Background: Concussion in the National Football League (NFL) remains an important issue. An initial description of the injury epidemiology involved 6 years from 1996 to 2001.
Hypothesis: The increased attention to concussions may have resulted in team physicians being more conservative in treating players in recent years.
Study design: Two consecutive 6-year periods (1996-2001 and 2002-2007) were compared to determine changes in the circumstances associated with the injury, the patterns of signs and symptoms, and the players' time loss from participation in the NFL.
Methods: During 2002-2007, concussions were recorded by NFL team physicians and athletic trainers using the same standardized reporting form used from 1996 to 2001. Player position, type of play, concussion signs and symptoms, loss of consciousness, and medical action taken were recorded.
Results: There were 0.38 documented concussions per NFL game in 2002-2007-7.6% lower than the 0.42 in the earlier period (1996-2001). The injury rate was lower in quarterbacks and wide receivers but significantly higher in tight ends during the second 6 years. The most frequent symptoms were headaches and dizziness; the most common signs were problems with information processing and immediate recall. During 2002-2007, a significantly lower fraction of concussed players returned to the same game, and more were removed from play. Most concussed players (83.5%) returned to play in < 7 days; the percentage decreased to 57.4% with loss of consciousness. The number of players returning in < 7 days was 8% lower during 2002-2007 and 25% lower for those with loss of consciousness.
Conclusion: The most recent 6 years of NFL concussion data show a remarkable similarity to the earlier period. However, there was a significant decrease in the percentage of players returning to the same game, and players were held out of play longer.
Clinical relevance: There was a more conservative management of concussion in NFL players from 2002 to 2007 even though the clinical signs and symptoms remained similar to the earlier 6-year period.
Keywords: concussion; injury epidemiology; sport injury prevention; traumatic brain injury.