Increased Snap Counts Were Not Seen Prior to Lisfranc Injuries in the National Football League

Introduction Athletes in the National Football League (NFL) subject their bodies to a great deal of physical strain, which places them at an increased risk for injury. The purpose of this study was to determine if there was an increase in snap counts played during a player’s injury game or season that may have contributed to an increased risk of sustaining a Lisfranc injury in the NFL. We hypothesized that players who play more snaps than they have in seasons prior will be at an increased risk of injury. Methods NFL players with Lisfranc injuries were identified by cross-referencing multiple online resources. Information on a player’s position, draft year, draft round selection, height, weight, snap counts, approximate value (AV), quarter of injury (first, second, third, fourth), quarter of a season (games one through four, five through eight, nine through twelve, thirteen through sixteen), and injured foot laterality was collected. A control group of players without a Lisfranc injury was then selected to compare performance data with our injured cohort that returned to play. Results Twenty-one NFL players, who met inclusion criteria, sustained a Lisfranc injury between the years 2013 and 2021. Players played significantly fewer snaps before sustaining a Lisfranc injury compared to their season average (33.9 ± 21.9 vs. 50.3 ± 15.8; p=<0.001), but when comparing the number of snaps played per game in their injury year with the number of snaps played per game over their career before injury, there was no significant difference (50.3 ± 15.8 vs. 45.7 ± 17.1; p=0.20). Most injuries occurred in either the first (42.9%) or second (33.3%) quarter of a regular season (games one through eight). During a game, the timing of most injuries was either the second (38.1%) or fourth (33.3%) quarter. There was no significant difference between injured players and controls post-injury between the number of average seasons played, AV, and snaps played per game. Conclusion Increased snap counts were not seen prior to Lisfranc injuries in the NFL.