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Updated: Aug 15, 2026
A Neuroscientific Approach to the Examination of Concussions in Student-Athletes
Published on: December 8, 2014
Return to Full Participation Following Concussion in the National Football League, 2015 Through 2020
Christina D Mack1, Mackenzie M Herzog1, Gary Solomon2,3
1Real World Solutions, IQVIA, Research Triangle Park, North Carolina.
Objective:
Quantify days missed, games missed, injury burden, and time to return to full participation (RTFP) among National Football League (NFL) players who sustained a concussion.
Design:
Retrospective cohort study.
Setting:
2015 through 2020 NFL seasons.
Participants:
National Football League players diagnosed with a concussion from 2015 to 2020.
Interventions:
National Football League-mandated graduated RTFP protocol.
Main Outcome Measures:
Days missed, games missed, burden, and time to RTFP, overall and by position.
Results:
An annual average of 3639 player-days of participation and 255 games were missed across NFL because of concussion. Concussed players missed a median of 9 days (mean = 15.0), a relatively stable metric over 6 years, with slight variation by position. Offensive linemen, tight ends, running backs, and linebackers missed the most days per concussion; defensive secondary, offensive linemen, and wide receivers sustained the highest injury burden. Postconcussion, 59% of players missed one or more scheduled games. Among players concussed in a Sunday game, 38% played in a Sunday game one week later.
Conclusions:
The 9-day median time missed post-concussion may be related to emphasis on graduated phase-based concussion management. No concussed player returned to competition on the day of injury, and less than 40% participated in games the following week. Further work is needed to better understand characteristics of concussions that take longer to return and movement through stages of return.
