Abstract
Anterior cruciate ligament (ACL) tears in National Football League (NFL) players are
devastating injuries that take nearly a year to recover. Players that do return to
sport have worse overall performance compared to pre-ACL tear. NFL players typically
play regular season games on Sunday with the next game played on the following Sunday,
allowing for 6 days between games. Deviation from the usual 6-day rest week has been
proposed as a potential risk for ACL tear. The main objective of this study was to
evaluate the risk of decreased rest or increased rest on ACL tear rates in NFL players.
ACL injury data of NFL players from the 2012 to 2013 season and 2022 to 2023 season
were gathered from publicly available sources. Player demographic data, position,
age at time of injury, seasons played, injury mechanism, and playing surface type
were recorded. Injuries were characterized as short, normal, or long week injuries.
ACL tears that occurred during the preseason, postseason, or during week 1 were excluded.
Descriptive statistics were calculated to report means, ranges, and percentages. Data
were analyzed to determine statistically significant differences using Fisher's exact,
chi-square, or one-way analysis of variance tests. A total of 524 ACL tears were recorded
in NFL players during the study window. Note that 304 ACL tears were excluded and
220 fit inclusion criteria. Twenty-four ACL tears occurred during short weeks, 68
during long weeks, and 128 during normal weeks. Players were 1.8 times more likely
to tear their ACL during a long week compared to a normal week (p < 0.001), and 1.5 times more likely to tear their ACL during a short week compared
to a normal week (p = 0.02). The findings from this study suggest that deviation from the normal 7-day
NFL week increases the risk of an ACL tear in NFL players when increasing or decreasing
rest time. Further research exploring the impact of short and long rest times on player
injury risk should be conducted to prevent season-ending injuries.
Keywords
ACL - NFL - Football - Rest - Injury
