Characterization of distal biceps tendon and triceps tendon injuries in National Football League players from 2009 to 2022

Abstract

Purpose

The purpose of this study is to determine the incidence and impact of distal biceps and triceps tendon injuries in the National Football League (NFL) from the 2009-10 to the 2022-23 seasons. This study explores the impact that player and injury characteristics have on injury risk, return-to-play, and player performance.

Methods

Data from the 2009-10 to the 2022-23 NFL seasons were analyzed for players with distal biceps or triceps tendon tears. Return-to-play (RTP) and performance metrics were recorded for each player during the season before and first two post-injury seasons. Data were analyzed to determine statistically significant differences in proportions using chi-square, Fisher's exact, or McNemar tests. Statistical significance was set at p < 0.05.

Results

Fifty tendon ruptures (26 biceps, 24 triceps) were identified. Biceps injuries were more common in defensive players (73.1 %), while triceps injuries predominantly affected offensive players (58.3 %). Significant risk factors for biceps injuries included BMI ≥31 (p = 0.0008) and ≥4 seasons of experience (p = 0.031, OR = 2.7). Triceps injuries were associated with BMI ≥31 (p = 0.01), age ≥26 (p < 0.0001), and ≥4 seasons of experience (p = 0.006). RTP rates were 73.1 % for biceps and 70.8 % for triceps injuries. However, only 52.6 % and 41.2 % of players with biceps and triceps injuries, respectively, returned to pre-injury performance levels. Younger players (<26 years) and those with fewer years of experience (≤4 years) were more likely to achieve prior performance levels.

Conclusion

Distal biceps and triceps tendon injuries are typically season-ending for NFL players. Significant risk factors include BMI ≥31, ≥4 years of NFL experience, and game exposure, with age ≥26 being an additional risk factor for triceps tendon injuries. RTP rates exceed 70 %, indicating a strong potential for athletes to return to the NFL post-injury.