Over the last few seasons, fans have seen a number of ACL tears in prominent NFL players. Combined with what looks like a rise in these injuries during training camp, many NFL writers have suggested we are witnessing an epidemic in these injuries. Knee pain maleThis spike in ACL injuries resembles the rise of Tommy John surgeries in Major League Baseball.

A notable percentage of athletes never return to play after tearing the ACL. Others fail to reach their preinjury level of performance. Therefore, it is critical that we learn whether these injuries are really increasing and who is most likely to suffer them.

In a recent study published in the Orthopaedic Journal of Sports Medicine, Christopher C. Dodson, M.D. and others collected data on ACL injuries that occurred between 2010 and 2013. Here are some of the findings:

• 219 NFL players suffered ACL injuries between 2010 and 2013.
• While injuries suffered during games remained stable over those four seasons, ACL tears increased in the off-season and during practices.
• The total number of ACL injuries was highest in August, during training camps and preseason games. With the large roster sizes in camps, the total number of players participating was much larger as well. Therefore, the increased number of ACL injuries in August compared to other months in the season wasn’t statistically significant when the researchers accounted for the larger number of players.
• As a group, wide receivers, tight ends, running backs, fullbacks and linebackers all had greater injury rates than the rest of the NFL.
• Interior offensive and defensive lineman (centers, guards and defensive tackles) had higher risks of ACL injuries than perimeter linemen (defensive ends and offensive tackles).
• Just over 18% of ACL injuries occurred in players with a history of a prior ACL injury. Of the 219 ACL tears, 27 were re-tears of the previous graft, while 16 were tears of the ACL in the contralateral or opposite knee. Five players suffered their third ACL injury.
• When looking at the playing surface, artificial turf fields like FieldTurf had a rate of 0.053 injuries per team games, compared to Knee brace ACL0.050 injuries per team game on natural grass. Those injury rates were not statistically significant.

While this data on ACL injuries applies only to NFL players and might not correlate to those in youth, high school or college football, it does provide important information on the risks among elite football players.

Also read:
Athletic performance after ACL surgery
Rehabilitation factors that might influence outcomes from ACL surgery

Does this data or any part of it surprise you? How do you think we can decrease ACL tears in the NFL? Please share your thoughts below!

Dodson CC, Secrist ES, Bhat SB, Woods DP, Deluca PF. Anterior Cruciate Ligament Injuries in National Football League Athletes From 2010 to 2013: A Descriptive Epidemiology Study. Orthop J Sports Med. 2016 Mar 3;4(3):2325967116631949.