NFL CONCUSSION DATA TRICKY TO DIGEST
Number of cases diagnosed rises slightly, but more players self-reporting injuries
While the number of concussions diagnosed in the NFL rose slightly in 2019 — continuing a ping-pong trend — incidence of knee ligament tears dropped substantially year over year.
According to data the league released on Thursday, covering both the 2019 pre-season and regular season, the number of ACL tears dropped 17.5 per cent, from 57 in 2018 to 47 in 2019.
Similarly, the number of MCL tears fell 17.4 per cent, from 132 in 2018 to 109 in 2019.
The league said it was too early to presume why.
Upon closer inspection of Thursday’s data dump, a meaningful reduction in ACL tears did not occur during the regular season period of September through December, because the number of such injuries suffered in games shrunk only slightly, from 24 to 23, and rose slightly in practices, from 29 to 30.
An overall ACL tear reduction occurred because of a 32.1 per cent drop during the pre-season, from 28 to 17. Breaking that down further, ACL tears in pre-season practices fell from 10 to seven, and in pre-season games from 18 to 10. Regarding MCL tears, the pre-season total dropped 18.9 per cent year over year, from 37 to 30, and the regular season total lowered 16.8 per cent, from 95 to 79.
As for concussions, the total number in 2019 rose 4.6 per cent, from 214 to 224. The regular-season subtotal increased from 135 to 145, a rise almost entirely owing to a rise in in-game concussions, from 127 to 136. Concussions diagnosed in regular-season practices remained paltry, rising from eight to nine.
While the pre-season concussion total remained exactly the same (79) from 2018 to 2019, the breakdown between practices and games swung wildly year over year, and in different directions; pre-season-practice concussions plummeted from 45 to 30, but pre-season game concussions skyrocketed from 34 to 49.
The league made special efforts last spring and summer to get teams and coaches to make pre-season practice regimens safer, and that presumably contributed to the 33 per cent drop in those settings.
The NFL has released concussion statistics since 2012. Whereas concussions rose 4.6 per cent in 2019, they dropped 24 per cent in 2018, a year after the number rose 15 per cent, which came a year after it dropped 12 per cent. That came a year after it rose 33 per cent, which came a year after it dropped 10 per cent, which came a year after it dropped 12 per cent.
NFL health and safety leaders on a Thursday conference call said all of the above raw injury numbers for 2019 are newly compiled, thus it’s too early to draw many meaningful or specific conclusions about what these year-over-year changes mean.
That said, the NFL’S executive vice-president of health and safety initiatives, Jeff Miller, framed this season’s concussion total as follows: “Last year the
NFL set a new benchmark. From here on we were going to be driving our concussion reduction efforts against that new benchmark. Last year’s number was a substantial drop, and this year’s number is statistically similar to it.
“We feel as if we’ve found a new place from which we can continue to push down the number of concussions, using our injury reduction plan, but also looking for new opportunities — whether that be in the equipment, rules, or practices space.”
I’ve been saying for years there are probably too many jostling factors to ever draw any meaningful assessments of concussion data. First and foremost, we never know exactly how many concussions actually are occurring. These numbers merely reflect how many of them the teams’ medical personnel can diagnose.
Because of improving detection protocols, the NFL casts a bigger, better net every year.
Dr. Allen Sills, the NFL’S chief medical offer, said on Thursday that about one-third of 2019’s 224 diagnosed concussions were self-reported, but some players still try to hide brain injury symptoms in order to keep playing.
As more concussed players self-report — with players all the time becoming better educated as to concussion symptoms and their long-term dangers — shouldn’t the number of annually reported concussions be going up, not down? And shouldn’t the NFL be less obsessed with getting that number down?
I asked NFL medical leaders about that conundrum.
“I have no doubt that our detection efforts are in a far different place today than they were, say, 10 years ago,” Sills said. “While no one’s detection efforts are perfect, we have a really robust system in place which we feel detects, according to our data, 99 per cent of concussions that occur on game day over the last few years.
“Clearly, player self-reporting is a good thing, and we want to continue to encourage that, and I do think that’s reflected in our data.
“At the same time I would offer that, if you’re trying to look at an effect of something like a rules change — like lowering the helmet behaviour, or even an equipment change — you have to consider more than just the number of concussions.
“And that would be one of (today’s) take-home messages. We don’t look at the concussion number and say, ‘Oh, this is a good year or a bad year.’ We’re looking at things like how many helmet-to-helmet blows were there? And what was the nature of the contact? And what was the severity of the injuries?”
While no one’s detection efforts are perfect, we have a really robust system in place which we feel detects, according to our data, 99 per cent of concussions that occur on game day.