Impact of Lumbar Disk Herniation on Performance Outcomes and New Contracts in the National Football League

Study Design: This was a retrospective cohort study. Objective: To determine performance outcomes and the contract-signing ability for the most recent cohort of professional football players treated for lumbar disk herniation (LDH). Summary of Background Data: LDH can have a significant impact on the career of a National Football League (NFL) player. Previous studies have found favorable return to play (RTP) and performance outcomes for players with LDH, but the impact on the ability to sign new contracts (an important surrogate to assess continued success) has not previously been studied. Materials and Methods: NFL players treated for LDH from 2000 to 2020 were identified from a public records search. Age, position, type of treatment, and RTP measures were collected. Pro Football Focus (PFF) performance grade and contract values were compared before the injury and after treatment. Multivariable logistic regression was used to identify independent risk factors associated with the ability to RTP and sign high-value contracts. Results: One hundred one players were treated for an LDH, of which 75 returned to play. Posttreatment performance as measured by PFF was similar to preinjury levels (P=0.2). However, both total and guaranteed contract values were significantly reduced (P<0.01). In multivariable analysis, both lower age and higher preinjury PFF grade were independent predictors of RTP and ability to sign a new contract. A preinjury contract that contained a high proportion of guaranteed money was found to be an independent predictor of the ability to sign a contract that was >20% guaranteed. Conclusion: Although the majority of players were able to RTP at preserved performance levels following LDH treatment, their contract values were significantly reduced. RTP and contract-signing ability were not associated with the type of treatment, but rather baseline factors such as the player's age, performance, and preinjury compensation.