NFL lockout might have led to spike in injuries

Editor's Note: Dr. Geier is Director of MUSC Sports Medicine and an orthopaedic surgeon. He writes a sports medicine column for The Post and Courier.

A fascinating debate between NFL owners and teams and their players has been developing in recent weeks. Yes, it centers around the lockout, but not in the sense you would expect. The concern has not been money or missed games. The question is whether the lockout has caused a spike in injuries.

While the NFL preseason has always seen its share of injuries, there appears to be an increase this year. Foot injuries to first-round draft picks Prince Amukamara and Nick Fairley have drawn attention, and a host of injuries to veteran players has been noted as well.

Most alarming is that 10 players suffered Achilles tendon ruptures before the first preseason games were played. According to Football Outsiders, only nine players were listed on the injured reserve list in 2010 for these injuries after the entire preseason. Dr. Elliott Hershman, the chairman of the NFL's Injury and Safety Committee, told the New York Times that an average of eight Achilles tendon ruptures typically occur in a full season.

How teams are coping with the shortened training camps and preseason schedules and potential injuries varies. The Kansas City Chiefs reportedly have been practicing without pads, and coach Todd Haley canceled all scrimmages prior to the first preseason game due to concerns about the physical conditioning of the players. Dr. Thom Mayer, the medical director for the NFL Players' Association, told the Associated Press, 'I think there's 32 different answers to how coaches and players are approaching this. (The lockout) has really changed the dynamic.'

Dr. Hershman points out that muscle and tendon injuries have always been more common in training camp, especially hamstring injuries. He offers another potential cause for the apparent increase in Achilles injuries: Since teams are allowed to have more players on the roster this year due to the lockout, there are more players at risk for injury.

I would also caution against reading too much into a spike of one particular injury. It may simply be an aberration that there have been so many Achilles injuries this year. Previous seasons have witnessed surges in other injuries, such as concussions.

In theory, the argument that the lockout is causing the rash of injuries this preseason makes at least some sense. If players sat around all offseason and didn't work out or eat well, they would report to camp in worse shape than they would in normal years due to a lack of offseason minicamps. In an abbreviated preseason, players would then suffer more muscle and tendon injuries that often occur in athletes who are trying to do too much too soon.

I doubt that players are that out of shape, though. From my experience with the NFL, I couldn't believe how businesslike players regarded the sport. This is their job, and they take it seriously. I would argue that they would train in the offseason to be in top physical condition just like I would prepare for a difficult surgery.

The fact that players and teams are rushing straight into competition might have more impact. The description of an Achilles rupture given to me by almost every athlete I see involves either starting a sudden sprint from standing or barely running or a sudden change of direction. They feel a sudden pop, almost as if someone had kicked them in the leg. In this case, it seems plausible that players, while in good overall shape, could be rushing back too fast to scrimmages and games and not be acclimated to these sudden movements.

If the lockout is associated with a spike in injuries, it should affect rookies more than veterans. The veterans, in theory, should understand what it takes to be ready physically and mentally for a grueling NFL season. College players only know the 13-game college schedule with no preseason games and shorter daily practices, not the 12-hour days of an NFL training camp. And the lockout's elimination of offseason workouts prevented rookies from adjusting through team minicamps.

It isn't clear that the lockout has anything to do with the injuries. But it will be another hotly debated storyline over the course of the season. Only time and further study will tell if the lockout has literally made players' Achilles tendons the NFL's Achilles' heel.

Read more about football injuries and other sports medicine topics on Dr. Geier's blog, www.drdavidgeier.com.