2017 ISAKOS Biennial Congress Paper #142


The Epidemiology of Injuries Identified at the NFL Scouting Combine and their Impact on Performance in the National Football League: 2203 Athletes, 2009-2015

Brendin Beaulieu-Jones, Hanover, NH UNITED STATES
George Sanchez, Vail, CO UNITED STATES
Bryan Vopat, Overland Park, Kansas UNITED STATES
Catherine A. Logan, MD, Vail, CO UNITED STATES
Mark David Price, MD, Wellesley, MA UNITED STATES
Matthew T. Provencher, MD, Vail, CO UNITED STATES

Massachusetts General Hospital, Boston, Massachusetts, UNITED STATES

FDA Status Not Applicable


Performance in the National Football League is affected differently according to history of previous injury at specific anatomic location as well as individual player position.


Background/Purpose: The annual National Football League (NFL) Scouting Combine is attended by medical staff from each NFL franchise with the purpose of evaluating collegiate athletes seeking to enter the NFL. Although some work has been done to quantify these injuries, little is known regarding their overall epidemiology and impact on NFL performance. The purpose of this study is to better understand the epidemiology of injuries identified at the NFL Scouting Combine and determine their impact on future NFL performance.


A retrospective review of all collegiate football injuries, as identified at the NFL combine between 2009-2015 was conducted. Medical records, imaging reports, and physical examination findings were examined to characterize collegiate injuries, their management and their impact on collegiate play. Games statistics for the first two seasons of NFL play were obtained for all players who attended the NFL combine from 2009-2013. Analysis of prevalence of injury and overall impact of each injury was performed. Draft status and position-specific player performance metrics were compared versus a position-matched control group with no prior history of injury, no surgical history, and no significant missed time (=2 total collegiate missed games). Positions analyzed included: (1) defensive backs, (2) defensive linemen, (3) linebackers, (4) offensive linemen, (5) quarterbacks, (6) running backs (7) wide receivers, and (8) tight ends.


A total of 2,203 athletes were evaluated, including 1,490 (67.6%) who were drafted and 1,040 (47.2%) who ultimately played a minimum of 2 years in the NFL. The most common sites of injury were the ankle (1160, 52.7%), shoulder (1143, 51.9%), knee (1128, 51.2%), spine (785, 35.6%), and hand (739, 33.5%). Shoulder injury to defensive linemen and offensive linemen were both noted to negatively impact an athletes draft position (p=0.044 and p=0.037, respectively). Odds ratios (OR) demonstrated QBs were most at risk of shoulder injury (OR 2.78, p=0.001) while RBs most commonly sustained ankle (OR 1.49, p=0.038) and shoulder injuries (OR 1.55, p=0.022). Performance metrics for each position were negatively impacted by prior history of injury with defensive players demonstrating a tendency to be more negatively impacted than offensive players.


The most common sites of injury identified at the NFL Scouting Combine were the (1) ankle, (2) shoulder, (3) knee, (4) spine, and (5) hand. Overall, performance in the NFL was found to be significantly impacted by history of prior injury. Performance outcome metrics were affected at each anatomic location of injury, and were dependent on the position played. Defensive players were more negatively impacted than offensive players.