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1. Purpose During the COVID 19 Pandemic, the NFL teams have been reported to have limited training sections in preparation for their games. This study compares the prevalence of injury during the 2018, 2019, and 2020 NFL seasons, with the aim to determine the potential causes of the differences in prevalence. 2. Method Official injury reports from each team were counted during the 17-week regular season of each year (2018, 2019, and 2020). The data was analyzed using an unpaired t-test to compare the injury prevalence between each of the three seasons. 3. Results The 2018 season produced a total of 1,561 injuries and a mean of 48.78 injuries per team. The 2019 season produced a total of 1,897 injuries and mean of 59.28 injuries per team, while the 2020 season produced a total of 2, 484 injuries and mean of 77.63 injuries per team. An unpaired t-test was performed using the data to compare the mean number of injuries per team of each of the seasons. Comparison of the 2020 season against the 2019 season showed a statistically significant difference (P=.0003). Comparison of the 2020 season to the 2018 season found a statistically significant difference (P=.0001). Comparison between the 2019 and the 2018 seasons found a statistically significant difference (P=.0314). Conclusion Although the 2019 and 2018 season showed a statistically significant difference (P=0.0314), this difference is not as astronomical when we compare the 2020 seasons vs 2019 and 2018 seasons (P=0.0003 and P=0.0001, respectively) (Figure 2). The astronomical increase in injury prevalence in the 2020 season over the previous years does raise the possibility that there was reduced physiological adaption to stress, due to the limited amount of training embarked on. The limited amount of training was the result of closure of practice facilities during the COVID-19 pandemic. More physiological investigation involving players must be done at the professional and amateur levels to determine if there is a lack of physiological adaptation due to limited use of practice and training facilities during the COVID-19 pandemic.

Competing Interest Statement

The authors have declared no competing interest.

Funding Statement

The study did not receive any funding.

Author Declarations

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.


The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

The data is openly attainable and can be obtained from the official NFL website, official NFL team websites or media accounts.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.


I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).


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Paper in collection COVID-19 SARS-CoV-2 preprints from medRxiv and bioRxiv

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