Seasonal Clustering of Achilles Tendon Ruptures in the NFL: A 15-Year Analysis Revealing Preseason Vulnerability
Dustin J. Kress, Patrick Waldron, David Han, Ajith MaligeBackground:
Achilles tendon ruptures remain devastating injuries in professional football. While return-to-play rates and postinjury outcomes are well documented, the temporal distribution of these injuries throughout the National Football League (NFL) season has not been systematically evaluated.
Purpose:
The purpose was to evaluate the distribution of Achilles tendon ruptures across season phases and identify periods of elevated injury risk in NFL players from 2010 to 2024.
Study Design:
Descriptive epidemiology study.
Methods:
Achilles tendon ruptures in NFL players from 2010 to 2024 were identified using publicly available data, including Pro Sports Transactions and team-specific reports. Injuries were stratified based on timing within the season using 4 analyses: (1) a 3-phase regular season model—early (weeks 1-5), mid (weeks 6-10), and late (weeks 11-17); (2) a 2-phase model—first half (weeks 1-8) and second half (weeks 9-17); (3) an extended-season analysis incorporating offseason, preseason, and postseason; and (4) a comparison of postseason injury rates between the pre-Week 18 era (2010-2020) and the Week 18 era (2021-2024). Injury frequencies were compared using the chi-square test and the Fisher exact test.
Results:
A total of 253 Achilles tendon ruptures were identified over 15 years. Preseason demonstrated the highest injury burden with 85 injuries (33.6%), representing a 3.0-fold higher injury density than the regular season (21.3 vs 7.1 injuries per week). Combined preseason and early regular season accounted for 62.1% of all ruptures. Two-phase regular season comparison showed significantly more first-half injuries (
Conclusion:
Our study demonstrated that Achilles tendon ruptures in NFL players cluster during the preseason and early regular season, with 62.1% occurring in these periods and preseason representing the highest-risk phase, accounting for one-third of all injuries despite lasting only 4 weeks. These findings identify critical vulnerability windows for targeted injury-prevention strategies, preseason conditioning protocols, and player load management to reduce Achilles rupture burden in elite football athletes.