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NFL's prioritization of player safety leads to promising injury data for 2023 season

The NFL has prioritized adjusting kickoff rules to make the play more exciting but safer as it heads into the offseason with some promising injury data, league officials said Wednesday.

The NFL saw a steep drop in the number of regular-season games missed to injury this season, largely thanks to a significant drop in lower extremity strains and ACL tears, season-end injury data showed.

The number of concussions remained largely stable from last season -- 219, including those suffered in preseason and regular-season games and practices. That is up from 213 in 2022, but still well below the high of 281 a few years ago.

Concussions sustained on kickoffs dropped by 60 percent, from 20 to eight. That is because kickoffs were returned less frequently after the NFL adjusted the rules governing kickoff returns last offseason, so that a returner could signal for a fair catch no matter where the ball was kicked, and the ball would be placed on the 25-yard line. The rule was designed to reduce the number of returns because a disproportionate number of concussions happen on the high-speed, high-impact collisions that occur on such plays. Returns did not get safer with the new rule, though. When there were returns, there were concussions, league officials said.

The NFL does not want to entirely eliminate kickoff returns -- one of the most exciting plays in the game -- so health and safety officials and the NFL Competition Committee will spend considerable time this offseason, starting at the NFL Scouting Combine in February, trying to come up with a compromise. They have even studied radically different kickoff ideas, including that used in the XFL, where 10 members from both the kickoff and return teams line up just five yards from each other at the opponent's 35-yard line while the kicker kicks off from his own 30.

"I do think we all share, the health and safety side and the committee, a desire to take what is now with a 22 percent return rate, what is now a very infrequent return and turn that into a more exciting play," said Jeff Miller, the NFL's executive vice president overseeing health and safety. "We believe that you can increase the return rate substantially and not increase the risk beyond that found on your typical rush or pass play. And so we need to design something to do that. I think we share the same perspective as the committee, which is to say that's the goal. And we want to make that an exciting, fun play because kickoffs can be, and yet extract the pieces of that play that provide the most risk."

The debate over the kickoff rule and an attempt to write a rule that will ban the hip-drop tackle are likely to dominate offseason rules conversation. The league looked at banning the hip-drop tackle last offseason but struggled to write a rule in a way that it could be officiated. They will look at it again because NFL data shows the hip-drop tackle is 20 to 25 percent more likely to cause injury than a typical tackle.

In all, the league's injury data showed that there were 700 fewer missed player games in 2023 than in 2022. The primary driver of the decrease was the league hitting a four-year low in the number of lower extremity strains -- there was a 29 percent decrease in strains during training camp. And with fewer initial strains, there was a 50 percent decline in recurrent lower extremity strains. That is particularly good news because, according to the NFL's chief medical officer, Dr. Allen Sills, lower extremity strains keep players off the field more than any other injury. The NFL points to an acclimation period at the start of training camps, which gradually ramps up workload over two weeks, as playing a significant role in the reduction of strains.

There were 52 ACL tears suffered in the 2023 season, down 24 percent from the past two seasons. Miller also said NFL data did not show a higher injury rate on Thursday night games, in international games or in Week 18 games.

Sills said there were 422 evaluations for concussions last season and another focus of the offseason will be trying to figure out how to drive down the number of concussions. The league looks at those who suffer a high volume of head impacts -- like offensive and defensive linemen -- and those who are hit at high velocity, as typically happens during a tackle in space.

Among the promising developments is the success of the Guardian Cap, the extra layer of protection worn by some position groups during preseason and regular-season practices, which produced a 48 to 50 percent reduction in concussions for the position groups that wore them. And this offseason, the NFL expects as many as eight more position-specific helmets coming on the market for quarterbacks and linemen.

"Obviously, while concussions are stable, we want to see them go down," Sills said. "We believe the game can continue to be made safer."