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Disc Herniations in the National Football League

Gray, Benjamin L., MD*; Buchowski, Jacob M., MD, MS*; Bumpass, David B., MD*; Lehman, Ronald A. Jr., MD; Mall, Nathan A., MD; Matava, Matthew J., MD*

doi: 10.1097/BRS.0b013e3182a67678

Study Design. Retrospective analysis of a prospectively collected database.

Objective. To determine the overall incidence, location, and type of disc herniations in professional football players to target treatment issues and prevention.

Summary of Background Data. Disc herniations represent a common and debilitating injury to the professional athlete. The NFL's (National Football League's) Sports Injury Monitoring System is a surveillance database created to monitor the league for all injuries, including injuries to the cervical, thoracic, and lumbar spine.

Methods. A retrospective analysis was performed on all disc herniations to the cervical, thoracic, and lumbar spine during a 12-season period (2000–2012) using the NFL's surveillance database. The primary data points included the location of the injury, player position, activity at time of injury, and playing time lost due to injury.

Results. During the 12 seasons, 275 disc herniations occurred in the spine. In regard to location, 76% occurred in the lumbar spine and most frequently affected the L5–S1 disc. The offensive linemen were most frequently injured. As expected, blocking was the activity that caused most injuries. Lumbar disc herniations rose in prevalence and had a mean loss of playing time of more than half the season (11 games). Thoracic disc herniations led to the largest mean number of days lost overall, whereas players with cervical disc herniations missed the most practices.

Conclusion. Disc herniations represent a significant cause of morbidity in the NFL. Although much attention is placed on spinal cord injuries, preventive measures targeting the cervical, thoracic, and lumbar spine may help to reduce the overall incidence of these debilitating injuries.

Level of Evidence: N/A

Disc herniations have a rising prevalence among professional football players in the National Football League. These injuries represent a significant morbidity with the mean loss of playing time of half the season. Defensive and offensive linemen are at greatest risk.

*Department of Orthopaedic Surgery, Washington University in St. Louis, St. Louis, MO

Department of Orthopaedics and Rehabilitation, Walter Reed National Military Medical Center, Bethesda, MD; and

St. Louis Center for Cartilage Restoration and Repair, Regeneration Orthopedics, St. Louis, MO.

Address correspondence and reprint requests to Jacob M. Buchowski, MD, MS, Washington University Orthopedics, 660 South Euclid Ave, Box 8233, St. Louis, MO; E-mail:

Acknowledgment date: December 6, 2012. First revision date: March 8, 2013. Second revision date: May 31, 2013. Acceptance date: July 21, 2013.

The manuscript submitted does not contain information about medical device(s)/drug(s).

No funds were received in support of this work.

Relevant financial activities outside the submitted work: board membership, consultancy, expert testimony, grants, payment for lecture, travel/accommodations/meeting expenses.

© 2013 by Lippincott Williams & Wilkins