Whole-Person Impairment in Younger Retired NFL Players

Background: This study reports the total whole person impairment (WPI) percentages in a cohort of retired NFL players based on the standardized American Medical Association (AMA)impairment guidelines. We hypothesize there will be a high orthopedic burden based on WPI percentages,related to impairment reported in retired NFL players.

Methods: During the study period of February 2011 toAugust 2013, 65 retired NFL players presented for impairment evaluations. A complete history and physical exam was performed on all symptomatic joints based on the AMA (5th Ed.) Guides to the Evaluation of Permanent Impairment.A retrospective chart review was conducted on 100% of presenting players to assess orthopedic burden. Body Part Impairment (BPI) percentage for each affected joint was generated. The impairment data for each extremity was then combined with spine impairment data to create WPI percentage. Player demographics, including age, position and playing timewas also recorded.

Results: The average whole person impairment percentage was 37% (range 19%-53%). Players participating in greater than 30 games had a statistically significant (p = 0.004) higher WPI than those playing in less than thirty games. Players playing greater than five seasons were 1.8 times more likely to have a WPI greater than 35%. The most common joints players reported as symptomatic were lumbar (n=63 or 97%) and cervical spine (n=58 or 89%). The average age at evaluation was 33.6 years old (range 27-42), and average number of seasons played was 7.9 (range 3 - 14), and the average number of games was 93 (range 2 - 236).

Conclusion: Our study demonstrated a very high burden of orthopedic injuries related to symptomatic jointsin a cohort of retired NFL players.These orthopedic injuries take a cumulative toll on the player, leading to significant whole body impairment by the end of a professional football career.