Abstract
Introduction
Injuries sustained by professional athletes have the potential to severely impact performance and abilities. While lower extremity injuries have dominated the literature, upper extremity trauma represents a significant source of morbidity in football players. The aim of this study is to characterize the impact of hand injuries on the performance of athletes in the National Football League (NFL). This is significant, due to the highly variable functional demands for each position.
Methods
NFL players who sustained phalanx, thumb, metacarpal, or carpal injuries from the 2012-2013 season to 2022-2023 season were identified using Pro Sports Transactions. Performance data was extracted from Pro Football Reference including player position and number of games missed, as well as number of games played, games started, and snap counts in the seasons prior to and following injury. Players were excluded if the injury occurred during the player’s rookie or final season or if additional injuries were sustained at the time of the upper extremity injury. Data was analyzed using ANOVA single factor test (alpha=0.05.)
Results
304 players sustained a phalanx, thumb, metacarpal, or carpal injury, with three players having injuries in two of these categories: metacarpal, n = 110 (35.8%); carpal, n = 80 (26.1%); thumb, n = 78 (25.4%); and phalangeal, n = 39 (12.7%). Linebackers (14.6%) and wide receivers (12.8%) were most likely to sustain one of these injuries. Most occurred during the preseason or in September (p 0.001). The average number of games missed due to injury was 5.5; carpal: 6.4, phalangeal: 5.8, thumb: 5.4, and metacarpal: 4.3 (p = 0.02). Sixty-five players were injured in their rookie season and 58 in their final season. The average change in games played in the preceding season to those in the following season was +1.0, with no significant difference when stratified by injury. The average change in games started was +0.5. The average change in snap counts was +72.8; by injury, phalangeal: +120.1, carpal: +31.5, thumb: +125.7, and metacarpal: +50.0. Safeties had the greatest decrease in games played (0.8 fewer), and the greatest decrease in games started (2.0 fewer). Safeties also had the largest decline in snap counts, with an average of 94.9 fewer snaps after injury.
Conclusion
Phalanx, thumb, metacarpal, and carpal injuries are common injuries in NFL players, with an average of about 25 recorded per season, and they have a measurable impact on player performance. Players missed an average of more than 5 games due to these injuries, which is nearly a third of a normal season. Fifty-eight players did not return to the NFL, suggesting that hand injuries may be costly to both players and organizations and should be carefully managed by trainers and medical staff. However, there was an overall improvement in performance among the players who returned the following season, which varied greatly depending on the position of the player. This study should help guide team physicians in anticipating the impact on players after a hand injury based on their position.