{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T21:50:22Z","timestamp":1793397022605,"version":"4.5.0"},"reference-count":24,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T00:00:00Z","timestamp":1591056000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100001267","name":"nfl charities","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100001267","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Sports Med"],"published-print":{"date-parts":[[2020,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Lower extremity injuries are the most common injuries in professional sports and carry a high burden to players and teams in the National Football League (NFL). Injury prevention strategies can be refined by a foundational understanding of the occurrence and effect of these injuries on NFL players.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose:<\/jats:title>\n                    <jats:p>To determine the incidence of specific lower extremity injuries sustained by NFL players across 4 NFL seasons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Study Design:<\/jats:title>\n                    <jats:p>Descriptive epidemiology study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This retrospective, observational study included all time-loss lower extremity injuries that occurred during football-related activities during the 2015 through 2018 seasons. Injury data were collected prospectively through a leaguewide electronic health record (EHR) system and linked with NFL game statistics and player participation to calculate injury incidence per season and per 10,000 player-plays for lower extremity injuries overall and for specific injuries. Days lost due to injury were estimated through 2018 for injuries occurring in the 2015 to 2017 seasons.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>An average of 2006 time-loss lower extremity injuries were reported each season over this 4-year study, representing a 1-season risk of 41% for an NFL player. Incidence was stable from 2015 to 2018, with an estimated total missed time burden each NFL season of approximately 56,700 player-days lost. Most (58.7%) of these injuries occurred during games, with an overall higher rate of injuries observed in preseason compared with regular season (11.5 vs 9.4 injuries per 10,000 player-plays in games). The knee was the most commonly injured lower extremity region (29.3% of lower body injuries), followed by the ankle (22.4%), thigh (17.2%), and foot (9.1%). Hamstring strains were the most common lower extremity injury, followed by lateral ankle sprains, adductor strains, high ankle sprains, and medial collateral ligament tears.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Lower extremity injuries affect a high number of NFL players, and the incidence did not decrease over the 4 seasons studied. Prevention and rehabilitation protocols for these injuries should continue to be prioritized.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/0363546520922547","type":"journal-article","created":{"date-parts":[[2020,6,2]],"date-time":"2020-06-02T17:36:06Z","timestamp":1591119366000},"page":"2287-2294","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":81,"title":["Incidence of Lower Extremity Injury in the National Football League: 2015 to 2018"],"prefix":"10.1177","volume":"48","author":[{"given":"Christina D.","family":"Mack","sequence":"first","affiliation":[{"name":"IQVIA Real World Solutions, Research Triangle Park, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard W.","family":"Kent","sequence":"additional","affiliation":[{"name":"Center for Applied Biomechanics, University of Virginia, Biomechanics Consulting & Research (Biocore), Charlottesville, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Coughlin","sequence":"additional","affiliation":[{"name":"University of California, San Francisco, San Francisco, California, USA"},{"name":"Coughlin Foot and Ankle Clinic, Saint Alphonsus Hospital, Boise, Idaho, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristin Y.","family":"Shiue","sequence":"additional","affiliation":[{"name":"IQVIA Real World Solutions, Research Triangle Park, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leigh J.","family":"Weiss","sequence":"additional","affiliation":[{"name":"New York Football Giants, Quest Diagnostics Training Center, East Rutherford, New Jersey, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James R.","family":"Jastifer","sequence":"additional","affiliation":[{"name":"Borgess Orthopedics, Kalamazoo, Michigan, USA"},{"name":"WMU Homer Stryker M.D. School of Medicine, Kalamazoo, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward M.","family":"Wojtys","sequence":"additional","affiliation":[{"name":"MedSport, Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert B.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Bellin Health Titletown Sports Medicine and Orthopedics, Green Bay, Wisconsin, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2020,6,2]]},"reference":[{"key":"bibr1-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1177\/2325967117708744"},{"key":"bibr2-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000741"},{"key":"bibr3-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1177\/1941738119854759"},{"key":"bibr4-0363546520922547","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-52.2.17"},{"key":"bibr5-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2012-092096"},{"key":"bibr6-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1177\/0363546508319898"},{"key":"bibr7-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512458888"},{"key":"bibr8-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516666815"},{"key":"bibr9-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1177\/1071100717718131"},{"key":"bibr10-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1177\/1941738118793378"},{"key":"bibr11-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1080\/14763141.2015.1024277"},{"key":"bibr12-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1080\/14763141.2015.1052749"},{"issue":"3","key":"bibr13-0363546520922547","first-page":"156","volume":"13","author":"Low K","year":"2004","journal-title":"J Surg Orthop Adv"},{"key":"bibr14-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1177\/0363546518808499"},{"issue":"1","key":"bibr15-0363546520922547","first-page":"14","volume":"24","author":"Mack CD","year":"2015","journal-title":"Chin J Epidemiol"},{"key":"bibr16-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1055\/s-0036-1584313"},{"key":"bibr17-0363546520922547","doi-asserted-by":"publisher","DOI":"10.1177\/0363546516645082"},{"key":"bibr18-0363546520922547","unstructured":"National Football League. 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