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2020 Preseason Injury Data: Key Takeaways

Each fall, the NFL analyzes and shares preseason injury data as a part of the league's ongoing efforts to advance the health and safety of players. The injury data are compiled and analyzed by IQVIA, an independent, third-party company retained by the NFL. The league analyzes injuries throughout the season, compares that data to trends over time and shares findings with the NFL, the NFL Players Association (NFLPA) and the NFL medical and football committees.

Due to the COVID-19 pandemic, the 2020 preseason was markedly different from prior years, with no preseason games and an altered training camp schedule. Despite those differences, there are lessons to be learned from this data as the league works to reduce injuries of all types.

Compared to previous NFL preseasons, the 2020 preseason saw a much longer ramp-up period in which players were participating in conditioning and other non-football activities but were not practicing on the field. Due to COVID impacts, the summer of 2020 also saw no off-season organized team activities and many players were unable to access gyms or their usual training equipment.

The 2020 preseason injury data include statistics on injuries occurring during preseason practices, including concussions, ACL and MCL injuries. Over the next several months, the league's medical and engineering experts will use the data to consider how equipment, protocols and rules changes are impacting player safety.

Although the league is laser-focused on mitigating risk around COVID-19 and keeping players safe from the virus, work on preventing and treating concussion and other injuries, especially soft tissue injuries, remains ongoing and of the utmost importance to the NFL and its medical committees in 2020.

There are three key takeaways from the 2020 preseason injury data.

1 – Number of total injuries during 2020 preseason practices was similar to the five-year trend

The total number of injuries, including MCL and ACL tears and concussions, during preseason practices in 2020 was similar to the numbers seen over the last five years. This year's preseason practices saw 30 concussions, 11 ACL tears and 16 MCL tears. From 2016-2020, the averages were 35.2 concussions, 10.4 ACL tears and 13.8 MCL tears.

"It is a credit to our clubs, players, coaches and medical staffs that despite this unusual off-season and the added challenges of getting into shape without our usual routines, we did not see an increase in injuries during preseason practices," said NFL Chief Medical Officer Dr. Allen Sills.

Further study will include bringing this injury data together with player performance data the league collects to better understand the context under which these injuries occurred. The league is also analyzing how changes to the preseason may have impacted injuries during the regular season.

"We're looking at ACL and MCL tears in a more holistic way as we evaluate them going forward," said Dr. Sills. "We want to understand their full context so we're looking at the video, combining that with imaging of the injury, considering the relevant equipment used, and taking a comprehensive look at how and why these injuries are happening on the field."

The league also has multi-year injury reduction strategies designed to reduce knee ligament injuries, ankle injuries and soft-tissue strains. To that end, the league is tracking the cleats worn by every player and the relative injury rates, working to better understand synthetic turf systems and encouraging innovation in this area, analyzing injuries and evaluating how to improve training regimens during preseason and the start of the season when there are often spikes in injuries, and partnering with the NFL's medical committee to study knee ligaments.

2 – Incidence of concussion was identical to last year

Incidence of concussion was flat year over year with 30 concussions occurring during preseason practice in both 2019 and 2020. In the absence of preseason games, more full-contact practices took place in 2020 than in 2019, meaning that the rate of concussion in preseason practice went down in 2020.

"The fact that we saw more exposure in preseason practices and a lower rate of concussion demonstrates that our ongoing interventions to prevent concussion have produced positive change year over year," said Dr. Sills.

3 – There were fewer heat illnesses of all types

Going into the 2020 preseason, there were concerns about an up-tick heat-related illness given that players may not have been entering camp at their usual level of physical fitness. However, the league saw incidence of heat illnesses of all types go down this preseason.

"We were quite worried about heat illness, because players were coming off of months of being out of their normal routines and the summer is always the most vulnerable period of the year for heat illness," said Dr. Sills. "The fact that we did not see a spike in heat illness, and actually saw incidence of heat illnesses go down, speaks to how well players and clubs did in mitigating those risks in that period of time."

NFL clubs applied increased vigilance to this issue given the circumstances and it seems that that heightened sensitivity and ongoing player education have paid off.

More information on the league's efforts to prevent and treat exertional heat stroke can be found here.