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A third of 375 concussion evaluations self-reported
While the number of concussion diagnoses in the NFL rose slightly in 2019 — continuing a ping-ponging trend — knee-ligament tears dropped substantially year-over-year.
According to data the league released Thursday, covering both the 2019 preseason and regular season, the number of ACL tears dropped 17.5%, from 57 in 2018 to 47 in 2019.
Similarly, the number of MCL tears fell 17.4%, from 132 in 2018 to 109 in 2019.
The league said it was too early to presume why.
Upon closer inspection of Thursday’s data dump, a meaningful reduction in ACL tears did not occur during the regular season period of September through December, because the number of such injuries suffered in games shrunk only slightly, from 24 to 23, and rose slightly in practices, from five to seven.
Rather, an overall ACL-tear reduction occurred because of a 32.1% drop during the preseason, from 28 to 17. Breaking that down further, ACL tears in preseason practices fell from 10 to 7, and in preseason games from 18 to 10.
Regarding MCL tears, the preseason total dropped 18.9% year-over-year, from 37 to 30, and the regular season total lowered 16.8%, from 95 to 79.
As for concussions, the total number in 2019 rose 4.6%, from 214 to 224 — because the regular-season sub-total increased from 135 to 145, a rise almost entirely owing to a rise in in-game concussions, from 127 to 136. Concussions diagnosed in regular-season practices remained paltry, rising from eight to nine.
While the preseason concussion total remained exactly the same (79) from 2018 to 2019, the breakdown between practices and games swung wildly year-over-year, and in different directions; preseason-practice concussions plummeted from 45 to 30 (a 33% drop), but preseason-game concussions skyrocketed from 34 to 49 (a 44.1% rise).
The league made special efforts last spring and summer to get teams and coaches to make preseason practice regimens safer, and that presumably contributed to the 33% drop in those settings.
The NFL has released concussion statistics since 2012. Whereas concussion diagnoses rose 4.6% in 2019, they’d dropped 24% in 2018, a year after the number rose 15%, which came a year after it dropped 12%, which came a year after it rose 33%, which came a year after it dropped 10%, which came a year after it dropped 12%.
Ping-ponging, roller-coastering — call it what you want. Just not consistent.
NFL health and safety leaders on a Thursday conference call said all the above raw 2019 injury numbers are newly compiled, thus it’s too early to draw many meaningful or specific conclusions about what these year-over-year changes mean.
That said, the NFL’s executive VP of health and safety initiatives, Jeff Miller, framed this season’s concussion total as follows: “Last year the NFL set a new benchmark. From here on we are going to be driving our concussion-reduction efforts against that new benchmark. Last year’s number was a substantial drop, and this year’s number is statistically similar to it.
“We feel as if we’ve found a new place from which we can continue to push down the number of concussions, using our injury-reduction plan, but also looking for new opportunities — whether that be in the equipment, rules, or practices space. But we look at this year as a validation of last year.”
I’ve been saying for years that there probably are too many jostling factors to ever draw any meaningful cross-year assessments of concussion data. First and foremost, because we never know exactly how many concussions actually are occurring; these numbers merely reflect how many of them the teams’ medical personnel can diagnose.
As I wrote last year, because of improving detection protocols the NFL casts a bigger, better net every year.
Still, while Dr. Allen Sills, the NFL’s chief medical offer, said on Thursday’s call that about one-third of 2019’s 224 diagnosed concussions had a self-report element to them, some players still try to hide brain-injury symptoms in order to keep playing.
As more concussed players who can self-report do — what with players all the time becoming better educated as to concussion symptoms and their long-term dangers — so, in turn, should the reported number of concussion diagnoses increase.
That’s a good thing, right?
But then shouldn’t the number of annually reported concussions be going up too, not down? And shouldn’t the NFL be less obsessed with getting that number down?
I asked NFL medical leaders about that conundrum on Thursday’s call.
“I have no doubt that our detection efforts are in a far different place today than they were, say, 10 years ago,” Sills said. “While no one’s detection efforts are perfect, we have a really robust system in place which we feel detects, according to our data, 99% of concussions that occur on game day over the last few years.
“So you’re correct to say that as players report more, and as we do more in detection, that would theoretically drive that number higher … Clearly, player self-reporting is a good thing, and we want to continue to encourage that, and I do think that’s reflected in our data.
“At the same time I would offer to you to say that if you’re trying to look at an effect of something like a rules change — like lowering the helmet behavior, or even equipment change — you have to consider more than just the number of concussions.
“And that would be one of (today’s) take-home messages: we don’t look at the concussion number and say, oh, this is a good year or a bad year. We’re looking at things like how many helmet-to-helmet blows were there? And what was the nature of the contact? And what was the severity of the injuries? You have to really take more of a comprehensive look.”
The league’s concussion-prevention initiatives, meantime, are ongoing.
The move by more than 99% of NFL players this past season to the safest brands of helmets — categorized in the league’s ranking chart as “green” — ought to have dropped the number of concussions in 2019, in theory.
Consider that just in 2017 only 41% of players wore a helmet designated green or top-performing, and that the handful of players who didn’t wear green helmets in 2019 wore a next-safest “yellow” type, what with lower-category “red” helmets now all banned.
The introduction in 2019 of more safety-minded rules also in theory should have reduced concussions.
It’s possible all those initiatives did indeed work, but maybe more players than ever came forward with their symptoms.
Probably we’ll never know for sure.
Copyright Postmedia Network Inc., 2020