Prevalence of Shoulder Labral Injury in Collegiate Football Players at the National Football League Scouting Combine

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Labral tears confirmed by magnetic resonance imaging (MRI) are a relatively common injury among collegiate athletes and can influence a player’s ability to compete at the professional level. Shoulder instability events in athletes, which commonly cause a shoulder labral tear, reportedly occur at a rate of 0.12 per 1000 exposures.11 Athletes in contact and collision sports have a higher risk of shoulder instability because of exposure to repeated traumatic loads on the shoulder. In rugby, for example, the shoulder has been reported to be the third most common site of injury. Yet the prevalence of injuries to the glenoid labrum in football has not been well documented in the literature, particularly in the context of football players entering the National Football League (NFL) Scouting Combine in an attempt to make a professional NFL roster. An understanding of the prevalence of labral tears has financial implications, as labral tears may negatively affect player draft order, which in turn lowers the value of the drafted player’s first contract. To date, limited epidemiological data are available in this specific patient population.

In addition to studying the prevalence of labral tears, studying the pathoanatomic characteristics of labral tears based on anatomic location and their association with foot- ball player position may be important. Such study may also assist with musculoskeletal evaluation and assessment, as anterior, posterior, and combined anterior and posterior labral tears may represent different mechanisms of injury, different spectrums of symptoms, and different effects on performance.

The NFL Scouting Combine is a weeklong showcase where collegiate football players are tested and evaluated. Because thorough injury evaluations are conducted by skilled medical teams, with supplemental imaging, the event provides a unique opportunity to collect and analyze injury data among an elite, high-demand athlete population. This study therefore aimed to characterize the epidemiological characteristics of labral tears, including anterior tears, posterior tears, combined anterior and posterior lab- ral tears, and superior labral anterior-posterior (SLAP) tears, in elite football players by analyzing the records of NFL Combine participants. We hypothesized that certain tear patterns would be more prevalent in certain player positions due to the repetitive movements exerted during play, the loads to which the shoulder is subjected, and position-specific training. We also hypothesized that line- men, both offensive and defensive, would have a higher incidence of posterior labral tears because of the at-risk shoulder orientation that their position requires, whereas SLAP tears would be more prevalent in quarterbacks owing to the overhead throwing motion of their position. Anterior labral tears were hypothesized to be more prevalent in wide receivers, tight ends, and other skill positions in which the player uses the arm in a more outstretched position, which increases the risk of traumatic anterior dislocation during tackling, collisions, or forceful landing.

Full Article: Prevalence of Shoulder Labral Injury in Collegiate Football Players at the National Football League Scouting Combine