Big Name Injuries Kill 2011 NFL Rosters Scanning the Monday morning NFL headlines this year has been more like picking up a in-patient chart at the emergency ward. Concussions, strained hamstrings, stressed and torn ACLs and ruptured Achilles tendons are among the most common. While ankles injuries and muscles strains are also fairly common, they usually don’t require the long term rehabbing that the prior listed injuries do. Achilles tendons popping like champagne corks began to effect NFL lineups even before the season started. During the truncated offseason programs there was an unofficial count of 10 Achilles injuries. In comparison, there is an average of eight Achilles injuries during a full season, according to Dr. Elliott Hershman, chairman of the NFL’s Injury and Safety Committee. Hershman explained that it is not uncommon to see a high number of a particular injuries during a season, citing the number of injuries occurring in the acromioclavicular joint in the shoulder in the league a few years prior. The NFL combats this by studying workout regimens and modifying training schedules and programs. While some speculate that the shortened off-season conditioning programs are contributing to an increase in injuries, the data is still too fresh to be interpreted with any certainty. In fact, professional athletes’ personal training is such a high priority some say an offseason program should have no bearing on injuries. “In this day and age these guys are working out the whole time with their personal trainers and there is such a focus on maintaining shape quotas, so to speak,” said James Rosneck, MD, a Cleveland Clinic orthopedic surgeon that specializes in ACL, hamstring and sports related injuries. Rosneck went on to explain that muscle memory for a particular sport or a particular play has more bearing on the types of injuries that he specializes in than the condition of a player’s personal fitness when reporting to training camp and playing in a game. As it is, there is nearly 180 players listed as questionable, doubtful and out heading into week eight of the NFL season. Of those listed on injured reserve (IR), a little more than 30 percent are a result of a hamstring or knee injuries. The league has made a concerted effort to address players’ health as of late, though the focus has been more on head injuries and concussions. By comparison, heading into week eight injuries of these types account for around seven percent of those on IR. Football is an inherently violent game and despite the league’s best intentions injuries are unavoidable. While changing rules and levying fines for play that results in concussions and other head injuries is possible, attempting to protect players’ ligaments and tendons is nearly impossible. “ACL injuries are caused most commonly by non-contact pivoting that happens when people land or try and change directions,” Rosneck said. “As far as the ACL goes, often times there is not much you can do (to prevent it). You’re leg is going one way and you’re changing direction. It’s like the perfect storm so to speak.” Rosneck went on to explain that there has been some rising correlations between fatigue and ACL injuries as a result of landing inappropriately or falling in a locked knee position. As doctors get a better understanding on the exact causes of the injuries they are better able to develop preventative measures. “We are focusing on neuromuscular education and training to improve mechanics” Rosneck said. “So when you fatigue you land appropriately so you don’t get in that perfect storm scenario.” Fortunately hamstring injuries are a bit more predictable, and in turn preventable. “We’ll see people in the clinic that have always had tight hamstrings, so we just know that’s a setup for these types of injuries,” Rosneck said, adding: “Maintaining, or obtaining, flexibility of the lower extremity and lower muscle groups is a preventative measure.” As the season heads into the halfway mark the number of serious injuries should decline, at least if prior season are any indication. However, the saying “on any given Sunday” need not only apply to wins and losses, but also a player’s health. Who knows when the next ACL will tear like a tawdry prom dress.