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Shoulder Injuries to Quarterbacks in the National Football League

Bryan T. Kelly, MD^*, Ronnie P. Barnes, MS, ATC, John W. Powell, PhD, ATC and Russell F. Warren^*,

From the ^* Sports Medicine and Shoulder Service, Hospital for Special Surgery, New York, New York, the New York Football Giants, Meadowlands, New Jersey, and the Graduate Athletic Training Program, Michigan State University, East Lansing, Michigan

Address correspondence to Russell F. Warren, Hospital for Special Surgery, 535 E. 70th St., New York, NY 10021 (warren{at}hss.edu).

Background: Quarterbacks are at risk for shoulder injury secondary to both the throwing motion as well as from contact injury.

Objective: To delineate the incidence and etiology of shoulder injuries to quarterbacks in the National Football League (NFL).

Methods: Using the NFL Injury Surveillance System (NFLISS), all reported injuries to quarterbacks between 1980 and 2001 were identified.

Results: A total of 1534 quarterback injuries were identified with a mean of 18.8 and a median of 6.0 days of playing time lost. The majority of these injuries occurred during a game (83.8%). Passing plays were responsible for 77.4% of all quarterback-related injuries. Shoulder injuries were the second most common injury reported (233 or 15.2%), following closely behind head injuries (15.4%). Direct trauma was responsible for 82.3% of the injuries, with acromioclavicular joint sprains being the most common injury overall (40%). Overuse injuries were responsible for 14% of the injuries, the most common being rotator cuff tendinitis (6.1%) followed by biceps tendinitis (3.5%).

Conclusion: In this review, the vast majority of shoulder injuries in quarterbacks occurred as a result of direct trauma (82.3%), and less than 15% were overuse injuries resulting from the actual throwing motion.

Key Words: shoulder injury • quarterback • throwing • AC joint • rotator cuff

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