National Football League Season Research Articles

Analysis of Concussions Reported in American Professional Football Injury Reports in the 2019 Through 2023 Regular Seasons

ObjectiveThe National Football League (NFL) has seen increasing scrutiny regarding its handling of concussions, especially following an on-field incident involving Miami Dolphins’ (™) Quarterback Tua Tagovailoa in the 2022 Season. The authors hoped to elucidate recent trends in the diagnosis and management of concussions over the course of five NFL seasons across 2019-2023. MethodsThe authors queried NFL injury reports from the 2019 through 2023 database recording players listed with Concussions. Weeks missed were calculated using NFL game logs. Player’s concussions that did not occur in games, complicated by other injuries, or roster status were excluded. ResultsSearches of NFL injury reports resulted in the identification of 664 of 692 (96%) concussions that occurred in regular season games across the 2019-2023 seasons. Over the course of these five seasons 31% of players returned without missing a game, 39% of players missed one game, and 30% of players missed two or games. No significant difference in the number of concussions per game or weeks missed was observed across the seasons observed. Players with concussions on teams that made the playoffs saw less weeks missed than those on non-playoff teams (0.86 v. 1.37, p=0.002). ConclusionsSince the start of the 2021 NFL season, an increasing incidence of concussions has been noted, yet there was no change observed in the number of weeks missed following concussions. Trends in the rates of concussions across seasons remain largely stable, despite increased scrutiny over concussions in the sport.

Epidemiologic trends in hand injuries in the National Football League from 2009-2010 to 2019-2020

ABSTRACT Objectives In American football, hand injuries have been shown to negatively impact performance. The purpose of this study is to characterize the prevalence and severity of hand injuries in National Football League (NFL) players. Methods A public online database was utilized to identify hand injuries in NFL players from 2009–2010 to 2019–2020. The primary outcome was to analyze the overall incidence of hand injuries (including wrist, metacarpus, finger, and thumb), injury type by each aforementioned anatomic location, and player position. Injury severity was evaluated based on percentage of injuries in which players returned to play (RTP), number of games missed before RTP, and the percentage of injuries resulting in the player being placed on injured reserve (IR). Results Of the 6,127 players included, 847 (13.8%) players sustained a hand injury, of which 24.8%, 34.3%, 17.9%, and 22.9% occurred at the wrist, metacarpus, finger, and thumb, respectively. Of the injured players, 97.4% returned to play following their injury, 14.8% were put on IR, and an average of 1.7 (SD 3.3) games were missed. Quarterbacks were the most likely to sustain hand injuries at all anatomic locations. Wrist injuries were associated with the lowest RTP rate (93.3%), the most players placed on injured reserve (28.6%), and the greatest number of games missed (mean 2.5, SD 4.2). Conclusion Hand injuries decreased in prevalence by 65.6% over the 11 NFL seasons evaluated. This trend coincides with the implementation of several safety rules that relate to components of play involving the hands. Quarterbacks experienced the greatest prevalence and severity for all hand injuries. Wrist injuries represent the anatomic location associated with the greatest severity. These findings may be able to inform tailored injury prevention practices by position, and advocate for the further adoption of safety rules to protect players from further injury.

Effects of COVID-19 on Rate of Injury and Position-Specific Injury During the 2020 National Football League Season.

Costello II, JP, Wagner, JD, Dahl, VA, Cohen, JL, Reuter, AM, and Kaplan, LD. Effects of COVID-19 on rate of injury and position-specific injury during the 2020 National Football League season. J Strength Cond Res XX(X): 000-000, 2023-Because of the COVID-19 pandemic, the National Football League (NFL) made changes to its operations for the 2020 season. We hypothesize an increase in the rate of injuries during the 2020 season. Publicly available data were reviewed to identify NFL injuries from the 2015-2020 seasons. Player position, description of injury, date of injury, and injury setting were recorded. p ≤ 0.05 was considered statistically significant. For the 2020 season, compared with the 2015-2019 seasons, there was an increased risk of injury during the regular season overall relative risk (RR) = 1.308 (p < 0.05), week (W)1 RR = 7.33 (p < 0.05), W1-6 RR = 1.964 (p < 0.05), W7-12 RR = 1.8909 (p < 0.05), and during the postseason overall RR = 1.1444 (p < 0.05), calculated using analysis of variance. There was an overall increased risk of abdominal or core injuries RR = 1.248 (p < 0.05), groin or hip injuries RR = 2.534 (p < 0.05), and hamstring injuries RR = 3.644 (p < 0.05). There was an increased risk of hamstring injuries in cornerbacks RR = 3.219 (p < 0.05) and running backs RR = 1.1394 (p < 0.05), hip or groin injuries in guards RR = 1.105 (p < 0.05), Achilles tendon injuries in safeties RR = 1.6976 (p < 0.05), quadriceps injuries in running backs RR = 1.6191 (p < 0.05), and arm injuries in defensive tackles RR = 1.221 (p < 0.05). There was an increase in the overall rate of injuries in the 2020 NFL season, both in the regular season and postseason, compared with the 2015-2019 seasons. The overall rate of abdominal or core, groin or hip, and hamstring injuries increased. Specific player positions saw unique increases in rates of injuries. These findings may be due to numerous operational changes implemented, such as reduced in-person training and the elimination of the preseason, leading to suboptimal, sports-specific conditioning and increased risk of musculoskeletal injury.

Association of Injury Rates Among Players in the National Football League With Playoff Qualification, Travel Distance, Game Timing, and the Addition of Another Game: Data From the 2017 to 2022 Seasons.

Injury incidence is higher in the National Football League (NFL) than in other collision sports. Although previous research has identified that scheduling variations, including overseas games and bye week timing, does not affect concussion risk, data are currently lacking regarding the effects of scheduling variation on season-long musculoskeletal injury incidence. To determine whether higher cumulative travel distance, overseas play, an early season bye week, and an expansion of the regular season is associated with higher injury rates in the NFL. Descriptive epidemiology study. All 1275 injuries across 5 NFL seasons from 2017 to 2018 through 2021 to 2022 were reviewed retrospectively. Injury data and travel distances were extracted from publicly available sources, which were cross-referenced for validation. Injury rates were calculated per 1000 athletic-exposures (AEs). Cumulative team travel distances were compared statistically using a linear regression. Single factor analysis of variance was used to compare categorical variables. Travel distance did not significantly predict injury rates (P = .47), and there was no difference in injury rates between teams that played a game overseas versus teams that did not (19.3 injuries per 1000 AEs for both; P = .96). In addition, no difference was found in injury rates (F[109,2100[ = 0.704; P = .73) or players placed on the injured reserve list (F[99,778] = 1.70; P = .077) between various bye weeks (P = .73). Injury rates did not differ between the new 17-game regular season (18.4 per 1000 AEs) versus the previous four 16-game regular seasons (19.7 per 1000 AEs; P = .12). However, teams that did not qualify for the playoffs had a significantly higher injury rate (19.9 per 1000 AEs) as well as players on injured reserve (8.0 per 1000 AEs) than playoff-qualifying teams (18.4 and 6.8 per 1000 AEs, respectively; P < .05 for both). Over 5 NFL seasons, cumulative travel distance, overseas play, bye week timing, and adding 1 regular season game were not associated with increased injury rates in NFL players. However, a lack of regular season success was associated with higher injury rates and more players on injured reserve.

Prophylactic Knee Bracing in Offensive Linemen of the National Football League: A Retrospective Analysis of Usage Trends, Player Performance, and Major Knee Injury.

Offensive linemen in American football are prone to high-energy valgus forces to the knee, leading to associated injuries. Some offensive linemen in the National Football League (NFL) wear prophylactic knee braces (PKB) to prevent ligamentous injury. This purpose of the study was to compare injury rates and performance between NFL offensive linemen who wear PKB and those who do not. It was hypothesized that brace wear would be associated with fewer major knee injuries and no difference in gameplay performance. Cohort study; Level of evidence, 3. For the 2014 through 2020 NFL seasons, offensive linemen with at least 200 game snaps per regular season were identified. Players were grouped by PKB status (bracers vs nonbracers) based on visualization of bilateral, dual-hinged metal knee braces as part of gameday uniforms on publicly available imaging databases and/or game videos. Major knee injuries, defined as those requiring the missing of games, were identified using publicly available data. Performance was assessed with Pro Football Focus grades for each season. Rates of major knee injury were compared between groups with the 2-sample Z test for proportions, and performance grades were compared with the unpaired t test. For the cumulative study period, bracers demonstrated a significantly lower rate of major knee injuries than nonbracers (0.013 vs 0.049 injuries per player, respectively; P = .04). Isolated MCL injury was the most common injury for nonbracers. There was no group difference in performance for the cumulative study period or during most individual seasons. Yearly prevalence of PKB usage declined steadily from 16.3% in 2014 to 5.6% in 2020. A subgroup analysis of rookie players demonstrated an overall downtrend in usage during the study period as well. Results indicated that knee brace prophylaxis by NFL offensive linemen was associated with a reduced risk of major knee injury without a significant difference in performance when compared with nonbracers. Despite this, the prevalence of PKB declined over the study period.

Lower Extremity Strains in the US National Football League, 2015-2019

Background: Lower extremity (LEX) strains, including hamstring, quadriceps, adductor, and calf strains, are among the most common injuries in sports. These injuries lead to high burden, resulting in significant missed participation time. Purpose: To describe the incidence of LEX strains in professional American football. Study Design: Descriptive epidemiology study. Methods: This study included all players who played in ≥1 National Football League (NFL) game or sustained a LEX strain during participation in the 2015-2019 seasons. LEX strain frequency was calculated by setting (game, practice, conditioning), timing in season (offseason, preseason, regular season, postseason), and roster position. Game incidence rates were calculated for season, roster position, and play type. LEX strains were identified in the standardized leaguewide electronic health record (n = 32 teams). Results: Across 5 years, 5780 LEX strains were reported among 2769 players (1-year risk, 26.7%; 95% CI, 26.0%-27.3%); 69% (n = 4015) resulted in time loss. Among all LEX strains, 54.7% were hamstring (n = 3163), 24.1% adductor (n = 1393), 12.6% calf (n = 728), 8.3% quadriceps (n = 477), and 0.3% multiple muscle groups (n = 19). Most were reported during preseason practices (n = 1076; 27%) and regular season games (n = 1060; 26%). The 2-week period of training camp practices comprised 19% of all time-loss strains. Among game injuries, preseason games had the highest rate of LEX strain (2.9/10,000 player-plays; 95% CI, 2.6-3.2). Defensive secondary players accounted for the highest proportion of time-loss LEX strains (27%; n = 1082). In games, punt plays had nearly twice the injury rate of kickoff plays (14.9/1000 plays [95% CI, 13.1-17.0] vs 7.5/1000 plays [95% CI, 6.2-8.9], respectively) and >3 times the rate of pass plays (4.3/1000 plays; 95% CI, 4.0-4.7) and run plays (2.6/1000 plays; 95% CI, 2.3-2.9). In aggregate, LEX strains led to an estimated 16,748 participation days missed each year and a median 12 days missed per injury. Conclusion: LEX strains affected 1 in 4 NFL players each year, resulting in a high burden of injury in terms of time lost from practice and competition. Safe return to the NFL season during training camp and reduction of injuries during regular season games are key focuses for future injury reduction.

Tom Brady and Simeon Poisson: An Unlikely Duo

Seven-time Super Bowl champion Tom Brady announced his retirement from the National Football League (NFL) on February 1, 2022. Forty days later, he changed his mind about retiring.&#x0D; Tom Brady’s records through twenty-two NFL seasons are numerous and well known to fans of professional football. During his first twenty seasons with the New England Patriots and, more recently, the Tampa Bay Buccaneers, the number of Tom Brady touchdown passes per game has something in common with a nineteenth century French mathematician, engineer, and physicist, Siméon Denis Poisson (1781 – 1840).&#x0D; In this paper, the authors hypothesize that the number of Tom Brady touchdown passes per regular season game (all games, wins or losses) and the corresponding number per playoff game (all games, wins or losses) have followed a Poisson probability distribution. The close correspondence of these statistics to a Poisson distribution is stunning and astonishing, two words that have also been used to describe the 44-year-old quarterback during his playing career.&#x0D;

Sportsbooks Record Historic Rout of Betting Public in September

Sportsbooks across the United States enjoyed a record-setting September when it came to gross revenue thanks in large part to a spate of unexpected results in the first three weeks of the National Football League (NFL) season that confounded bettors. The house won single-event wagers at historic levels while the public's continued interest in parlays further played into operators' hands as win rates from those bets reached stratospheric highs.

Optimizing the Expected Maximum of Two Linear Functions Defined on a Multivariate Gaussian Distribution

We study stochastic optimization problems with objective function given by the expectation of the maximum of two linear functions defined on the component random variables of a multivariate Gaussian distribution. We consider random variables that are arbitrarily correlated, and we show that the problem is NP-hard even if the space of feasible solutions is unconstrained. We exploit a closed-form expression for the objective function from the literature to construct a cutting-plane algorithm for a highly nonlinear function, which includes the evaluation of the cumulative distribution function and probability density function of a standard normal random variable with decision variables as part of the arguments. To exhibit the model’s applicability, we consider two featured applications. The first is daily fantasy sports, where the algorithm identifies entries with positive returns during the 2018–2019 National Football League season. The second is a special case of makespan minimization for two parallel machines and jobs with uncertain processing times; for the special case where the jobs are uncorrelated, we prove the equivalence between its deterministic and stochastic versions and show that our algorithm can deliver a constant-factor approximation guarantee for the problem. The results of our computational evaluation involving synthetic and real-world data suggest that our discretization and upper bounding techniques lead to significant computational improvements and that the proposed algorithm outperforms suboptimal solutions approaches. History: Andrea Lodi, Area Editor for Design &amp; Analysis of Algorithms–Discrete. Supplemental Material: The online appendix is available at https://doi.org/10.1287/ijoc.2022.1259 .

Injury Rates Remained Elevated in the Second National Football League Season After the Onset of the COVID-19 Pandemic

The purpose of this study is to compare the injury incidence of the 2018-2019 and 2020 National Football League (NFL) seasons with the 2021 season. Publicly released NFL weekly injury reports were queried to identify players listed as "out" or placed on injured reserve (IR) for at least one game in the 2018-2021 seasons. Injuries were then categorized into upper extremity, lower extremity, spine/core, and head. Incidence per 1,000 athlete exposures were calculated for each season and proportions of injuries by position were calculated separately for the 2018-2019, 2020, and 2021 cohorts. Incidence rate ratios (IRR) were used to compare injury rates. Overall injury incidence in the 2021 NFL season increased compared to the pre-COVID-19 seasons (2018-2019) in all anatomical zones except for the upper extremity. [28.70 vs. 23.09 per 1,000 exposures, IRR 1.24 (95% CI: 1.14-1.36); p< 0.001]. The injury rate remained elevated and further increased in 2021 compared to the 2020 season for all anatomical zones other than the spine/core [28.70 vs. 21.64 per 1,000 exposures, IRR 1.33 (1.19-1.47); p< 0.001]. No significant difference existed during the early season (weeks 1-4); however, injury rates after week 4 increased in 2021 compared to both the 2018-2019 and 2020 seasons. The injury incidence in the 2021 season remained elevated and increased further compared to both the 2018-2019 and 2020 seasons. Traumatic injuries resulting in missed games increased despite return to a more traditional season since the beginning of the COVID-19 pandemic. The injury rates significantly increased in mid- to late season. III, cross-sectional study.

Association of National Football League Fan Attendance With County-Level COVID-19 Incidence in the 2020-2021 Season

The 2020-2021 National Football League (NFL) season had some games with fans and others without. Thus, the exposed group (ie, games with fans) and the unexposed group (games without fans) could be examined to better understand the association between fan attendance and local incidence of COVID-19. To assess whether NFL football games with varying degrees of in-person attendance were associated with increased COVID-19 cases in the counties where the games were held, as well as in contiguous counties, compared with games without in-person attendance for 7-, 14-, and 21-day follow-ups. This cross-sectional study used data for all 32 NFL teams across the entirety of the 2020-2021 season. Separate daily time-series of COVID-19 total cases and case rates were generated using 7-, 14-, and 21-day simple moving averages for every team and were plotted against the actuals to detect potential spikes (outliers) in incidence levels following games for the county in which games took place, contiguous counties, and a combination. Outliers flagged in the period following games were recorded. Poisson exact tests were evaluated for differences in spike incidence as well across games with different rates of attendance. The data were analyzed between February 2021 and March 2021. Games with fan attendance vs games with no fan attendance, as well as the number of fans in attendance for games with fans. The main outcome was estimation of COVID-19 cases and rates at the county and contiguous county level at 7-, 14-, and 21-day intervals for in-person attended games and non-fan attended games, which was further investigated by stratifying by the number of persons in fan-attended games. This included a total of 269 NFL game dates. Of these games, 117 were assigned to an exposed group (fans attended), and the remaining 152 games comprised the unexposed group (unattended). Fan attendance ranged from 748 to 31 700 persons. Fan attendance was associated with episodic spikes in COVID-19 cases and rates in the 14-day window for the in-county (cases: rate ratio [RR], 1.36; 95% CI, 1.00-1.87), contiguous counties (cases: RR, 1.31; 95% CI, 1.00-1.72; rates: RR, 1.41; 95% CI, 1.13-1.76), and pooled counties groups (cases: RR, 1.34; 95% CI, 1.01-1.79; rates: RR, 1.72; 95% CI, 1.29-2.28) as well as for the 21-day window in-county (cases: RR, 1.49; 95% CI, 1.21-1.83; rates: RR, 1.50; 95% CI, 1.26-1.78), in contiguous counties(cases: RR, 1.37; 95% CI, 1.14-1.65; rates: RR, 1.45; 95% CI, 1.24-1.71), and pooled counties groups (cases: RR, 1.41; 95% CI, 1.11-1.79; rates: RR, 1.70; 95% CI, 1.35-2.15). Games with fewer than 5000 fans were not associated with any spikes, but in counties where teams had 20 000 fans in attendance, there were 2.23 times the rate of spikes in COVID-19 (95% CI, 1.53 to ∞). In this cross-sectional study of the presence of fans at NFL home games during the 2020-2021 season, results indicated that fan attendance was associated with increased levels of COVID-19 in the counties in which the venues are nested within, as well as in surrounding counties. The spikes in COVID-19 for crowds of over 20 000 people suggest that large events should be handled with extreme caution during public health event(s) where vaccines, on-site testing, and various countermeasures are not readily available to the public.

Surgically Treated Pectoralis Major Tears Impact the Play and Performance of National Football League Athletes

Purpose: To evaluate the return-to-play rate and performance level changes in National Football League (NFL) athletes after a surgically treated pectoralis major muscle (PMM) tear.Methods: A descriptive epidemiologic study was conducted. All NFL players from 1933 to 2013 were reviewed for surgically treated PMM tears. Age at injury, height, weight, body mass index, date of injury, position played, draft selection, and total seasons played were recorded. Return to play was assessed for the entire cohort, as well as by position. Performance analysis before and after injury was also conducted for the entire cohort, as well as by position and draft selection. Data analysis was performed with the paired-samples t test, with P < .05 considered statistically significant.Results: Our review of 80 NFL seasons from 1933 to 2013 provided a total of 55 instances of PMM tears. All instances occurred between the time frame of 2004 and 2012. After exclusions, 24 instances unique to 24 NFL athletes were confirmed by 2 separate investigators and these athletes were included as our final study cohort. Of the 24 players identified to have a surgically repaired PMM tear, 20 (83%) returned to play. The mean return-to-play period was 302 ± 128 days. The mean difference in performance scores before versus after PMM injury was 171.33 and was statistically significant, with P = .0330.Conclusions: In this study, there was an 83% return-to-play rate after surgical repair of PMM tears. Although we found a statistically significant decrease in player performance after surgery, this difference was no longer seen after players were stratified by position type and draft selection.Level of Evidence: Level IV, therapeutic case series.

Computing the Number of Winning NFL Survivor Pool Entries

The average number of winning survivor pool entries is computed for the 2019 National Football League (NFL) season. The probability of having to share the winning pot, given realistic expectations on game outcomes, is also shown.

Drafting strategies in fantasy football: A study of competitive sequential human decision making

AbstractDrafting is a competitive task in which a set of decision makers choose from a set of resources sequentially, with each resource becoming unavailable once selected. How people make these choices raises basic questions about human decision making, including people’s sensitivity to the statistical regularities of the resource environment, their ability to reason about the behavior of their competitors, and their ability to execute and adapt sophisticated strategies in dynamic situations involving uncertainty. Sports provides one real-world example of drafting behavior, in which a set of teams draft players from an available pool in a well-regulated way. Fantasy sport competitions provide potentially large data sets of drafting behavior. We study fantasy football drafting behavior from the 2017 National Football League (NFL) season based on 1350 leagues hosted by the http://sleeper.app platform. We find people are sensitive to some important environmental regularities in the order in which they draft players, but also present evidence that they use a more narrow range of strategies than is likely optimal in terms of team composition. We find little to no evidence for the use of the complicated but well-documented strategy known as handcuffing, and no evidence of irrational influence from individual-level biases for different NFL teams. We do, however, identify a set of circumstances for which there is clear evidence that people’s choices are strongly influenced by the immediately preceding choice made by a competitor.

Return to Full Participation Following Concussion in the National Football League, 2015 Through 2020.

Quantify days missed, games missed, injury burden, and time to return to full participation (RTFP) among National Football League (NFL) players who sustained a concussion. Retrospective cohort study. 2015 through 2020 NFL seasons. National Football League players diagnosed with a concussion from 2015 to 2020. National Football League-mandated graduated RTFP protocol. Days missed, games missed, burden, and time to RTFP, overall and by position. An annual average of 3639 player-days of participation and 255 games were missed across NFL because of concussion. Concussed players missed a median of 9 days (mean = 15.0), a relatively stable metric over 6 years, with slight variation by position. Offensive linemen, tight ends, running backs, and linebackers missed the most days per concussion; defensive secondary, offensive linemen, and wide receivers sustained the highest injury burden. Postconcussion, 59% of players missed one or more scheduled games. Among players concussed in a Sunday game, 38% played in a Sunday game one week later. The 9-day median time missed post-concussion may be related to emphasis on graduated phase-based concussion management. No concussed player returned to competition on the day of injury, and less than 40% participated in games the following week. Further work is needed to better understand characteristics of concussions that take longer to return and movement through stages of return.

Effect of COVID-19 on Injury Rates and Timing in the National Football League.

Background:The coronavirus 2019 (COVID-19) pandemic resulted in the cancellation of the 2020 National Football League (NFL) preseason and a decreased preseason roster size. The effect of this disruption on athlete injury rates is unknown.Purpose/Hypothesis:The purpose was to quantify the rates of anterior cruciate ligament (ACL), Achilles tendon, and hamstring tendon injuries in NFL players before and after the COVID-19 pandemic. We hypothesized that injury rates in the 2020 season would be higher than those seen prepandemic.Study Design:Descriptive epidemiology study. Level of evidence, 4.Methods:An online search using publicly available data was carried out to identify all NFL players who sustained an ACL, Achilles tendon, or hamstring tendon injury between April 1, 2017, and March 31, 2021. Data collected included player characteristics as well as career and season of injury workloads.Results:The number of Achilles tendon (27 vs 20; P = .024) and hamstring tendon (186 vs 149; P < .001) injuries, respectively, in the 2020 NFL season were significantly higher than the average of the 2017 to 2019 seasons. However, the number of ACL injuries sustained remained constant (43 vs 46; P = .175). More than half (52.9%) of ACL injuries in the 2017 to 2019 seasons occurred in the preseason, while most of the injuries (34.9%) in the 2020 season occurred in weeks 1 to 4. There was no player characteristic or career workload variable collected that was significantly different for players who sustained an ACL, Achilles tendon, or hamstring tendon injury in the 2020 NFL season compared with the 2017 to 2019 seasons.Conclusion:In the 2020 NFL season, the number of Achilles tendon and hamstring tendon injuries rose while the number of ACL injuries remained constant compared with the 2017 to 2019 seasons. Injuries that occurred during the first 4 games of the 2020 NFL season were consistent, with higher rates of injuries seen in the preseason in previous years.

Increased Regular Season Soft Tissue Injury Rates in National Football League (NFL) Players May Be Associated With the Canceled 2020 NFL Preseason Due to COVID-19.

IntroductionThe purpose of this study is to evaluate the rates of regular season soft tissue injuries in National Football League (NFL) players during the 2020 season, which had a canceled preseason due to the COVID-19 pandemic.MethodsThis study retrospectively reviewed the injury rates of the 2020-2021 NFL regular season in comparison to the 2018-2019 NFL regular season using publicly available injury data. The focus of our analysis was comparing the following soft tissue injuries: hamstring, groin, calf, quadriceps, thigh, knee - anterior cruciate ligament (ACL), pectoral, and Achilles. The week of injury occurrence, duration of injury in weeks, position of the injured player, and age of the NFL player at injury were obtained. Injury rates were calculated per 1000 athletic exposures with 95% confidence intervals (CIs). A chi-square test and Student’s t-test were utilized as appropriate.ResultsThere were 1370 total injuries in the 2018-2019 regular NFL season and 2086 total injuries reported in the 2020-2021 regular NFL season. The total number of injuries per 1000 athletic exposures was significantly higher in the 2020-2021 NFL season compared to the 2018-2019 NFL season (88.57 versus 58.17, p < 0.001). The rates of injuries per 1000 athletic exposures for hamstring (9.98 versus 5.31, p = 0.043), groin (5.56 versus 2.46, p = 0.007), calf (4.08 versus 1.61, p = 0.006), quadriceps (2.00 versus 0.72, p = 0.030), and thigh (1.23 versus 0.30, p = 0.012) injuries were significantly higher in the 2020-2021 regular NFL season compared to the 2018-2019 NFL regular season.ConclusionsThe 2020-2021 NFL season had a significantly higher incidence of soft tissue injuries compared to the 2018-2019 regular NFL season, which may have been associated with the absent preseason due to the COVID-19 pandemic and an abrupt increase in the athletic workload of players.

COVID-19 Return to Sport: NFL Injury Prevalence Analysis

BackgroundSport injuries have been common among athletes across the globe for decades and have the potential to disrupt athletic careers, performance, and psyche. Many health professionals and organizations have undertaken injury mitigation strategies to prevent sport injuries through protective equipment, training protocols, and a host of other evidence-based practices. Many of these specialized training methods were disrupted due to protocols to mitigate the spread of COVID-19. This research examines the effects of the COVID-19 pandemic in relation to the prevalence of athletic injuries in the National Football League (NFL).ObjectiveDuring the COVID-19 pandemic, NFL teams and athletes across all levels of sport were reported to have reduced training in preparation for their seasons due to protocols to mitigate the spread of COVID-19. This study compares the prevalence of injury during the 2018, 2019, and 2020 NFL seasons, with the aim to determine the potential causes of the differences in injury prevalence.MethodsOfficial injury reports from each team were counted during the 17-week regular season of each year (2018, 2019, and 2020). The data were analyzed using an unpaired t test to compare the injury prevalence between each of the three seasons.ResultsThe 2018 season produced a total of 1561 injuries and a mean of 48.8 injuries per team. The 2019 season produced a total of 1897 injuries and a mean of 59.3 injuries per team, while the 2020 season produced a total of 2484 injuries and a mean of 77.6 injuries per team. An unpaired t test was performed using the data to compare the mean number of injuries per team during each of the seasons. Comparison of the 2020 season against the 2019 season showed a statistically significant difference (P<.001); comparison of the 2020 season to the 2018 season found a statistically significant difference (P<.001); and comparison between the 2019 and the 2018 seasons found a statistically significant difference (P=.03).ConclusionsAlthough the 2019 and 2018 seasons showed a statistically significant difference (P=.03), this difference is not as large when we compare the 2020 seasons versus the 2019 (P<.001) and 2018 (P<.001) seasons. The astronomical increase in injury prevalence during the 2020 season over the previous years raises the possibility that there was a reduced physiological adaptation to stress, due to the limited amount of training as a result of the closure of practice facilities in order to slow the spread of COVID-19.

Anthem Protests, Viewer Politics, and the Demand for NFL Games: Assessing the Impact of National Anthem Protests on Viewership

This paper analyzes the effect of anthem protests on viewership for National Football League (NFL) games controlling for measures of NFL market-specific political beliefs and other demand determinants. To capture the effect of the protests on viewership, we create two classes of protests (unambiguous and ambiguous protests) and support the classification based on the meaning of the protest, actions by NFL owners, and statements by Donald Trump. Using data from all early and late-afternoon Sunday games from the 2014 through 2017 regular NFL seasons, we show that: (1) unambiguous protests reduce viewership in the week following the protests by about 15% while ambiguous protests do not generally produce statistically significant reductions in viewership; (2) the negative effect of unambiguous protests on viewership is particularly strong in metro locations that voted more heavily for Donald Trump in 2016; and (3) following Donald Trump's statements in week 3 of the 2017 season, both ambiguous and unambiguous protests increased and the increase in ambiguous protests was particularly large.

ACL Tears in the National Football League From 2013 to 2020: Analysis of the 2020 Season After Delays and Schedule Changes From the Early COVID-19 Pandemic Relative to Prior Seasons.

Background:The impact of fatigue and preseason preparation on anterior cruciate ligament (ACL) tears in the National Football League (NFL) are not well described. The 2020 NFL season did not include the standard preseason in response to changes secondary to the coronavirus disease-2019 (COVID-19) pandemic.Purpose:To evaluate the association of game play on ACL tears in NFL athletes and to determine if differences in ACL tear epidemiology were present based on season of play from 2013 to 2020.Study Design:Descriptive epidemiology study.Methods:ACL tears in NFL athletes were identified using publicly available data. Games played and snap counts at the time of injury were recorded for each athlete sustaining game-related injuries. Tear rates were determined, and injuries were also calculated per 1000 athlete-exposures. Incidence rate ratios (IRRs) with 95% confidence intervals (CIs) were calculated.Results:Overall, 379 ACL tears were identified, including 256 (67.6%) during game play and 118 (31.1%) during practice. Practice-based injuries were significantly higher in the preseason versus the remainder of the season. Games and snaps at the time of injury did not differ by year. The incidence rate of preseason injuries was significantly greater relative to in-season injuries (IRR = 2.68; 95% CI, 2.18-3.29; P < .00001). There was an elevated incidence rate of in-season injuries in 2020 relative to 2014-2019 combined (IRR = 1.49; 95% CI, 0.98-2.19; P = .048). In 2013 to 2019, the most frequent month of injury was the first month of the preseason in August (119/334 tears; 35.6%), whereas in 2020, the most frequent month was September (13/41 tears, 31.7%). The proportion of tears in September 2020 was not different from the proportion of tears in August 2013 to 2019.Conclusion:There was an increased proportion of in-season ACL tears in the 2020 NFL season relative to 2014 to 2019; this is attributable to a frameshift in the consistent trend of injuries in the 1st month to return of competitive play, with 2020 being in the regular season in September as opposed to the preseason in August.