Written from 15 named sources · Sep 24 · rewritten The Deal with the RPO: An Epidemiological Set About Nothing What is the deal with the RPO? You ever see this? The Run-Pass Option. It’s the new thing! Every team has it. It’s like the "low-fat" frozen yogurt of football. Is it a run? Is it a pass? The quarterback is standing there, he’s holding the ball in the stomach of the running back—they’re having a little meeting! "Should we go? Should we stay? What do you want for lunch?" Meanwhile, there’s a 300-pound man named 'Tank' sprinting at them, and we’re all sitting on the couch going, "He’s gonna get killed! This is the end of the quarterback!" But have you looked at the numbers? I looked at the numbers. You know who’s getting hurt? The guys not running! The "Inverted U" of Pain It turns out, if you run a lot—I’m talking the Lamar Jacksons, the Vicks, the guys who are basically playing tag with the defense—they don’t get hurt as much! Their missed-start rate is below the league average of 10.4% [12]. And the guys who never move? The Brads, the Peytons? They’re fine too! They just get rid of the ball and go home to do insurance commercials. It’s the guys in the middle! The "I think I’m mobile" guys. The Baker Cousins, the Dak Trubiskys. They’re in that "Inverted U-curve" of misery [12]. They’re fast enough to get into trouble, but not fast enough to get out of it. It’s like being a pedestrian in midtown—you either stay on the sidewalk or you sprint across the street. You don't saunter in front of a bus! The Pocket: A Danger Zone with a View We think the pocket is safe. "Stay in the pocket!" It’s like a panic room made of grass. But the data says the pocket is where the real carnage happens. Look at the SIS charting [12]: Passer Knockdowns: 1 injury every 57 plays. That’s a 1.8% chance of "ouch." Sacks: 1 every 75 plays. Designed Runs (The RPO Keep): 1 every 174 plays! You’re three times safer running a designed play than you are getting knocked down in the pocket [12]! In the pocket, you’re a statue. You’re waiting for the mail. And the mail is a linebacker who hasn’t had a carb since 2014. On a run, you’re in control! You can slide, you can dive, you can run out of bounds and talk to the cheerleaders. You have agency! The Rules: The "Don't Touch the Merchandise" Policy And the rules! Have you seen these roughing-the-passer calls? You can’t land on them with your "body weight" [1,8]. What is that? If you’re a defensive lineman, your entire job is body weight! Now they have to hit the quarterback and then mid-air, they have to perform a Cirque du Soleil maneuver to land next to him. William Hayes tried to avoid a guy and tore his own ACL [3,8]! It’s like a waiter trying not to drop a tray and breaking both his legs. The Verdict So, is the RPO killing the quarterback? The epidemiology says... no [4,12]. Musculoskeletal injury rates have been basically flat from 2017 to 2022—about 19 per 1,000 exposures [4]. It doesn't matter if you're playing in London, playing on a Monday, or playing in an RPO scheme [4]. The quarterback isn't more fragile because of the scheme. He’s just in a different kind of danger. It’s like choosing between a shark and a lion. One’s in the water, one’s on the land, but either way, you don't want to be the guy in the middle holding a ball! So keep your RPOs. Keep your meshes. Just don't be a "middle-frequency" runner. Either stay on the couch or run like the wind—anything else is just a trip to the Injured Reserve [12]. And who wants to go there? There’s no buffet! Sources [1] Roughing the passer — https://en.wikipedia.org/wiki/Roughing_the_passer [3] Making sense of NFL rule changes at midseason: What has worked - ESPN - NFL Nation- ESPN — https://www.espn.co.uk/blog/nflnation/post/_/id/286660/making-sense-of-nfl-rule-changes-at-midseason-what-has-worked [4] 🔎📈 Upside Study: Association of Injury Rates Among Players in the NFL With Playoff Qualification, Travel Distance, Game Timing, and the Addition of Another Game — https://www.theupside.us/p/upside-study-association-of-injury [8] NFL's changes to roughing the passer rule: Rob Ryan and Solomon Wilcots debate if it is a step too far? — https://www.skysports.com/nfl/news/12040/11511151/nfls-changes-to-roughing-the-passer-rule-rob-ryan-and-solomon-wilcots-debate-if-it-is-a-step-too-far [9] [PDF] An Updated Epidemiology of National Football — https://physical_medicine_rehabilitation.cureus.com/articles/213050-decreased-concussion-incidence-following-the-implementation-of-the-targeting-rules-an-updated-epidemiology-of-national-football-league-concussions-from-2017-to-2022.pdf?email= [12] New Study: Quarterbacks That Run Most Are Not Injured Most FilmstudyBaltimore — https://www.filmstudybaltimore.com/new-study-quarterbacks-that-run-most-are-not-injured-most (PDF) The Injury Rate in NFL Players was Increased Following ... — https://www.researchgate.net/publication/351964020_The_Injury_Rate_in_NFL_Players_was_Increased_Following_Cancellation_of_Preseason_Games_due_to_COVID_19 [PDF] NFL Rule Changes Favor Offenses - Ursinus Digital Commons — https://digitalcommons.ursinus.edu/context/bus_econ_hon/article/1057/viewcontent/auto_convert.pdf [PDF] Paying for Protection - UTK V.O.L. Journals — https://voljournals.utk.edu/jasm/article/3241/galley/3885/download Effect of Passing Plays on Injury Rates in the National Football League — https://www.researchgate.net/publication/356688471_Effect_of_Passing_Plays_on_Injury_Rates_in_the_National_Football_League Brandon Graham - Wikipedia — https://en.wikipedia.org/wiki/Brandon_Graham Is there actually a correlation between a QB's size and his chance ... — https://www.reddit.com/r/nfl/comments/24795h/is_there_actually_a_correlation_between_a_qbs Injury Data Since 2015 — https://www.nfl.com/playerhealthandsafety/health-and-wellness/injury-data/injury-data Roughing the Passer By Quarterback - All Quarterbacks — https://nflpenalties.com/roughing-the-passer-by-qb.php?view=all Which NFL Teams Were Most and Least Affected by Injuries in 2025 — https://www.sportsinfosolutions.com/2025/12/03/which-nfl-teams-have-been-most-and-least-affected-by-injuries-in-2025