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NFL Athletes at High Risk for ACL Injuries During Change-of-Direction Scenarios

Strategic Insights

— 1 min read

Investigators have conducted a research study to identify ACL injuries during change-of-direction (CoD) scenarios in the National Football League (NFL). The study, published in The American Journal of Sports Medicine, reported that NFL athletes face a substantial risk for anterior cruciate ligament (ACL) injuries, particularly during special team plays. The research team, led by Paul M. Inclan from the University of Arkansas for Medical Sciences, found that 98% of athletes involved in a CoD scenario were decelerating at the time of their ACL injury.

Key Takeaways:

  • NFL athletes are at a high risk for ACL injuries, particularly during special team plays, with 32% of ACL injuries classified as noncontact, 42% as indirect contact, and 46% as CoD scenarios.
  • Among the ACL injuries reviewed, 98% occurred during CoD scenarios, with athletes decelerating at the time of injury.
  • Maximum speed and normalized maximum deceleration power were both significant predictors of the CoD ACL injury risk, with odds ratios of 1.52 and 1.08 per 1-m/s increase in maximum speed and 1-W/kg increase in maximum deceleration power, respectively.
  • Punt and kickoff returns had a significantly increased CoD ACL injury risk only when maximum speed and normalized maximum deceleration power metrics were excluded from the generalized linear mixed model (GLMM).
  • The study concluded that the inclusion of these metrics in a GLMM helped to explain the variation in CoD ACL injury rates observed across different play types.

Statistics:

  • 216 ACL injuries occurred in games during the 2018 to 2022 NFL seasons.
  • 32% of ACL injuries were noncontact, 42% were indirect contact, and 46% were classified as CoD scenarios.
  • 98% of athletes involved in a CoD scenario were decelerating at the time of their ACL injury.
  • Maximum speed (odds ratio, 1.52 per 1-m/s increase in maximum speed) and normalized maximum deceleration power (odds ratio, 1.08 per 1-W/kg increase in maximum deceleration power) were both significant predictors of the CoD ACL injury risk.

Sources:

  • Player Tracking Metrics to Predict Risk of Anterior Cruciate Ligament Injuries During Change-of-Direction Scenarios in the National Football League. The American Journal of Sports Medicine, 2025;53(11):2523-2532.
  • Researchers from University of Arkansas for Medical Sciences Report Details of New Studies and Findings in the Area of Sports Medicine (Player Tracking Metrics to Predict Risk of Anterior Cruciate Ligament Injuries During Change-of-Direction ...). Health & Medicine Week. September 19, 2025; p 6631.

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