In preparation for my next blog, I was reviewing some old posts and happen to see one that I wrote back in 2013 entitled "NFL ACL Epidemic - Will This Season Be Any Different?". Out of curiosity, I read through it to see, had anything changed? As I read through this previous blog, I was a little saddened, disheartened, discouraged and little frustrated. You would think we all the resources that are available to the NFL and the knowledge we have on what puts an athlete at risk that we would have seen significant improvement in these numbers. Results speak for themselves. The table below is what the NFL reports for ACL tears from 2012 to 2017.
As you can see, from 2014 - 2017, the numbers really have not changed that much, with an average of 56 per season (224 total). Over the past 4 years, an average of 25.5 (46.8%) of ACL injuries occur in pre-season, a slight increase over previous years.
As much as I would love to believe it should be a 100% focus on athlete safety and health, the harsh reality is that performance/results is what motivates and drives change in professional organizations. Considering this, you would think a study like Mai et al Am J Sports Med 2017 would be motivation enough. In this study, the authors looked at NFL, NBA, NHL and MLB players and compared their individual performance after returning to play following an ACL reconstuction. What the study found was that NFL players had a decrease in performance across all performance measures collected for up to two years after the ACLR and they shortened their professional career by up to 2 years.
So let's think about this for a moment. This study looked at players "after" return to play. This is key because most players are out for one whole season after the ACL reconstruction. So, according to the results of this study, the true impact is 3 years. One for the season that is lost for the player to have surgery and rehab and then the 2 years decreased performance upon return to play. Considering, the financial impact to the team and the player is huge. For the team, they may be loosing a key player (or their high performance) for up to 3 years from the injury. This can impact wins, tickets sales, and sponsors. For the player, this also has huge financial ramifications with lost bonuses and future earning potential.
After hearing this, we may be thinking to ourselves, well that is just one study. If that were the case across the board, then surely the NFL would do something about this and things would change. However, in a study by Mohtadi et al Am J Sport Med 2018 , the authors did a systematic review of the literature to see what the impact of an ACLR was on future athletic performance. Although elite athletes did return to their previous level of performance, this:
- Took time - 1 to 2 years
- Was variable based on sport - NBA players did better than NFL
- Was dependent on level of play - Start vs. 2nd string, DI versus pro
Another factor and I hate to say it, is the rehab. As PTs, ATCs and strength coaches, as much as we may think we change movement, do we really? We are going to continue this discussion next week as we look at a recent study by King et al Am J Sports Med 2019, so stay tuned.