The glaring spotlight focused on bran injuries in professional football has led to renewed concern about players in youth leagues and high school programs suffering the same injuries. In a new policy statement released online Oct. 25 in the journal Pediatrics, the American Academy of Pediatrics (AAP) addressed those concerns, providing guidelines for parents and pediatricians that are based on relevant studies and that focus on the association between tackling and football-related injuries.
“We’re trying to bring the evidence to the decision-making process as opposed to simply emotion and anecdote,” lead author William P. Meehan III, MD, director of the Medical Center for Sports injury Prevention, Division of Sports Medicine at Boston Children’s Hospital, said in an AAP news release.
A review of football injuries revealed that most major injuries are caused by tackling, and the worst ones are the result of head-to-head contact. Spear tackling – when a tackler leads with the crown of the helmet – is the lead cause of injuries that result in quadriplegia.
As it turns out, the helmet that players are required to wear for safety can have the opposite effect. “Helmets are so well made now that players in recent years have learned to use the helmet as a weapon,” co-author Gregory L. Landry, MD, a professor of pediatrics at the University of Wisconsin School of Medicine and Public Health, said in the news release.
In a strongly worded condemnation of the practice, Landry and his colleagues wrote, “There is a culture of tolerance of head first, illegal hits. This culture has to change to one that protects the head for both the tackler and those players being tackled.”
Indeed, the policy statement’s most emphatic recommendation is that football leagues and officials consistently penalize contacts to the head because the most severe injuries are the result of improper or illegal tackling. In the same vein, the policy guidelines concluded that coaches need to teach proper tackling techniques in practice at a young age to prevent injuries. Delaying such instruction, they say, could backfire because even though it would reduce injuries in younger players, it would place older players at greater risk if they begin tackling when they are bigger, heavier, faster, and can deliver more forceful blows.
Other AAP recommendations included the expansion of non-tackling football leagues for young athletes, stricter enforcement of game rules by coaches and officials, and having athletic trainers present on the field during practices and games.
Another of the organization’s recommendations – limiting the amount of contacts players have during practice sessions – was the topic of research presented Oct. 24 at the AAP National Conference & Exhibition in Washington, D.C. The study looked at sports-related concussion rates among more than 16,000 Wisconsin high school football players after the state’s interscholastic athletic association mandated limits on the amount of and duration of full-contact activities during team practice.
The rule went into effect in the 2014 season and prohibited full contact during the first week of practice. It limited full contact to 75 minutes during the second week and capped full contact to 90 minutes thereafter. Full contact was defined as drills or game situations when full tackles are made at a competitive pace and players are taken to the ground.
Findings showed that the rate of sports-related concussions sustained during high school football practice was more than twice as high in the two seasons prior to the rule change as compared to the 2014 season.
“This study confirms what athletic trainers who work with high school football programs have long believed regarding the association of full contact drills and practices and the likelihood a player will sustain a concussion,” Timothy A, McGuire, PhD, a senior scientist at the University of Wisconsin-Madison, said in an AAP news release. “This is probably true for other football injuries such as sprains, fractures and dislocations.”