The Use of Fantasy Points to Evaluate Return-to-Play Performance After Time-Loss Injuries in the National Football...

Background National Football League (NFL) "fantasy leagues," in which fans accumulate points based on the NFL players' in-game performance, have boomed in popularity. There is a paucity of objective measures to track player performance following injuries. Therefore, our study evaluates whether fantasy football points can serve as an assessment tool for player recovery after time-loss injuries. Methods In this descriptive epidemiology study, injuries in offensive skill positions over five NFL seasons (2017-2022) resulting in at least one missed game were retrospectively reviewed. Return to performance was assessed by the difference in fantasy points per game (PPG) between the injury year and the following season. Results Reported injuries resulted in a change of -0.50 (CI: -0.67, -0.33) PPG. Quarterbacks (QBs) had the greatest decrease in PPG at -1.95 PPG (CI: -3.47, -0.44) followed by WR at -0.33 PPG (CI: -0.53, -0.12). Injury to the shin resulted in the greatest decrease in PPG at -3.24 PPG (CI: -7.69, 1.2). Injury to the arm had the second greatest decrease in PPG at -2.65 PPG (CI: -6.78, 0.04). No association between the number of games missed and difference in PPG was found (R²=0.0047). Injury prior to a bye week did not alter PPG, yet injury after a bye week lead to increased loss of -1.22 PPG (CI: -1.491, -0.964). Players in the league for three years or more experienced a decline in PPG recorded of -17.10 (CI: -21.61, -12.591). Conclusion The use of fantasy football points may serve as an objective tool for assessing player return to performance post-injury, though correlation with rigorous clinical evaluation is still needed, especially since fantasy points lack the precision needed for injury severity and since various team-related factors may influence fantasy point performance. QBs and players with shin or arm injuries experience the greatest decline in fantasy PPG. Longer NFL careers may also contribute to performance decline, while injury timing has a lesser effect.