Epidemiology of Tibial Fractures in Professional American Football Athletes From 2013 to 2019

Abstract

Background: Lower extremity injuries occur with high frequency in National Football League (NFL) athletes and cause high burden to players and teams. Tibial fractures are among the most severe lower extremity injuries sustained in athletes and are associated with prolonged time loss from sport. Purpose: To determine the number of tibial fractures in NFL athletes from the 2013 to 2019 NFL seasons and describe athlete demographics, fracture characteristics, and details of injury onset. Study Design: Case series; Level of evidence, 4. Methods: A retrospective review of the NFL injury database was performed to identify all NFL athletes sustaining tibial fractures over the 2013 to 2019 NFL seasons. Athlete characteristics, injury characteristics, days missed, and treatment (operative vs nonoperative) were examined. Descriptive statistics were used to calculate means, standard deviations, ranges, and percentages. Results: A total of 64 tibial fractures were identified in 60 athletes, resulting in a median loss of 74 days. Defensive secondary athletes had the highest number of injuries (n = 10; 16%), followed by running backs (n = 9; 14%), while 61% of these injuries occurred during NFL regular-season games, primarily between weeks 13 and 17. The most commonly reported activity during injury was athletes being tackled, with a direct impact to the tibia being the most common mechanism of injury. Lateral tibial plateau fractures were the most frequently reported, while distal tibial fractures resulted in the greatest number of days lost. The median time lost for injuries requiring surgery was 232 days compared with 56 days for injuries treated using conservative management. Conclusion: The highest proportion of tibial fractures were injuries to defensive secondary athletes and athletes being tackled while sustaining a direct impact to the leg, primarily to the lateral tibial plateau. Tibial fracture injuries were commonly sustained during NFL regular-season games, primarily during the final 4 weeks of the NFL regular season. Further investigations examining performance and career longevity in athletes sustaining tibial fractures are warranted to help improve the health and safety of NFL athletes.

Effects of Body Posture and Different Exercise Intensity on Athletes’ Limb Injury

“…The player had obvious pain points in the anterior horn of the lateral meniscus of his right knee, and he had been closed twice because of the pain affecting training, but the effect was not obvious [ 18 ]. In the complete set of movements, there are many rotation movements that require the knee joint to be straightened and used as a support; due to the existence of this pain point, players are either unable to complete or are very strenuous, and this can also cause functional compensation of other joints and muscles in the kinematic chain, thereby increasing the risk of injury by overloading these joints.…”

Quantifying the Performance of Professional Athletes Following Traumatic Tibial Fractures

“…Previous literature is limited in this population and lacks measurement of athletic performance following tibial fracture [ 11 ]. A 2021 study by Knapik et al investigated National Football League (NFL) players who suffered from tibial fractures with an interest in time from injury to return, mechanism of injury, and timing of the injury in the context of the NFL season [ 15 ]. Another study by Robertson et al investigated whether athletes who suffered tibial stress fractures were able to return to play at all [ 16 ].…”