NFL issues significant call to action after high injury rates on special teams, officials say

The NFL has issued a significant call to action in response to disproportionately high injury rates on special teams, league officials said this week. Rule changes and new training requirements are among the possible solutions that NFL medical staffers and competition committee members will discuss in the coming weeks.

Concussions across all plays continued their downward trend from recent years, the league reported Monday as part of its annual health and safety meeting with reporters covering Super Bowl LVI. But the data showed that concussions are occurring with higher frequency on punts and kickoffs despite a series of recent rule changes designed to make both safer.

One in six NFL concussions occurred this season on special teams, according to chief medical officer Dr. Allen Sills, along with 30% of ACL tears and 29% of muscle injuries to lower extremities. Those numbers require "our attention immediately" Sills said, because special teams represent only 17% of plays in a typical NFL game.

Punts have surpassed kickoffs as the most injurious play in football, he added, but both have unacceptably elevated rates of injury. In one particularly notable play this season, the Green Bay Packers' Kylin Hill tore an ACL and the Arizona Cardinals' Jonathan Ward suffered a concussion when they collided during a kickoff return in Week 8.

The NFL redesigned the kickoff in 2018, outlawing most double-team blocks, eliminating the running starts of cover men and limiting the number of blockers who can line up near the returner. The NFL also eliminated most blindside blocks in 2019, a rule change it hoped would impact punts. But injuries on punts haven't really abated, and they have passed kickoffs in part because nearly 60% of all kickoffs go unreturned for touchbacks.

Jeff Miller, the NFL's executive vice president of communications, public affairs and policy, said the league wouldn't solely look at rule changes this spring and made clear that there remains a strong preference against eliminating any part of special teams.

"You have to ask the question whether the players on special teams are training for the sorts of movements and experiences they have on special teams plays," Miller said. "If they're not, why not? And if they need to do more of it, then they should. And that's before you get to rules. Even then, when you get to rules, and the competition committee has addressed this many times in the past few years, the health and safety input into potential rule changes and how you would model a rule that would in fact keep the foot in the game -- and still keep the excitement of the play and find a way to mitigate some of the risk of injury -- is a tall order. But it's something we're going to spend a lot of time working on. These numbers call that out."

The NFL issued a similar call to action against concussions across the board in 2018 and has since seen a steady decrease. Overall, there were 187 concussions during practice and games (including the preseason) in 2021, according to data released Monday. That figure was higher than 2020 (172), but that number came after the NFL canceled its preseason because of the COVID-19 pandemic. The three-year average 2015-17 was 266.3. There were 214 in 2018 and 224 in 2019.

Over the past year, the NFL has increased its efforts to count not only each concussion but also every instance of head impact, or any time the helmet hits something, be it another helmet, the body of an opponent/teammate or the ground. It now has the ability to reliably track impact through artificial intelligence analysis of video, and it will begin distributing the resulting data to teams and players in the coming year.

"I would go so far as to say we want to remove avoidable head contact from the game," Sills said. "There's always going to be some instances when players hit the ground or collide, but to the extent that avoidable head contact can be removed, we want to do that. ... That's going to involve teaching better techniques, training and practices, probably some element of rule changes, use of the Guardian Cap [an extra pad affixed on a helmet]. It will be a very comprehensive effort and is our next big frontier when it comes to the neurological health of our players.

"We are pleased with the concussion numbers, but we feel it's not the full picture and we really want to aggressively reduce and work to eliminate avoidable head contact."

According to Miller, the efforts will be particularly focused on offensive and defensive linemen, who have the highest rate of head impact among positions. Repeated subconcussive head impact is believed to be the primary cause of chronic traumatic encephalopathy (CTE).

In other NFL health and safety news:

* Sills said he considered the NFL's COVID-19 response in 2021 "a success," especially after pivoting in mid-December in response to the omicron variant. A total of 1,224 players and staff tested positive between Dec. 12 and Jan. 8, but numbers dipped dramatically once the playoffs began. Sills attributed the drop to the high number of infections in December, as well as "significant self-regulation" by players and coaches during the most important weeks of the NFL season. Although the league stopped testing asymptomatic players, Sills said the drop "is not because we're not looking." He added: "We're still doing symptom screening on everyone, and we're still doing testing, but in a targeted manner."

* The league finished the year with 95% of its players and nearly 100% of staff members vaccinated. As a result, only one "member of the NFL family" was hospitalized during the season, Sills said. The league does not identify outcomes for specific individuals, but Minnesota Vikings offensive lineman Dakota Dozier told ESPN that he spent three nights in a local hospital because of breathing problems after testing positive in November.

* An initial analysis of total injuries during the NFL's first 17-game season showed no difference than previous seasons, Miller said, largely because the addition of one regular-season game corresponded with the elimination of one preseason game. There had been some fears that fatigue-based injuries would increase in the final week of the season, but Miller said the numbers were flat. "That's what our supposition was going in," he said, "and it's only one season, but it's something we looked at."

* Injuries to hamstring, quadriceps and abductor muscles were up "significantly," Sills said, driven primarily by spikes during the early portions of training camp. The league is conducting studies on the connection of various cleats and playing surfaces, and it donated $4 million to the University of Wisconsin last summer to study ways to minimize hamstring injuries in particular.