Athletes With Musculoskeletal Injuries Identified at the NFL Scouting Combine and Prediction of Outcomes in the NFL: A Systematic Review

Abstract

Background:Prior to the annual National Football League (NFL) Draft, the top college football prospects are evaluated by medical personnel from each team at the NFL Scouting Combine. On the basis of these evaluations, each athlete is assigned an orthopaedic grade from the medical staff of each club, which aims to predict the impact of an athlete’s injury history on his ability to participate in the NFL.Purpose:(1) To identify clinical predictors of signs, symptoms, and subsequent professional participation associated with football-related injuries identified at the NFL Combine and (2) to assess the methodological quality of the evidence currently published.Study Design:Systematic review; Level of evidence, 3.Methods:A systematic review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. We reviewed all studies that examined musculoskeletal injuries identified among athletes at the NFL Combine and associated outcomes. Data on signs, symptoms, and subsequent NFL participation were collected, and the methodological quality of the studies was assessed.Results:Overall, 32 studies, including 30 injury-specific studies, met the inclusion criteria. Twenty studies analyzed data collected at the NFL Combine from 2009 and later. When compared with matched controls, athletes with a history of a cervical or lumbar spine injury, rotator cuff repair, superior labrum anterior-posterior repair, anterior cruciate ligament reconstruction, full-thickness chondral lesions of the knee, or Lisfranc injury played in significantly fewer games early in their NFL careers. Additionally, athletes with a history of a cervical or lumbar spine injury, rotator cuff repair, and navicular injury had decreased career lengths versus controls. Defensive players and linemen were found to have decreased participation in the NFL for several injuries, including prior meniscectomy, anterior cruciate ligament reconstruction, and shoulder instability. Career length follow-up, measures of athletic participation, and matching criteria were highly variable among studies.Conclusion:For medical professionals caring for professional football athletes, this information can help guide orthopaedic grading of prospects at the NFL Combine and counseling of athletes on the potential impact of prior injuries on their professional careers. For future studies, improvements in study methodology will provide greater insight into the efficacy of current treatments and areas that require further understanding.

Can NFL Combine Results be Used to Estimate NFL Defensive Players Longevity?

“…Many previous studies have been performed that have sought to find a link between prior orthopedic injury or NFL combine orthopedic testing results and career outcomes [3,[15][16][17][18][19][20][21]. For example one such study found that certain injuries, such as cervical spine injury, rotator cuff repair, or navicular injury, led to decreased career length when compared to a control group [3].…”

“…The National Football League (NFL) Scouting Combine is an annual event where hundreds of college football players across the nation gather for physical, medical, and psychological evaluation [1,2]. The combine includes substantial medical testing, with each player receiving an orthopedic grade that estimates a player's injury risk [3]. For example, a study examining the combine from 1987 to 2000 showed players receiving a high orthopedic grade having a mean career length of 42 games, players with a low orthopedic grade playing 34 games, and players with a failed orthopedic grade playing 19 games [4].…”

Characterization of Rookie Season Injury and Illness and Career Longevity Among National Basketball Association Players

“… 8 , 9 , 10 This difficulty in load management may reflect decreased fitness and development. Although injury incidence research among NBA rookies has been sparse, previous research among military recruits 11 and National Football League combine participants 12 indicates that previous injury and lower fitness levels indicate future injury risk and decreased career longevity. Therefore, identifying injury incidence and risk specific to rookies is necessary to individualize injury mitigation programs that address the unique needs of rookie players.…”

Epidemiology of Traumatic Posterior Hip Instability in the National Football League

“…In recent years, hip injuries have received considerably less attention in the media and among the scientific community than injuries to the shoulder, the knee, or the ankle, which are more common and can be more impactful in NFL prospects and active players. 1 , 9 , 13 A descriptive epidemiology study by Mack et al 9 analyzed all time loss from lower extremity injuries that occurred in the NFL during the 2015-2018 seasons. Of the 8024 lower extremity injuries sustained in the full NFL season, only 590 (7.4%) involved the hip compared with injuries to the knee (29.3%), the ankle (22.4%), the thigh (17.2%), and the foot (9.1%).…”