Estimating drivers of concussions from punt returns in professional American football.

OBJECTIVES

To estimate drivers of concussions during punt kick returns in football and consider rule change incentives to potentially reduce concussions.

STUDY

DESIGN

The design of the study was to analyze concussions during punt returns.

METHODS

National Football League data of all punts from the 2016 and 2017 seasons are examined using propensity score matching (PSM) to estimate the causal effect of punt returns on the likelihood of a player concussion.

RESULTS

The PSM logistic regression estimates that the odds of a concussion increase 8.31, or are 731% higher, when a punt is returned versus not returned (log-odds b = 2.118, P < .001). Punt distance increases punt return likelihood, but time left in the game and the yard line where the punt is received reduces punt return likelihood.

CONCLUSIONS

Returning a punt substantially increases the risks of a concussion. To reduce concussions in football, incentives should encourage punters to not make the punt returnable and encourage punt returners to not return the punt.