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Lower Extremity Strains in the US National Football League, 2015-2019.
Mackenzie M Herzog1,2, Leigh Weiss3, Rebecca Y Lee1
1IQVIA Injury Surveillance and Analytics, Durham, North Carolina, USA.
The American Journal of Sports Medicine
|June 1, 2023
Summary
Lower extremity strains impact nearly 27% of National Football League players annually, causing significant missed playing time. Hamstring strains are most common, with preseason practices and regular season games posing the highest risks.
Area of Science:
- Sports Medicine
- Epidemiology
- Orthopedics
Background:
- Lower extremity (LEX) strains are frequent sports injuries, leading to substantial missed participation.
- Common LEX strains include hamstring, quadriceps, adductor, and calf injuries.
Purpose of the Study:
- To determine the incidence of lower extremity strains in professional American football players.
- To analyze LEX strain frequency by setting, timing in season, and player position.
Main Methods:
- A descriptive epidemiology study analyzed data from 2015-2019 NFL seasons.
- Included players participating in at least one game or sustaining a LEX strain.
- LEX strains were identified via a standardized electronic health record system across 32 teams.
Main Results:
- Over five seasons, 5,780 LEX strains were reported, with a 1-year risk of 26.7%; 69% resulted in time loss.
- Hamstring strains were most prevalent (54.7%), followed by adductor (24.1%), calf (12.6%), and quadriceps (8.3%).
- Preseason practices and regular season games showed the highest incidence rates, with defensive secondary players most affected. Punt plays had the highest game injury rate.
Conclusions:
- Lower extremity strains affect approximately one in four NFL players annually, creating a significant injury burden.
- Reducing injuries during training camp and regular season games is crucial for future prevention strategies.

