Return to Full Participation Following Concussion in the National Football League, 2015 Through 2020

Christina D. Mack, Mackenzie M. Herzog, Gary Solomon, Margot Putukian, Rebecca Y. Lee, Matthew J. Matava, Javier Cárdenas, Nicholas Theodore, Allen Sills

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Objective:Quantify days missed, games missed, injury burden, and time to return to full participation (RTFP) among National Football League (NFL) players who sustained a concussion.Design:Retrospective cohort study.Setting:2015 through 2020 NFL seasons.Participants:National Football League players diagnosed with a concussion from 2015 to 2020.Interventions:National Football League-mandated graduated RTFP protocol.Main Outcome Measures:Days missed, games missed, burden, and time to RTFP, overall and by position.Results:An annual average of 3639 player-days of participation and 255 games were missed across NFL because of concussion. Concussed players missed a median of 9 days (mean = 15.0), a relatively stable metric over 6 years, with slight variation by position. Offensive linemen, tight ends, running backs, and linebackers missed the most days per concussion; defensive secondary, offensive linemen, and wide receivers sustained the highest injury burden. Postconcussion, 59% of players missed one or more scheduled games. Among players concussed in a Sunday game, 38% played in a Sunday game one week later.Conclusions:The 9-day median time missed post-concussion may be related to emphasis on graduated phase-based concussion management. No concussed player returned to competition on the day of injury, and less than 40% participated in games the following week. Further work is needed to better understand characteristics of concussions that take longer to return and movement through stages of return.

Original languageEnglish
Pages (from-to)E605-E613
JournalClinical Journal of Sport Medicine
Issue number6
StatePublished - Nov 1 2022


  • American football
  • National Football League
  • concussion
  • epidemiology
  • return to play


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