The number of diagnosed concussions NFL players suffered in 2018 dropped significantly, indicating that a heightened effort this season -- which included two much-discussed rules changes -- might have contributed to the difference.
The numbers, released by the league on Thursday, show a 24 percent decrease in concussions during the preseason and regular season, from 281 in 2017 to 214 this season. The drop was particularly noteworthy in the regular season, when the number of diagnosed concussions went from 190 in 2017 to 135 in 2018 -- a 29 percent decrease. That means the average team would suffer a concussion to a player once every fourth game, while in 2017, it was once every third game.
This is good news after 2017, when the league was startled by a spike in concussion figures. The NFL's medical officials, though, caution that it is too soon to know what caused the shift. The league's health and safety specialists will spend the next few weeks analyzing the data. By the time the league gathers for the NFL Scouting Combine in late February, a clearer picture of what led to the decrease should emerge.
"We're certainly pleased with the progress on concussion reduction," said Jeff Miller, the NFL's executive vice president for health and safety. "There is a lot more work to do."
The controversial rule to prevent using the helmet to initiate contact was put in place last offseason in response to the 2017 concussion data, and Competition Committee officials have admitted that its administration and enforcement has been more complicated than expected. After the rule was closely enforced during the preseason, sparking criticism from players, coaches and fans alike, enforcement seemed to ease during the year. Rich McKay, the chairman of the Competition Committee, said late in the 2018 regular season that the offseason would be spent educating officials and teams about how the league wants the rule enforced. There were also changes made to the kickoff -- eliminating, for instance, the wedge and the running start -- in an effort to improve the safety of what many consider the game's most dangerous play.
The league has also made a point of encouraging the use of more advanced helmets, and 74 percent of players now use them, a big jump from the 41 percent who used them in 2017. That number will rise again next year, because the lowest-performing helmets will be banned. The number of sideline concussion evaluations during games remained high -- 538 -- even though 75 percent of those evaluations did not result in a concussion diagnosis.
"We continue to emphasize an extremely conservative approach," said Dr. Allen Sills, the NFL's chief medical officer. "If they even suspect someone is concussed, we screen that player."
The league is planning to introduce other initiatives this year, including a pilot program that will place sensors in the mouthguards of players on four teams to collect even more detailed data about the kinds of impact that cause concussions and a challenge launching this spring to redesign helmets for improved safety.
Also, the Competition Committee will consider the ideas from a crowd-sourced project to make the punt safer. Four finalists will present their ideas to a panel during Super Bowl week in Atlanta.
While much of the public attention in recent years has focused on concussions, knee injuries continue to bedevil players, and the league was less pleased with the data on those. The number of ACL and MCL tears remained largely flat over a seven-year span, with players suffering 57 ACL tears in 2018. Miller said the NFL is concerned that the number of lower-extremity injuries -- damage to knees, ankles and hamstrings, for example -- is not declining.
Sills said that the league believes the data-driven approach it has incorporated to address concussions could be used to drive down the number of lower-extremity injuries. By the end of the year, the NFL plans to put in place a program to analyze, among other things, cleat patterns and different playing surfaces, as well as the timing of player training.