College Football Athletes Research Articles

Exploring the Notion of Individual Social Responsibility (ISR) among Black Male College Football Athletes

Black male athletes are prominent figures in sport and society; and, as such, they are often subjected to the pressure of acting in a socially responsible manner. Given the predominance of Black males in American college athletics, it is important to examine their roles in society both on and off the field of play. Building upon of Agyemang and Singer’s (2013) study on the individual social responsibility (ISR) of Black male professional athletes, the purpose of this study was to explore the concept of ISR among Black male college athletes. In this study, we engaged in semi-structured interviews with Black male football athletes in efforts to garner a baseline understanding of how they perceive their social responsibility as notable members of society. Initial findings suggest notions of being a role model, engaging in ethical behavior, and overcoming marginalization, mainly in regard to issues of race. Implications for future research are discussed.

Comparison of Head Impact Exposure Between Concussed Football Athletes and Matched Controls: Evidence for a Possible Second Mechanism of Sport-Related Concussion

Studies of football athletes have implicated repetitive head impact exposure in the onset of cognitive and brain structural changes, even in the absence of diagnosed concussion. Those studies imply accumulating damage from successive head impacts reduces tolerance and increases risk for concussion. Support for this premise is that biomechanics of head impacts resulting in concussion are often not remarkable when compared to impacts sustained by athletes without diagnosed concussion. Accordingly, this analysis quantified repetitive head impact exposure in a cohort of 50 concussed NCAA Division I FBS college football athletes compared to controls that were matched for team and position group. The analysis quantified the number of head impacts and risk weighted exposure both on the day of injury and for the season to the date of injury. 43% of concussed athletes had the most severe head impact exposure on the day of injury compared to their matched control group and 46% of concussed athletes had the most severe head impact exposure for the season to the date of injury compared to their matched control group. When accounting for date of injury or season to date of injury, 72% of all concussed athletes had the most or second most severe head impact exposure compared to their matched control group. These trends associating cumulative head impact exposure with concussion onset were stronger for athletes that participated in a greater number of contact activities. For example, 77% of athletes that participated in ten or more days of contact activities had greater head impact exposure than their matched control group. This unique analysis provided further evidence for the role of repetitive head impact exposure as a predisposing factor for the onset of concussion. The clinical implication of these findings supports contemporary trends of limiting head impact exposure for college football athletes during practice activities in an effort to also reduce risk of concussive injury.

Chapter 4 - Catastrophic neurologic injuries in sport

Tens of millions of children and adults participate in organized sport in the United States each year. Although uncommon, fatal and severe nonfatal brain and spine injuries can occur during these activities. These "catastrophic" injuries have been noted in contact sports such as football, rugby, and ice hockey, as well as in noncontact sports including baseball, cheerleading, swimming and diving, equestrian, gymnastics, pole vault, rodeo, snow skiing, snowboarding, and wrestling. They happen at all levels of play, from youth to professional. Among all sports, football has the highest number of fatal brain and cervical spine injuries. While these injuries are more frequent in high school football, the rate is higher amongst college football athletes. Patterns exist in the types of brain and spine injuries most often occurring as a result of traumatic impacts in sport, but incidence and mechanisms of injury vary dramatically between sports. Understanding these patterns is essential to informing prevention efforts; football, pole vault, and cheer are all examples of sports benefiting from successful catastrophic injury prevention efforts. Participating in sport provides many benefits to physical and mental health. Despite these benefits, rare devastating injuries can be traumatic for the athletes, their families, and communities and can raise safety concerns that may reduce participation in sport. Understanding and preventing these types of injuries are critical to fostering participation in sport and ensuring both children and adults reap the physical, social, and mental benefits of sport.

Effects of Career Duration, Concussion History, and Playing Position on White Matter Microstructure and Functional Neural Recruitment in Former College and Professional Football Athletes.

Purpose To better understand the relationship between exposure to concussive and subconcussive head impacts, white matter integrity, and functional task-related neural activity in former U.S. football athletes. Materials and Methods Between 2011 and 2013, 61 cognitively unimpaired former collegiate and professional football players (age range, 52-65 years) provided informed consent to participate in this cross-sectional study. Participants were stratified across three crossed factors: career duration, concussion history, and primary playing position. Fractional anisotropy (FA) and blood oxygen level-dependent (BOLD) percent signal change (PSC) were measured with diffusion-weighted and task-related functional magnetic resonance imaging, respectively. Analyses of variance of FA and BOLD PSC were used to determine main or interaction effects of the three factors. Results A significant interaction between career duration and concussion history was observed; former college players with more than three concussions had lower FA in a broadly distributed area of white matter compared with those with zero to one concussion (t29 = 2.774; adjusted P = .037), and the opposite was observed for former professional players (t29 = 3.883; adjusted P = .001). A separate interaction between concussion history and position was observed: Nonspeed players with more than three concussions had lower FA in frontal white matter compared with those with zero to one concussion (t25 = 3.861; adjusted P = .002). Analysis of working memory-task BOLD PSC revealed a similar interaction between concussion history and position (all adjusted P < .004). Overall, former players with lower FA tended to have lower BOLD PSC across three levels of a working memory task. Conclusion Career duration and primary playing position seem to modify the effects of concussion history on white matter structure and neural recruitment. The differences in brain structure and function were observed in the absence of clinical impairment, which suggested that multimodal imaging may provide early markers of onset of traumatic neurodegenerative disease. © RSNA, 2017 Online supplemental material is available for this article.

The Latarjet Procedure at the National Football League Scouting Combine: An Imaging and Performance Analysis.

Background:The Latarjet procedure is commonly performed in the setting of glenoid bone loss for treatment of recurrent anterior shoulder instability; however, little is known regarding the outcomes of this procedure in elite American football players.Purpose:(1) Determine the prevalence, clinical features, and imaging findings of elite college football athletes who present to the National Football League (NFL) Combine with a previous Latarjet procedure and (2) describe these athletes’ performance in the NFL in terms of draft status and initial playing time.Study Design:Case series; Level of evidence, 4.Methods:After review of all football players who participated in the NFL Combine from 2009 to 2016, any player with a previous Latarjet procedure was included in this study. Medical records, position on the field, and draft position were recorded for each player. In addition, imaging studies were reviewed to determine fixation type, hardware complications, and status of the bone block. For those players who were ultimately drafted, performance was assessed based on games played and started, total snaps, and percentage of eligible snaps in which the player participated during his rookie season.Results:Overall, 13 of 2617 (<1%) players at the combine were identified with a previous Latarjet procedure. Radiographically, 8 of 13 (61%) showed 2-screw fixation, while 5 of 13 (39%) had 1 screw. Of the 13 players, 6 (46%) players demonstrated hardware complications. All players had evidence of degenerative changes on plain radiographs, with 10 (77%) graded as mild, 1 (8%) as moderate, and 2 (15%) as severe according to the Samilson Prieto classification. Six of the 13 (46%) players went undrafted, while the remaining 7 (54%) were drafted; however, no player participated in more than half of the plays for which he was eligible during his rookie season.Conclusion:Only a small percentage of players at the NFL Combine (<1%) had undergone a Latarjet procedure. High rates of postoperative complications and radiographically confirmed degenerative change were observed. Athletes who had undergone a Latarjet procedure demonstrated a variable amount of playing time, but none participated in more than half of their eligible plays during their rookie season.

Epidemiological Patterns of Ankle Sprains in Youth, High School, and College Football

Background: Variations in ankle injury rates and distributions among competition levels are unclear, but such data may help inform strategies to prevent ankle sprains during American football. Purpose: To describe the epidemiological patterns of ankle sprains in youth, high school (HS), and collegiate American football. Study Design: Descriptive epidemiological study. Methods: Data regarding youth, HS, and college football athletes were collected from 3 injury surveillance programs: (1) the Youth Football Safety Study (YFSS), (2) the National Athletic Treatment, Injury and Outcomes Network (NATION), and (3) the National Collegiate Athletic Association (NCAA) Injury Surveillance Program (ISP). During the 2012-2014 seasons, the YFSS, NATION, and NCAA ISP included 310, 184, and 71 football team-seasons, respectively. Athletic trainers (ATs) attended each practice and game and reported injuries and athlete-exposures (AEs) via their preferred injury documentation application. Ankle sprain rates for each type of ankle sprain were calculated overall, by event type (ie, practices and games), and specifically for severe injuries (ie, participation restriction time >21 days) and recurrent injuries (as defined by ATs). Rate ratios (RRs) were used to compare ankle sprain rates by competition level and event type. Injury proportion ratios (IPRs) were used to compare differences in severity, surgical needs, recurrence, injury mechanism, and injury activity by competition level. RRs and IPRs with 95% confidence intervals excluding 1.00 were considered statistically significant. Results: A total of 124, 897, and 643 ankle sprains were reported in youth, HS, and college football, respectively. This led to respective rates of 0.59, 0.73, and 1.19 sprains per 1000 AEs. The ankle sprain rate in college football was higher than the rates in HS (RR = 1.64; 95% CI, 1.48-1.82) and youth (RR = 2.01; 95% CI, 1.65-2.43) football. The proportion of ankle sprains that were recurrent in youth football was higher than the proportions in HS (IPR = 2.73; 95% CI, 1.68-4.50) and college (IPR = 2.19; 95% CI, 1.33-3.61) football. Conclusion: Ankle sprain rates were highest in college athletes. However, level-specific variations in ankle sprain severity and recurrence may highlight the need to develop level-specific policies and prevention strategies to reduce injury incidence.

Response to Heavy Rope Interval Training and Active Recovery in Division I College Football Players

Heavy rope interval training is widely used to improve athletic performance, but there has been very little research conducted on the physiological effects of acute bouts of heavy rope interval training. There is also a lack of research concerning the impact of active recovery following bouts of interval training in college football athletes. PURPOSE: To examine the physiological response to acute bouts of heavy rope high-intensity interval training and compare the influence of active recovery (AR) and passive recovery (PR) on blood lactate clearance in Division I college football players. METHODS: The study population was comprised of 13 male Division I college football players (20.2 ± 1.4 years, 183.3 ± 6.0 cm, 89.5 ± 7.9 kg). The study used a randomized crossover groups design. Participants were randomly assigned to one of two groups based on the order of the recovery type. During the heavy rope protocol, participants performed six, 15 s bouts of vigorous exercise separated by 30 s rest intervals. Participants recovered either actively or passively depending on their group assignment. The active recovery protocol consisted of walking at two miles per hour on a treadmill, and the passive recovery required the participant to sit still between exercise bouts. After a minimum rest period of 48 hr, participants in both groups repeated the intervention and the method of recovery was switched. Blood lactate concentration was measured at four time points; after a 4 min warm-up period, immediately after the heavy rope interval exercise, and at 2 and 5 min post exercise. RESULTS: Results of a two-way repeated measures ANOVA demonstrated a significant recovery by time interaction F (3, 12) = 15.6, p < 0.01. Pairwise comparisons revealed that blood lactate concentration using active recovery was significantly lower than passive recovery immediately following the heavy rope high-intensity interval training bout (AR: 6.81 ± 1.06 mmol/l; PR: 7.69 ± 1.55 mmol/l, p < 0.05) and at 2 min (AR: 7.34 ± 1.26 mmol/l; PR: 8.92 ± 1.83 mmol/l, p < 0.01) and 5 min post exercise (AR: 7.07 ± 1.17 mmol/l; PR: 9.00 ± 1.82 mmol/l, p < 0.01). CONCLUSION: Active recovery following acute bouts of heavy rope interval training is more effective than passive recovery to enhance blood lactate clearance in Division I college football players.

Assessing Concussions In Collegiate Football Players

PURPOSE: Concussion-related injuries are approximately 6% of all collegiate injuries. Assessing and managing concussions are generally a multifaceted approach (Guskiewicz et al., 2004), but research in this area has been insufficient, especially within the university football population. The purpose of this study was to evaluate symptoms and recovery periods after a concussion was identified in college football players, using balance and a computerized neurocognitive assessment tool. METHODS: Division 1 college football athletes, from 18 to 24 years (n = 166; age, 19.3±1.2 y; height, 183.6±5.5 cm; weight, 102.7±7.6 kg), before fall practice, over a period of 3 years, underwent baseline postural stability testing (sensory organization test [SOT], NeuroCom) and the Impact assessment. Players, who had a concussion (e.g., headache, dizziness, fatigue, confusion, and/or loss of consciousness) during practice or actual competition (n=15, 18.6±.8 y, 185.9±4.5 cm, 107.8±6.6 kg), were reevaluated on both assessments, starting at 24 hours post-concussion. When the player was considered asymptomatic, the test was repeated on the 1st and 7th day. They did retake the online concussion assessment. A control group of non-concussed college males were age-matched to the concussed player. The controls were tested during the same time frame as the concussed players. RESULTS: Results indicated the concussion group had a statistically significant (p = 0.037) change from their baseline SOT (balance) score and the control group (p = 0.025). This change remained significant until day 14 of post-testing. The concussion online assessment also was significant (p=0.41) from their pre-test scores. CONCLUSIONS: The online (Impact) and balance (SOT) assessment tests, if available, should be considered as other methods of evaluating concussed college-aged football players. This information may also provide additional scientific data to aid with the decision for the player to exercise, attend football practice and, possibly, return to play. This study was only one small part of the complete evaluation provided to the decision makers (physicians, coaches, athletic trainers, and strength and conditioning coaches) in the concussed athlete’s return to play.

University Football Players, Postural Stability, and Concussions.

Concussion in football athletes is certainly more prevalent and has potentially serious outcomes. With current concerns and increasing return-to-play issues, additional assessment focus is needed. Division 1 college football athletes, from 18 to 20.9 years (n = 177; age, 19.7 ± 1.2 years; height, 182.3 ± 4.5 cm; weight, 97.3 ± 10.6 kg), before fall practice, over a period of 3 years, underwent baseline postural stability testing (sensory organization test [SOT], NeuroCom). Individuals, who were diagnosed with a concussion (headache, dizziness, fatigue, confusion, or loss of consciousness) during practice or actual competition (n = 15; age, 18.9 ± 0.9 years; height, 181.8 ± 2.5 cm; weight, 86.6 ± 3.6 kg), underwent serial evaluation after injury and 24 hours after concussion. As soon as the player was considered asymptomatic, the test was completed on the first and 14th day. A control group of noninjured male athletes (n = 15; age, 19.1 ± 0.4 years; height, 178.2 ± 3.2 cm; weight, 78.6 ± 2.1 kg) were tested for the same time frame. This particular study was only one part of the total evaluation conducted for the concussed athlete's return to play. Results indicated that the concussion group had a statistically significant (p = 0.037) change from their baseline SOT score and the control group (p = 0.025). This change remained significant until day 14 of posttesting. These data indicate that the SOT, when available, may be a positive additional assessment of concussed college-aged football players. Professionals, when dealing with concussion in competitive sports, do need to continue to work together, but awareness of SOT assessments may also contribute to the return-to-play decisions.

The Influence of Social Status and Power on the Sexual Behavior of Male Collegiate Football Athletes

The purpose of this study was to explore the perceived influence that status and social power have on the sexual behavior of 15 male football players at a Southeastern university. Participants were individually interviewed and findings revealed four major themes concerning college football players: (a) they have a polarizing image among women, (b) their status influences their self-perception and behavior, (c) women are attracted to their status, and (d) they believed women perceived benefits in having sex with them. Understanding the lived experience of college football athletes can aid in further studies of their behaviors as well as the development of programs and services focused on at-risk behavior prevention.

Rates and Determinants of Return to Play After Anterior Cruciate Ligament Reconstruction in NCAA Division 1 College Football Athletes: A Study of the ACC, SEC, and PAC-12 Conferences.

Background:For competitive athletes, return to play (RTP) and return to preinjury levels of performance after anterior cruciate ligament (ACL) reconstruction are the main goals of surgery. Although outcomes of ACL surgery are well studied, details on factors influencing RTP in elite college football players have not been evaluated thoroughly.Purpose:To determine the rate of RTP following ACL surgery among National Collegiate Athletic Association (NCAA) Division 1 collegiate football athletes and to examine variables that may affect these rates. The hypothesis was that the RTP rate in this cohort will be influenced by factors reflecting skill and accomplishment; that is, athletes higher on the depth chart, those on scholarship, and those later in their careers will have higher RTP rates. It was also predicted that graft type and concomitant procedures may have an effect on RTP rates.Study Design:Case series; Level of evidence, 4.Methods:Using athlete- and surgery-specific data from participating institutions in 3 major Division 1 college football conferences, information on athletes who had ACL reconstruction from 2004 through 2010 was collected. Statistical analyses were performed to determine the RTP rate as a function of the variables, such as depth chart position, in the data collected.Results:Of the 184-player cohort, 82% of the athletes, including 94% of starters, were able to RTP. Rates were greater among athletes higher on the depth chart (P = .004) and on scholarship (P = .008). Year of eligibility also affected RTP rates (P = .047), which increased from the redshirt and freshman year to the sophomore and junior years, but then decreased slightly into the senior and fifth-year senior seasons. The use of an autograft versus allograft was associated with increased RTP (P = .045). There was no significant difference (P = .18) between players who underwent an isolated ACL reconstruction versus those who underwent additional procedures.Conclusion:More than 80% of football players at the Division 1 level were able to RTP following ACL reconstruction. Factors representative of a player’s skill were associated with higher rates of RTP. Surgery-specific variables, in general, had no effect on RTP, except for the use of autograft, which was associated with a greater RTP rate.

Rates and Determinants of Return to Play after Anterior Cruciate Ligament Reconstruction in Division 1 College Football Athletes: A Study of the ACC, SEC, and PAC-12

Objectives:In competitive athletes, return to play (RTP) and return to pre-injury levels of performance are the main goals of anterior cruciate ligament (ACL) surgery. RTP has been studied in several athletic populations, such as the National Football League. However, to our knowledge, RTP has not been comprehensively evaluated in Division 1 college football. This study aimed to determine the rate of RTP amongst players in three major Division 1 college football conferences, and to investigate several athlete and surgery related variables that may affect RTP. We hypothesized that rates of RTP would be higher than those previously reported in the National Football League and that graft choice and history of concomitant menisectomy would affect RTP. We also hypothesized that players with more experience, at higher depth chart positions, and/or on scholarship would RTP at higher rates than other players.Methods:Head team orthopaedists and athletic trainers at institutions in the Atlantic Coast Conference, Southeastern Conference, and Pacific 12 Conference were contacted to request their participation in the study. Following IRB approval participating institutions were sent a standardized data collection spreadsheet that asked for RTP and other athlete- and surgery-specific information on all football players undergoing ACL reconstruction from 2004-2010. RTP was defined as an athlete participating in a full practice or official game after the date of his surgery. Athletes whose eligibility expired while injured were excluded from our analysis. Data from each institution was pooled and Chi-square and Fisher Exact tests were used to test the association between any categorical variables and RTP rates.Results:Data from a total of 184 athletes was obtained. The overall rate of RTP was 82% amongst all athletes. 76% of athletes were able to return to a level of play equal or higher than before their injury. Player’s depth chart position before injury did have a significant (p = .0049) association with RTP, with 73% of players who rarely played, 88% of utilized players, and 95% of starters returning to play after surgery. Athletes on scholarship returned to play at a higher rate (88%), than those not on scholarships (69%) (p = .014). Years of experience also had a significant (p = .047) effect on RTP, with freshman RTP at 83%, sophomores at 94%, juniors at 89%, seniors at 73%, and fifth year seniors at 75%. The use of autograft vs. allograft and the specific choice of autograft did not have a significant impact on RTP rates. Players who underwent a menisectomy returned to play at a rate (79%) similar to those who did not have a concomitant menisectomy (84%) (p = .56).Conclusion:The overall rate of RTP in our Division 1 college football athlete cohort was higher than that previously reported in professional football players. Athletes at higher positions on the depth chart and those on scholarship returned to play at higher rates. Year in school also had a significant effect on RTP rates, while the type of ACL graft and the performance of menisectomy did not.

Evaluation of peak skeletal muscle perfusion in the lower extremities of athletes using arterial spin labeling

Background Arterial spin labeling (ASL) magnetic resonance imaging (MRI) allows for evaluation of skeletal muscle perfusion and provides a non-invasive index of vascular function. Previous studies have investigated ASL responses during reactive hyperemia in healthy subjects and patients with peripheral vascular disease; however, ASL has not been applied for assessment of tissue perfusion in athletes. This study evaluated regional differences in peak tissue perfusion among calf muscle groups during reactive hyperemia in college football athletes and compared ASL responses to lower body strength and functional test results. Methods ASL MRI was performed on the mid-calf of 19 male athletes (19.8 ± 1.0 yrs) with a 3T magnet to evaluate peak hyperemic tissue perfusion among individual muscle groups during reactive hyperemia induced by proximal cuff occlusion. Athletes were separated by position (larger linemen vs. smaller position players) for comparison purposes. Athletes’ lower body strength and jumping ability were evaluated and compared to peak skeletal muscle perfusion responses. Results Linemen presented with higher body mass, body fat, and systolic blood pressure (p < 0.05). Athletes did not significantly differ in maximal lower body strength; however, position players had greater vertical and broad jump performance (p < 0.0001). In analysis of all athletes, the soleus muscle, a muscle with traditionally high capillary density, exhibited significantly higher peak perfusion during reactive hyperemia when compared to all other muscle groups (p < 0.05). Additionally, peak perfusion in the 4 calf muscles of interest was significantly greater in position players when compared to linemen and was associated with greater jumping performance. Conclusions ASL MRI offers a non-invasive technique for quantifying regional differences in lower extremity tissue perfusion

Abstract 18596: Regional Assessment of Lower Extremity Tissue Oxygenation in Athletes Using Blood Oxygen Level-Dependent Magnetic Resonance Imaging

Background: Blood oxygen level-dependent (BOLD) MRI allows for evaluation of hemoglobin oxygenation within skeletal muscle, providing a non-invasive index of microvascular function. This study evaluated differences in relative signal intensity of BOLD MRI among lower extremity muscle groups during transient ischemia and reactive hyperemia in college football athletes, while also comparing strength and functional exercise results. Methods: BOLD MRI was performed on the lower leg of 19 males (19.8 ± 1.0 yrs) with a 3T magnet to evaluate regional changes in signal intensity among individual muscle groups during ischemia and reactive hyperemia induced by proximal cuff occlusion. Athletes were separated by position (larger linemen vs. smaller position players) for comparison purposes. The peak hyperemic value (PHV), or the maximum percent change in BOLD signal intensity from baseline, was assessed for each muscle group. Athletes’ lower body strength and jumping ability were evaluated and compared to BOLD responses. Results: Linemen presented with higher body fat and systolic blood pressure (p&lt;0.05). Athletes did not differ in maximal lower body strength; however, position players had greater vertical and broad jump performance (p&lt;0.0001). In analysis of all athletes, the soleus muscle, a slow twitch muscle generally with high capillary density, exhibited the largest PHV. The PHVs of gastrocnemius muscles for position players were significantly higher than linemen (p=0.03) and were associated with greater jumping performance. No differences were observed in other muscle groups when comparing position players and linemen. Conclusions: BOLD MRI offers a non-invasive technique for quantifying regional differences in lower extremity tissue oxygenation in the evaluation of microvascular function in relation to functional performance. Evaluation of changes in BOLD responses may help to evaluate and optimize exercise training for improved function.

Test–retest reliability and responsiveness of gaze stability and dynamic visual acuity in high school and college football players

ObjectivesThe purpose of this study was to establish reliability and responsiveness of the dynamic visual acuity test (DVAT) at head speeds of 150–200 degrees per second (deg/s) and the gaze stabilization test (GST) in high school and college football players. DesignReliability design. ParticipantsFifty high school and college football athletes completed the DVAT and GST in both the yaw (horizontal) and pitch (vertical) planes twice within two weeks. ResultsTest–retest reliability for the DVAT was good in yaw, Intraclass Correlation Coefficient (ICC) = 0.770, and moderate/good in pitch, ICC = 0.725. Minimal detectable change (MDC) was 0.16 logMAR for yaw and 0.21 logMAR for pitch. GST reliability was moderate in yaw, ICC = 0.634, and poor in pitch, ICC = 0.411. MDCs were 73.4 deg/s (yaw) and 81.2 deg/s (pitch). ConclusionsThe DVAT is reliable at high head speeds in high school and college football athletes in both yaw and pitch. GST head speeds were higher than previously reported in the literature, but reliability of this tool for this population was poor to moderate. From a clinical perspective, DVAT may be reliably used in the assessment of high school and college football athletes; however, GST requires further evaluation.

Anthropometric and Performance Changes in NCAA Division III College Football Athletes

Anthropometric and Performance Changes in NCAA Division III College Football Athletes

Effect of Shoulder Stabilization on Career Length in National Football League Athletes

Background: Shoulder instability and surgical stabilization are common in college football athletes. The effect of shoulder stabilization during college on the length of an athlete’s career in the National Football League (NFL) has not been well examined. Hypothesis: Athletes with a history of shoulder stabilization before the NFL combine have a shorter career than do matched controls. Study Design: Cohort study; Level of evidence, 3. Methods: A database containing the injury history and career NFL statistics of athletes from 1987 to 2000 was used to match athletes with a history of shoulder stabilization and no other surgery or significant injury to controls without a history of any previous surgery or significant injury. Athletes were matched by position, year drafted, round drafted, and additional minor injury history. Results: Forty-two athletes with a history of shoulder stabilization were identified and matched with controls. A history of shoulder stabilization significantly reduced the length of career in terms of years (5.2 ± 3.9 vs 6.9 ± 3.6 years; P = .01) and games played (56 ± 53 vs 77 ± 50, P = .03) as compared with controls. By position, linemen and linebackers (20 athletes) with a history of shoulder stabilization had a significantly shorter career in years (4.7 ± 3.8 vs 6.7 ± 3.4 years; P = .049) and games played (51 ± 58 vs 81 ± 48; P = .046) than did controls. Among the other positions (22 athletes), the difference was not statistically significant in this small cohort. Conclusion: A history of shoulder stabilization shortens the expected career of a professional football player, particularly for linemen and linebackers. Further research is warranted to better understand how these injuries and surgeries affect an athlete’s career and what can be done to improve the long-term outcome after treatment.

Evaluation of Iranian College Athletes’ Sport Nutrition Knowledge

The purpose of this study was to assess the nutrition knowledge and the factors determining this knowledge in Iranian college basketball and football athletes. By highlighting gaps in nutrition knowledge of these athletes, sport nutrition professionals may begin to address these gaps by educating athletes with a view toward minimizing injury and enhancing sport performance. Sixty-six basketball and 141 football players (response rate 78.4%) from 4 medical and 8 nonmedical universities in Tehran agreed to participate in this cross-sectional study. A 2-part questionnaire was used; the first part comprised questions identifying demographic information, and the second part comprised a previously well-validated questionnaire on sport nutrition knowledge. The overall knowledge score was 33.2% (+/- 12.3%). Men scored 28.2% (+/- 12.7%), and women, 38.7% (+/- 14.2%). In both genders, the highest score was obtained for the nutrients subcategory, and the supplements subcategory was the most poorly answered. When compared with their peers, a significantly higher score was obtained by women (p < .001), athletes at medical universities (p < .001), and those obtaining nutrition information from reputable sources (p = .03). The coach was cited by 89.4% of athletes as their main source of nutrition information. This study showed that the sport nutrition knowledge of these athletes is inadequate. Considering that this substandard level of knowledge may contribute to poor dietary behaviors, these athletes would benefit from nutrition-related training and education.

Effect of Anterior Cruciate Ligament Reconstruction and Meniscectomy on Length of Career in National Football League Athletes

Background Meniscal and anterior cruciate ligament (ACL) injuries are common in college football athletes. The effect of meniscectomy and/or ACL surgery on the length of an athlete’s career in the National Football League (NFL) has not been well examined. Hypothesis Athletes with a history of meniscectomy or ACL surgery before the NFL combine have a shorter career than matched controls. Study Design Case-control study; Level of evidence, 3. Methods A database containing the injury history and career NFL statistics of athletes from 1987–2000 was used to match athletes with a history of meniscectomy and/or ACL surgery, and no other surgery or major injury, to controls without previous surgeries. Athletes were matched by position, year drafted, round drafted, and additional injury history. Results Fifty-four athletes with a history of meniscectomy, 29 with a history of ACL reconstruction, and 11 with a history of both were identified and matched with controls. Isolated meniscectomy reduced the length of career in years (5.6 vs 7.0; P = .03) and games played (62 vs 85; P = .02). Isolated ACL surgery did not significantly reduce the length of career in years or games played. Comparing the athletes with meniscectomy or ACL reconstruction to athletes with combined ACL reconstruction and meniscectomy, a history of both surgeries, resulted in a shorter career in games started (7.9 vs 35.1; P <.01), games played (41 vs 63; P = .07), and years (4.0 vs 5.8; P = .08) than a history of either surgery alone. Conclusion A history of meniscectomy, but not ACL reconstruction, shortens the expected career of a professional football player. A combination of ACL reconstruction and meniscectomy may be more detrimental to an athlete’s durability than either surgery alone. Further research is warranted to better understand how these injuries and surgeries affect an athlete’s career and what can be done to improve the long-term outcome after treatment.

Predictive Value of Prior Injury on Career in Professional American Football is Affected by Player Position

Background The National Football League holds an annual combine where individual teams evaluate college football players likely to be drafted for physical skills, review players’ medical history and imaging studies, and perform a physical examination. Purpose The purpose of this study was to test the effect of specific diagnoses and surgical procedures on the likelihood of playing and length of career in the league by position. Study Design Cohort study; Level of evidence, 3. Methods A database for all players reviewed at the annual National Football League Combine by the medical staff of 1 National Football League team from 1987 to 2000 was created, including each player's orthopaedic rating, diagnoses, surgical procedures, number of games played, and number of seasons played in the National Football League. Athletes were grouped by position as follows: offensive backfield, offensive receiver, offensive line, quarterback, tight end, defensive line, defensive secondary, linebacker, and kicker. The percentage of athletes who played in the National Football League was calculated by position for each specific diagnosis and surgery. Results The effect of injury on the likelihood of playing in the league varied by position. Anterior cruciate ligament injury significantly lowered the likelihood of playing in the league for defensive linemen (P = .03) and linebackers (P = .04). Meniscal injury significantly reduced the probability of playing (P < .05) and length of career (P = .002) for athletes in the defensive secondary. Shoulder instability had a significant effect on playing in the league for offensive (P = .03) and defensive linemen (P = .02), and shortened the length of career for defensive linemen (P = .016). Spondylolisthesis did not significantly reduce the chance of playing in the league for any position, while a history of spondylolysis had a significant effect for running backs (P = .01). Miscellaneous injuries (eg. acromioclavicular joint, knee medial collateral ligament, carpal fractures) had isolated position-specific effects. Conclusion The significant injuries and diagnoses appear congruent with the position-specific demands placed on the athletes. This information is useful to physicians and athletic trainers caring for college football athletes as well as those assessing these athletes at the National Football League Combine.