Stature, Body Mass, and Body Mass Index in High School American Football Players: Appropriate Determinants of Obesity Prevalence?

Return to Play, Performance, and Economic Analysis of National Football League Players After Lisfranc Injury

Background

A Lisfranc injury can occur to either the ligament or bone, which causes instability when attempting to perform strength and balance maneuvers.

Purpose/Hypothesis

The study's aims were to (1) analyze the return-to-play (RTP) rate and performance level of players in the National Football League (NFL) after Lisfranc injury and (2) determine the economic and financial impact of Lisfranc injuries to the NFL. We hypothesized that there would be a low RTP rate following Lisfranc injury in the NFL.

Study Design

Case series; Level of evidence, 4.

Methods

Multiple online public records were used to identify NFL players with Lisfranc injuries between the 2009 and 2020 seasons. Players were assessed according to their RTP statistics: snap count, approximate value (AV), games played, and games started. Nonparametric methods were used to compare player statistics before and after injury. Also, player salaries while injured were calculated (in 2022 US dollars after adjusting for inflation) to approximate economic loss for those players who returned to play.

Results

A total of 33 NFL athletes sustained a Lisfranc injury during the study period. Most Lisfranc injuries were experienced by offensive linemen (n = 8; 24.2%), followed by running backs (n = 7; 21.2%). Overall 27 players (81.8%) returned to play after injury at a median of 11.0 months (IQR, 10.2-11.8 months). There were no significant differences between pre- and postinjury snap counts or number of games played and started. In terms of player performance, there was a statistically significant decrease in AV at 1 year postinjury (median [IQR], 6.0 [4.0-10.0] preinjury vs 5.0 [2.5-7.5] postinjury; P = .022). The overall cost of recovery amounted to $104.7 million, with quarterbacks (n = 4) accounting for the greatest cost at $32.6 million. The next 2 most expensive positions were offensive and defensive linemen (n = 5 each) at $19.4 million each.

Conclusion

Our results did not support the hypothesis, as the RTP rate for NFL athletes sustaining Lisfranc injuries was 81.8%. This injury was associated with a significant decrease in AV 1 year postinjury. In terms of economic impact, quarterbacks accounted for almost one-third of expenses while constituting only 14.8% of injuries.

Increased Snap Counts Were Not Seen Prior to Lisfranc Injuries in the National Football League

Introduction Athletes in the National Football League (NFL) subject their bodies to a great deal of physical strain, which places them at an increased risk for injury. The purpose of this study was to determine if there was an increase in snap counts played during a player's injury game or season that may have contributed to an increased risk of sustaining a Lisfranc injury in the NFL. We hypothesized that players who play more snaps than they have in seasons prior will be at an increased risk of injury. Methods NFL players with Lisfranc injuries were identified by cross-referencing multiple online resources. Information on a player's position, draft year, draft round selection, height, weight, snap counts, approximate value (AV), quarter of injury (first, second, third, fourth), quarter of a season (games one through four, five through eight, nine through twelve, thirteen through sixteen), and injured foot laterality was collected. A control group of players without a Lisfranc injury was then selected to compare performance data with our injured cohort that returned to play. Results Twenty-one NFL players, who met inclusion criteria, sustained a Lisfranc injury between the years 2013 and 2021. Players played significantly fewer snaps before sustaining a Lisfranc injury compared to their season average (33.9 ± 21.9 vs. 50.3 ± 15.8; p=<0.001), but when comparing the number of snaps played per game in their injury year with the number of snaps played per game over their career before injury, there was no significant difference (50.3 ± 15.8 vs. 45.7 ± 17.1; p=0.20). Most injuries occurred in either the first (42.9%) or second (33.3%) quarter of a regular season (games one through eight). During a game, the timing of most injuries was either the second (38.1%) or fourth (33.3%) quarter. There was no significant difference between injured players and controls post-injury between the number of average seasons played, AV, and snaps played per game. Conclusion Increased snap counts were not seen prior to Lisfranc injuries in the NFL.

Effects of aerobic exercise and resistance exercise on physical indexes and cardiovascular risk factors in obese and overweight school-age children: A systematic review and meta-analysis

Background

Obesity is a serious social and public health problem in the world, especially in children and adolescents. For school-age children with obesity, this stage is in the transition from childhood to adolescence, and both physical, psychological, and external environments will be full of challenges. Studies have showed that school-age children are the largest proportion of people who continue to be obese in adulthood. Physical exercise is considered as an effective way to control weight. Therefore, we focus on this point to study which factors will be improved to reduce childhood obesity.

Objective

To assess the effects of aerobic and resistance exercise on physical indexes, such as body mass index (BMI) and body fat percentage, and cardiovascular risk factors such as VO₂peak, triglycerides (TG) and low-density lipoprotein (LDL), high-density lipoprotein (HDL), total cholesterol (TC), insulin and insulin resistance in school-age children who are overweight or obese.

Method

PubMed, SPORTDiscus, Medline, Cochrane-Library, Scopus, Ovid and Web of Science were searched to locate studies published between 2000 and 2021 in obese and overweight school-age children between 6–12 years old. The articles are all randomized controlled trials (RCTs) and in English. Data were synthesized using a random-effect or a fixed-effect model to analyze the effects of aerobic and resistance exercise on six elements in in school-age children with overweight or obese. The primary outcome measures were set for BMI.

Results

A total of 13 RCTs (504 participants) were identified. Analysis of the between-group showed that aerobic and resistance exercise were effective in improving BMI (MD = -0.66; p < 0.00001), body fat percentage (MD = -1.29; p = 0.02), TG (std.MD = -1.14; p = 0.005), LDL (std.MD = -1.38; p = 0.003), TC (std.MD = -0.77; p = 0.002), VO₂peak (std.MD = 1.25; p = 0.001). However, aerobic and resistance exercise were not significant in improving HDL (std.MD = 0.13; p = 0.27).

Conclusions

Aerobic exercise and resistance exercise are associated with improvement in BMI, body fat percentage, VO₂peak, TG, LDL, TC, while not in HDL in school-age children with obesity or overweight. Insulin and insulin resistance were not able to be analyzed in our review. However, there are only two articles related to resistance exercise in children with obesity and overweight at school age, which is far less than the number of 12 articles about aerobic exercise, so we cannot compare the effects of the two types of exercises.

Performance Differences between National Football League and High School American Football Combine Participants

PURPOSE

The purpose of this study was to determine magnitudes of differences for anthropometric and athletic performance scores between high school and elite college-level American football players.

METHOD

Participants included high school-age (n = 3,666) athletes who participated in American football combines, as well as elite college-level (n = 5,537) athletes who participated in the National Football League (NFL) scouting combine. Combine data included position; height; weight; 10-, 20-, and 40-yard dash; pro-agility (PA); L-cone drill (LC); vertical jump (VJ); and broad jump (BJ). Athletes were separated into their respective position group, defensive back (DB), wide receiver (WR), linebacker (LB), quarterback (QB), running back (RB), tight end (TE), defensive line (DL), and offensive line (OL) for analysis of performance differences. Percent differences for each dependent variable were calculated to quantify magnitudes of differences.

RESULTS

NFL combine participants scored 3% to 25% better on all measurements, with the largest differences between weight and VJ (14%-25%).

CONCLUSION

The largest measurement-specific differences between high school-age and elite college-level American football players were body size and power. Although it may seem intuitive that elite college-level players would perform better, these data provide a unique perspective to high school players, parents, and coaches, giving new information to use when designing measurement-specific athletic development programs. Thus, strength and conditioning professionals may benefit from emphasizing increases in muscle mass and power output in strength and conditioning programs.