Back

The NFL Tackles the ACL: Knee Injuries in Professional Football

When it comes to anterior cruciate ligament (ACL) injuries, football is a high-risk sport. In fact, the risk of ACL injury may be 10 times higher in football than in other sports. Although knee injuries are common in football, no one has specifically analyzed these injuries at the professional level.

Researchers tracked knee injuries in the National Football League (NFL) over a five-year period. During this time, knee injuries accounted for 20 percent of all injuries. ACL injuries made 16 percent of  knee injuries. Based on these results, football has about the same risk of ACL injury as skiing.

Offensive and defensive linemen had the most ACL injuries. However, the risk of ACL injury was greatest for running backs. Injuries were more common during games than during practice. The only exception to this was during the preseason months of July and August. Practice may be more intense during these months.

During games, most ACL injuries happened in the second and third quarters. ACL injuries happened at roughly the same rate on artificial surfaces (AstroTurf) and grass.

For linemen and quarterbacks, most NFL team doctors recommended surgery soon after ACL injury. For kickers and punters, more doctors tried a wait-and-see approach. This was especially true if the injury affected the kicking leg. Most doctors used tissue from the player's kneecap (patellar tendon) to repair the ACL.

In general, players returned to sport six to nine months after surgery. Although ACL injuries can be season-enders for NFL players, most players are able to get back into the game.

References: James P. Bradley, MD, et al. Anterior Cruciate Ligament Injuries in the National Football League: Epidemiology and Current Treatment Trends Among Team Physicians. In Arthroscopy. May/June 2002. Vol. 18. No. 5. Pp. 502-509.

Back