Guest post by:
Shane K. Woolf, MD
Associate Professor of Orthopaedics and Chief of Sports Medicine

As the 2014 NFL preseason has moved through its third week and college football games are about to get underway, early season injuries are a common concern for coaches and players. During preseason practices, scrimmages and games, players are acclimating to new systems, new plays, and to higher intensity scenarios compared to off-season training workouts in the gym and off the field. This places players at risk for both minor as well as season-ending injuries and is one reason why coaching staffs limit the number of plays and series that marquee players are on the field during somewhat irrelevant preseason scrimmages.

Most coaches look at preseason as a an opportunity to give their veterans players just enough playing time to shake off the dust from the off-season and to try new plays and personnel combinations or to decide on who crown as the starting quarterback.
For some prospects, aggressive preseason play might mean a chance to earn a roster position putting them at greater risk for an injury. With four months of regular season play, there is ample opportunity for injury, so it is imperative to effectively condition and train players while minimizing injury risk, especially early in the year.

Fortunately, many injuries warrant just a short period of time off the field, but not necessarily end a player’s season. On the NFL’s injury report this past week, for instance, the majority of listed medical issues were conditions such as hamstring/groin strains, ankle sprains, and bruised limbs or ribs. These injuries, while limiting and nagging to players, usually recover fairly quickly with rest and rehabilitation. More importantly, they do not typically require surgery and do not often end a player’s season. It is imperative though that players with bruised shoulders, groin strains, ankle sprains and other minor injuries are assessed daily by their team’s medical staff and that return to play is guided by pain and functional assessments. Ideally, the individual player’s health and well-being are paramount and availability for the lineup is secondary to sufficient healing.

Relatively minor injuries, like Cam Newton’s hairline rib fracture sustained last weekend, will heal quickly without intervention and can be sufficiently protected with special pads when he is ready to return under center. Similarly, Clemson fans may be holding their collective breaths as the highly touted Buffalo Bills rookie, Sammy Watkins, sits out preseason games and practices with bruised ribs. Fortunately, these injuries, while painful and frustrating for the players, usually recover within a few weeks and players get back onto the field nearly full strength by then.

Unfortunately, other injuries can immediately jeopardize a season or even a career. Just this weekend, Sam Bradford, quarterback of the St. Louis Rams, suffered his second season-ending ACL injury in as many seasons when the previously repaired knee was struck by a Cleveland defensive player on the opening drive of a preseason game. In an instant, all of the reconstructive work, dedicated rehabilitation and patience are lost. Another surgery, most likely, and another year of recovery with hopes of one day returning to pro football. As one might expect, a repeat injury to the joint makes for a challenging road back to the same level of play, regardless how well the knee is reconstructed.

In recent years, contact drills in practices have been reduced and innovations made in training routines to optimize players’ ability to learn plays and hone decision skills. Many have argued against a long preseason because of the inherent risk of injury with each successive exposure to live action. Of course, injury risk during the regular season is a given. It goes with the territory. No sport is free of potential injury. However, the toll that injury can take on an athlete’s body and future consequences are things that each individual must consider, and the team’s medical staff is obligated to protect the athlete’s health interests. Perhaps the argument to reduce preseason-playing time in order to minimize injury risk has merit after all.