National Football League Players Association

ObjectiveTo compare the severity of head impacts between professional and Division I (D-I) collegiate football games for the purpose of improving protective equipment.MethodsA total of 243 football players from the National Football League (NFL) and from D-I of the National Collegiate Athletic Association (NCAA) were equipped with instrumented mouthpieces capable of measuring six degrees-of-freedom head kinematics. Head impacts were processed using a custom algorithm and combined with game period descriptors to produce a curated dataset for analysis. Head impact severity distributions for several kinematic-based metrics were compared within position groupings between leagues.ResultsA total of 11 038 head impacts greater than 10 g from 1208 player-games were collected during 286 player-seasons (2019–2022). No significant differences were found between leagues in the distributions of kinematic-based metrics for all investigated position groupings (p≥0.320). The median and IQRs for peak linear acceleration for NFL and NCAA were 17.2 (9.3) g and 17.0 (8.6) g for linemen, 20.7 (13.8) g and 20.0 (13.5) g for hybrid and 21.0 (17.0) g and 20.8 (15.5) g for speed position groupings, respectively.ConclusionThe absence of statistically significant differences in the distributions of head impact severity between professional and D-I collegiate football players indicates that these data can be combined for the purpose of understanding the range of loading conditions for which new protective equipment, such as position-specific helmets, should be designed. This observation underscores the potential for knowledge transfer regarding biomechanical factors affecting head loading across professional and D-I college football, highlighting crucial implications for innovation in protective equipment.

ABSTRACT North American professional sport continues to evolve by adopting robust performance development strategies that place a premium on player care and competitive readiness. These strategies can be demonstrated by the increase of clubs implementing high-performance departments to maximize service quality rendered to rostered players. Although this transition to an integrated approach to player care is appreciated, it has become evident that there is a need to clarify the role, responsibilities, and job demands of high-performance directors. This emerging executive position is charged with leading complex systems of intertwined departments through the development of an environment that fosters a transdisciplinary approach to athlete preparation and care through enhanced organizational communication and the reduction of disciplinary silos that can thwart collaboration. Therefore, the current article describes the high-performance environment, allowing for a more accurate definition and representation of a modern high-performance director. The current article relies on the authors' collective experience as current professional-sport high-performance leaders to provide meaningful recommendations and insight into the field.

Hill, Kevin P. MD, MHS; Wu, Andrew MD; Solomon, Gary S. PhD; Mack, Christina PhD, MSPH, FISPE; Ling, Geoffrey MD, PhD; Mayer, Thom MD, FACEP, FAAP, FACHE; Sills, Allen K. MD Author Information

BackgroundPopulation screening with highly sensitive diagnostic tools, such as nucleic acid amplification testing (NAAT), can enable early identification and isolation of cases and reduce transmission of SARS-CoV-2.ObjectiveTo describe the results of a rigorous, large-scale COVID-19 testing and monitoring program with confirmatory processes and adjudication of positive results.DesignDescriptive Epidemiology StudySetting32 U.S. National Football League (NFL) Clubs during the 2020 seasonParticipantsNFL players and staffMethodsThe NFL/NFL Players Association instituted a COVID-19 Testing and Surveillance Program for the 2020 Season, which included daily testing for players and staff, full medical follow-up and adjudication of cases. Clinical adjudication was based on subsequent daily testing, symptoms, and clinical history; persons remained in isolation during adjudication.ResultsBetween August 1 and November 14, 2020, a total of 632,370 RT-PCR tests were administered to 11,668 individuals; 270 (2.4%) confirmed cases were observed. PPVs of the initial positive result ranged from 73–82% across RT-PCR platforms. Initial positive results were positive on re-processing 61–79% of the time. PPV increased when both results were positive to >95%; however, initial positives that were negative on confirmatory processing resulted in true cases a portion of the time, depending on machine and population prevalence. High Ct values (33 to 37) could indicate onset of infection. Infected individuals were identified and isolated early in infection, preventing spread.InterventionsDaily or frequent testing using three NAAT platforms, rapid point-of-care testing, and symptom monitoring.Main Outcome MeasurementsCOVID-19 infection.ConclusionRoutine RT-PCR testing allowed early detection of infection. Cycle threshold values provided a useful guidepost for understanding results. Confirmatory processing of initial positive values significantly improved PPV. Antigen POC testing was unable to reliably rule out COVID-19 early in infection. Adjudication processes were able to confirm or rule out SARS-CoV-2.

Editor's Note—Since the publication of his book Out of Their League, Dave Meggyesy has brought a thoughtful and public voice to the player's perspective in professional football. This comment was received in our editorial office January 11, 1993, five days after an agreement between the NFL owners and players had been announced.