The Effect of Bye Weeks on Injury Event Rates in the Canadian Football League

Objective: To determine the effect of bye weeks (no practices or games) on the injury event rate in the Canadian Football League (CFL). Design: Historical (retrospective) cohort study. Setting: CFL. Participants: CFL athletes between 2011 and 2018. Intervention: CFL pseudorandom assignment of bye weeks each season (2011-2013: 1; 2014-2017: 2; 2018: 3). Main Outcome Measures: Game injury incident rate ratio (IRR) in the week following a bye week compared with non–bye weeks. Sensitivity analyses: IRR for the 2 and 3 weeks following a bye week. We conducted exploratory analyses for combined game and practice injury events because we did not have the number of players exposed during practice. Results: The IRR was 0.96 (0.87-1.05), suggesting no meaningful effect of a bye week on the post–bye week game injury event rate. We obtained similar results for cumulative game injury events for subsequent weeks: IRR was 1.02 (0.95-1.10) for the 2 weeks following the bye week and 1.00 (0.93-1.06) for the 3 weeks following the bye week. The results were similar with 1, 2, or 3 bye weeks. However, the combined game and practice injury event rate was increased following the bye week [IRR = 1.14 (1.05-1.23)]. These results are expected if the break period results in medical clearance for preexisting injuries; increasing pain in these locations following the bye week would now be considered new injuries instead of “exacerbations.” Conclusions: Bye weeks do not appear to meaningfully reduce the injury event rate. Furthermore, there was no injury reduction when adding additional bye weeks to the schedule.