The CBA’s Dirty Little Secret

Are Player Injuries Really Down or Has the League Sold a Bill of Goods?

Soon we’ll be focusing our attention on training camp. It’s a grind, one that the players must embrace. There’s little choice. That said, camp isn’t what it used to be. Not by any stretch. Yet the inevitable still happens – injuries, many of which aren’t even related to contact. I’ve always believed that a good day at camp is one during which the team gets in all of its scheduled work without injury. But those days are few and far between.

When the NFL and the NFLPA hammered out the 2011 Collective Bargaining Agreement, one of the priority missions was player safety. Two-a-days were kicked to the curb. And only one padded practice per day during training camp was allowed. A hard cap on full-contact practices during the regular season was also implemented — just 14 for the year, with 11 of those packed into the first 11 weeks. The players had spoken. Physical contact that they deemed unnecessary had to stop.

Then came the 2020 CBA, which doubled down on that philosophy like a jackhammer to another crumbling Baltimore boulevard. Training camp would now include a five-day acclimation period, a 2.5-hour limit on padded and full-speed practices, with no more than three consecutive padded days allowed during any given stretch. And the big one: teams were limited to 16 padded practices during training camp, a dramatic reduction from the previous padded-practice limit of 28. Once the 17-game regular season kicked in, the league went further still. Teams are not allowed to add padded practices in the regular season once the 17-game seasons start, and in-season padded practices remain limited to 14, 11 of which must be held during the first 11 weeks.

The intent was noble. The result? Complicated at best. A trainwreck at worst.

The Body Wasn’t Ready

Here’s the thing about muscles, tendons, and ligaments that the CBA negotiators apparently forgot to consult a sports medicine textbook about: they need stress to become resilient. You don’t make a hammock stronger by never sitting in it. You make it stronger by using it repeatedly, progressively, deliberately.

The NFL forgot that part.

A “classic case of unintended consequences” is how one researcher framed it — the idea being that if you don’t practice enough, if you’re undertraining, you’re not getting those muscles and tendons and ligaments strong enough to survive the rigors of an NFL season. Leigh Steinberg, one of the most accomplished agents the sport has ever seen (he even appeared in Jerry MaGuire), wasn’t buying the party line either. He argued that the new CBA created an NFL environment where players might be “in shape” but not “in football shape.” There’s a difference. A significant one.

We got the proof in the most painful way possible.

When COVID-19 wiped out the entire 2020 preseason, the league essentially ran the most potentially devastating natural experiment in the history of sports medicine. Players went from a truncated offseason into a regular season without a single preseason game, without the usual ramp-up in contact, without their bodies being put through the gradual collision conditioning that prepares them for 17 weeks of organized albeit extreme violence.

The results were grim. There were 1,370 total injuries in the 2018–2019 regular NFL season. In the 2020–2021 regular season, that number exploded to 2,086. The total number of injuries per 1,000 athletic exposures was significantly higher — 88.57 versus 58.17.

Read those numbers again. Nearly 52 percent more injuries when players didn’t get a proper preseason. That’s not a rounding error. That’s a flashing red alarm.

It’s Not What Was Hurting Them Before

What makes the post-2020 CBA era especially telling isn’t just the volume of injuries — it’s the type. The old injuries, the ones everyone feared: concussions, broken bones, the violent trauma of a sport that pays men to destroy each other — those have trended better in some respects. It’s the soft tissue injuries, the sneaky, insidious ones that come from a body not properly conditioned for what it’s being asked to do, that have surged.

According to National Institutes of Health, hamstring injuries jumped from 5.31 to 9.98 per 1,000 athletic exposures. Groin injuries nearly doubled, from 2.46 to 5.56. Calf injuries went from 1.61 to 4.08. Quadriceps injuries nearly tripled, from 0.72 to 2.00. Thigh injuries went from 0.30 to 1.23. All those increases were statistically significant. And calf and Achilles tendon strain injuries went from 17 in 2019 to 39 in 2020, groin injuries from 25 to 46, and ACL tears from 14 to 29 — all statistically eye-opening jumps.

These are non-contact, conditioning-dependent injuries. A receiver runs a post route and pulls up grabbing his hamstring. A defensive back plants to change direction and his calf gives out. A quarterback drops back and his Achilles explodes. None of that requires a helmet. None of that requires contact. It’s simply the collateral damage of bodies that weren’t ready.

We’d seen the warning before. The last time NFL players had restricted access to training facilities before 2020 was during the 2011 lockout, which lasted 14 weeks. As that lockout ended and training camp began, there was a marked increase in Achilles tendon ruptures — 12 Achilles tendon ruptures in the first 29 days after the lockout, compared to 6 and 10 total Achilles ruptures across the two prior full seasons.

The 2011 lockout was the canary in the coal mine. The league and the union looked at it, shrugged, and wrote a new CBA that flirted with the same cliff.

Did It Get Better?

Here’s where the story gets more nuanced and, to be fair, a little more hopeful — though not as hopeful as the league’s PR machine wants you to believe.

The NFL introduced a mandatory preseason acclimation strategy starting in 2022, gradually ramping players back into football activity at the start of training camp. That has shown genuine results. Since the acclimation period was introduced in 2022, lower-extremity strains are down 27% in 2024 compared to the 2021 preseason, according to NFL.com. ACL tear injuries in the 2024 preseason remained lower than the nine-season average, while Achilles rupture injuries were lower than 2023.

In 2023, lower extremity strains — the highest-burden injury in terms of time lost among NFL players — reached a four-year low across the preseason and regular season. There was a 29% decrease in missed time due to lower-extremity strains during training camp compared to 2021, and players experienced a 50% lower recurrence rate of lower-extremity injuries. The NFL also claims that ACL tears in the 2023 season were down 24% from the prior two seasons.

Good news, right? Sure.

But let’s pump the brakes.

The league is essentially patting itself on the back for solving a problem it created. The 2021 season, the first full season under the new CBA, was still brutal. Overall injury incidence in 2021 increased compared to pre-COVID seasons in all anatomical zones except for the upper extremity. And the reason the 2022 acclimation period helped is precisely because it reintroduced some of what the CBA had stripped away: a sensible ramp-up of physical stress before the real bullets start flying. The league fixed its self-inflicted wound with a bandage and called it innovation. Sounds like a propaganda machine to me. How about you?

The Concussion Paradox

On head injuries, the picture is almost deliberately confusing.

In 2022, the NFL acknowledged that concussions rose significantly during the regular season — 149 concussions over 271 games, an 18% jump from 2021 and 14% higher than the three-year average between 2018 and 2020, per ESPN. The league’s chief medical officer cited protocol changes that broadened the definition of what counts as a concussion, which tells you something important: better reporting doesn’t mean the hits are actually worse, but it also doesn’t mean the player is less hurt. They’re just more honest about counting the damage now.

Meanwhile, the league did experience a genuine bright spot: after tweaking the acclimation period at the start of training camp and requiring players at certain positions to wear Guardian Cap pads on their helmets, the NFL brought practice concussions to an eight-year low of 25. The position groups required to wear Guardian Caps experienced a 52% reduction in concussions over the same period in 2021, also according to.

So: practice concussions down, game concussions up. Training camp soft-tissue injuries improving, regular-season soft-tissue injuries still elevated compared to pre-CBA baselines. The scorecard is as messy as one at Shinnecock Hills.

What It All Means

Here is the bottom line, stripped of the league’s spin and the union’s cheerleading.

The NFL and NFLPA built a CBA around a theory — that less contact in practice means fewer injuries — without fully reckoning with the countervailing science that undertrained bodies break down just as readily as overtrained ones, just in different, sneakier ways. They eliminated the brutal two-a-days of the old training camp era, and they were probably right to do that. But in their zeal, they overcorrected. Going from a limit of 28 padded practices in training camp to just 16 is a seismic shift — one that left an entire league of professional athletes structurally underprepared for professional football.

The soft tissue epidemic of 2020 and 2021 wasn’t a coincidence. It was a consequence.

Bill Belichick, a man who has forgotten more about football than most of us will ever know, saw this coming. He said plainly: “I’m in favor of total preparation for the players for the season. And I think that’s been changed significantly and, I would say, not necessarily for the better, when you look at the injury numbers. You have a gap between preparation and competition level. And that’s where you see a lot of injuries occurring.” They dismissed him as a crotchety old coach protecting his turf. Turns out he was reading the science correctly.

The improvements since 2022 are real and they deserve acknowledgment. The acclimation period works. The Guardian Cap works. ACL numbers are better. Lower-extremity strains are down from their ugly peak. The league is learning, slowly, how to retrofit its philosophy to match the reality of human physiology.

But here’s what nobody wants to say out loud in a league office or a union meeting: the 2020 CBA, for all its good intentions, made players less safe in the short term by trying to make them safer in the long term. It swapped one set of injuries — the violent, high-impact, contact-driven trauma of the old training camp — for a different set: the silent, structural, soft-tissue failures of chronically underprepared bodies being asked to run, cut, plant, and explode at professional football speed.

Different injuries. Not fewer injuries. Just different.

And in a league that put 17 regular-season games on the schedule at the same time it cut practice time (and now threatening with an 18-game schedule), that’s a deal worth scrutinizing a lot harder than either side has been willing to do.

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Source: https://russellstreetreport.com/2026/06/22/lombardis-way/njuries-in-the-nfl/