“…Unlike the negative effect of concomitant injures with anterior labral injuries, 20 concomitant injuries did not significantly affect any metric when combined with posterior labral tears, perhaps suggesting that the labral tear is the most limiting factor in posterior instability. This may be because of the nature of the injury, with anterior instability generally occurring in a more acute, traumatic mechanical fashion and posterior instability occurring with repetitive, chronic microtrauma in which significant concomitant injuries are less likely to be present.…”

“…This is important, considering that linemen have a significantly higher risk for labral tears in at least 1 shoulder. 21 Mair et al 19 hypothesized that contact athletes who engage their opponents with their arms in front of the body, as linemen typically do, were more susceptible to this injury because of the compressive force and shearing force that result from repeated posteriorly directed impact. With modern blocking and block-shedding techniques, the posterior capsule is subject to repetitive microtrauma, which can lead to attenuation of the labrum and laxity of the posterior capsule, resulting in posterior instability.…”

“…Of the 581 players who underwent shoulder MRI in the 2009 to 2015 NFL Combine, 58.5% showed evidence of labral tearing, which represented 14.9% of the overall NFL Combine population. 21 Given the prevalence of labral injuries within this population of athletes, the purpose of this study was to evaluate the effect that posterior labral tears have on draft position and early NFL performance based on position, concomitant injuries, and operative versus nonoperative management. We hypothesized that these injuries would negatively affect NFL performance, concomitant injuries would be further detrimental to NFL performance, and operative management would improve performance compared with nonoperative management.…”

Magnetic Resonance Arthrography in Rugby Players Undergoing Shoulder Stabilization for Glenohumeral Instability: Professionals Have Higher Frequencies of More Pathologies

“…The mechanism of this pathology in cases of glenohumeral instability involve the humeral head being displaced anteriorly from the glenoid labrum; this theoretically reinforces the rationale for the high frequencies of bony and chondral pathologies in collision athletes such as rugby players. Although the literature widely reports that American football athletes have a similarly increased risk of glenoid labral tears (among other pathologies) secondary to collisions, [19][20][21] Knapik et al 22 reported that not only unilateral tears are commonplace in this cohort but so too are recurrent and bilateral tears on MR imaging. Despite this, they found that this did not directly affect future short-term participation in the National Football League.…”

Epidemiology and Impact of Prior Musculoskeletal Injury and Orthopaedic Surgery on Draft Rank, Availability, and Short-term Performance in Major League Baseball: A Summary Analysis and Matched Cohort of 1890 Predraft Players

“…15,18,20 In the National Football League (NFL), the impact of predraft injuries and surgical procedures, including anterior cruciate ligament reconstruction, rotator cuff tears, and shoulder labral tears, has been reported extensively from the medical records of the treating physicians; the findings portend unfavorable career prognoses for those with a musculoskeletal injury history, including a lower likelihood of a successful draft and a greater likelihood of decreased performance. 1,2,9,13,17…”