What the N.F.L. Says, and What It Doesn’t, About Injuries

Not in the data it routinely publishes.

Football players have been anxious about heart problems for decades, and researchers have long studied former players. In 2019, for instance, a study published in the Journal of the American Heart Association found that former N.F.L. players were far more likely to have atrial fibrillation than people in the general population. (The study, funded in part by the N.F.L., acknowledged shortcomings, like the possibility of recruitment bias and the absence of long-term monitoring.)

Concerns about cardiac risks extend to current players. By the 2019 regular season, the N.F.L. was worried enough about the threat of sudden cardiac arrest that it circulated an educational video to its teams.

In the presentation, Dr. Jonathan A. Drezner, the team physician for the Seattle Seahawks and the director of the Center for Sports Cardiology at the University of Washington, warned that sudden cardiac arrest was the top cause of death among exercising athletes. Most cases, he noted, occurred in basketball, football or soccer players and could often be traced to ventricular fibrillation, which renders the heart ineffective.

N.F.L. officials expected that team medical staffs would review the video annually, and doctors felt that teams should include sudden cardiac arrest in their mandatory preseason rehearsals for in-game emergencies.

The N.F.L., like other professional leagues and the N.C.A.A., was concerned in the early months of the coronavirus pandemic about the possibility of Covid-19 leading to heart troubles in athletes. In some instances, the N.F.L. recommended that players who tested positive for the virus undergo certain cardiac tests, such as an electrocardiogram, which charts electrical activity in a heart, and an echocardiogram, an ultrasound that allows doctors to evaluate visually a heart’s structure and function.

By the N.F.L.’s count, at least, they are less common than they once were. In the 2015 preseason and regular season, including practices, the league formally recorded 275 concussions, which can be challenging to diagnose. In 2021, that number declined to 187.

Concussions especially plunged in the 2018 season, after the league introduced a rule prohibiting players from lowering their heads and crashing into opponents with their helmets. There were 214 that year, including preseason practices and games, down from 281 in the previous season.

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