Published on: 24-Aug-2026
Every August, NFL headlines fill with players leaving practice after a non-contact injury or pulling up with a hamstring strain. These aren’t simply isolated events. They often reflect predictable patterns of how the body responds to rapid increases in training demands. Here’s what preseason injuries reveal about recovery, injury prevention, and the realities of staying healthy throughout the NFL season.
Why the Preseason Injury Wave Is Not Random
Training camp concentrates an enormous amount of physical stress into a compressed period, typically six to eight weeks of two-a-days, full-contact practices, and preseason games following months of lower-intensity offseason work. The jump in workload is the primary driver of the injury patterns that emerge each August. Research published after the 2020 NFL season, when the preseason was canceled entirely due to COVID-19, found that the 2020 regular season had significantly higher rates of hamstring, groin, calf, quadriceps, and thigh injuries compared to a normal season, with total injuries per 1,000 athletic exposures nearly 52 percent higher than a typical year. The conclusion was direct: an absent preseason was associated with a meaningful rise in soft tissue injury rates during the regular season that followed.1 Preseason injuries are not simply misfortune. They are partly the price of the rapid workload escalation that camp requires, and partly the signal that certain players are carrying tissue vulnerability into the season.
Hamstring Injuries: The Most Predictable Pattern
Hamstring strains dominate the training camp injury wire because they are the most common soft tissue injury in sprint-dependent sports, and NFL camp involves a rapid return to full-speed running after a relatively reduced offseason. The clinical pattern is well established. Grade one and two strains, which involve partial tearing without complete disruption, typically carry return-to-play timelines of one to four weeks depending on location and severity. What matters clinically beyond the immediate camp absence is whether the strain occurs at the proximal tendon near the sit bone, which carries a longer recovery timeline and higher re-injury risk, or in the muscle belly, which tends to heal more predictably. A hamstring strain in camp that is poorly rehabilitated or returned from too quickly becomes one of the most reliable predictors of a recurrent in-season injury, since the tissue has not fully remodeled before it is loaded at full speed again.
Non-Contact Knee Injuries: The High-Stakes Signal
Non-contact knee injuries during camp carry a different weight entirely. When a player goes down without being touched, the clinical concern immediately turns to the ACL, meniscus, and surrounding ligamentous structures. These injuries appear in camp every year, and the 2025 preseason was no exception, with multiple high-profile non-contact knee events drawing attention across rosters. For cartilage and ligamentous injuries of the knee, the in-season implications depend heavily on the specific structure involved and the degree of damage. A partial meniscus tear managed conservatively may allow a player to return in weeks. An ACL rupture ends the season and begins a nine to twelve month reconstruction and rehabilitation process. The non-contact mechanism matters because it suggests the tissue failed under loads the player generates themselves, which is a different risk profile than a collision injury.
Shoulder Injuries: The Collision Variable
The shoulder is the other major structure that accumulates significant stress during camp, particularly once padded practices and live contact begin. Acromioclavicular joint sprains, rotator cuff strains, and labral injuries from collision and fall mechanisms show up consistently through preseason. Unlike hamstring and knee injuries, many shoulder injuries in camp occur through contact rather than pure overload, making them somewhat less predictable from a workload standpoint but no less consequential for the season ahead. A player managing a rotator cuff strain or labral irritation through the preseason frequently finds that the cumulative contact demands of a full regular season either resolve the issue with time or gradually expose the underlying structural problem more clearly. For shoulder injuries that involve structural damage rather than simple muscle soreness, the preseason period is often where the decision between conservative management and surgical intervention first gets made.
What Camp Injuries Predict About In-Season Risk
The clinical takeaway from the preseason injury wave is not simply which players missed time in August. It is which players have demonstrated tissue vulnerability under the specific demands of their sport at full intensity. A hamstring strain in camp that resolves cleanly and is followed by a structured return-to-sprint progression carries a different in-season risk profile than one that was rushed back ahead of a preseason game. The pattern of which injuries recur, which body regions accumulate multiple events across a roster, and how individual players respond to their rehabilitation protocols provides a clinical picture of where the fragility is concentrated as the season begins. For the sports medicine physician on the sideline, that picture informs decisions about load management, practice participation, and when to escalate to imaging or further intervention throughout the season.
Treatment Timelines and the Return-to-Play Decision
Return-to-play decisions for NFL players involve the same fundamental biology as any other athlete, regardless of the financial and competitive pressures surrounding them. Soft tissue heals on a biological timeline that rehabilitation can optimize but not override. Orthobiologic options including PRP and bone marrow concentrate are increasingly used as adjuncts for soft tissue injury recovery in elite sport, with the goal of supporting the tissue environment during healing rather than replacing the timeline that biology requires. The players who return successfully and stay healthy through a full regular season are generally those whose camp injuries were managed with that biological reality in mind rather than compressed beyond what the tissue can support.
If you have experienced a soft tissue injury from a return to sport after a training break and want to understand what your recovery timeline actually looks like, a proper evaluation is the clearest way to find out what the tissue needs rather than guessing.
Frequently Asked Questions
Training camp concentrates a rapid escalation in workload after months of reduced activity, which is the primary driver of the soft tissue injury patterns that emerge each August.
Research from the 2020 season, when the NFL preseason was canceled, found significantly higher regular season injury rates compared to normal years, supporting the idea that preseason training plays a protective role and that players who sustain camp injuries carry elevated in-season risk if not fully recovered.
Grade one and two hamstring strains typically carry return-to-play timelines of one to four weeks depending on location and severity, with proximal tendon injuries generally taking longer and carrying higher re-injury risk than muscle belly strains.
Yes. Orthobiologic treatments including PRP and bone marrow concentrate are increasingly used as adjuncts in elite sport to support the tissue environment during soft tissue injury recovery, though they work alongside rather than replacing the biological healing timeline.
Non-contact knee injuries involving the ACL, meniscus, and cartilage structures are among the most clinically significant, with outcomes ranging from a conservative return in weeks for partial meniscus tears to season-ending surgery for ACL ruptures.
Training camp reminds us that even the world’s most highly conditioned athletes are vulnerable when physical demands increase rapidly. If persistent joint pain, muscle injuries, or sports-related conditions are limiting your performance, an evaluation by an orthopaedic sports medicine specialist can help identify the problem, guide treatment, and support a safe return to the activities you enjoy.
The post NFL Preseason Injuries: What Training Camp Casualties Tell Us About the Regular Season appeared first on Sports Medicine Weekly By Dr. Brian Cole.