October 2015

Pediatricians Tackle Youth Football Injuries

With football remaining one of the most popular sports for children and teens, the American Academy of Pediatrics (AAP) is issuing new recommendations to improve safety for all players while on the field.

In a policy statement announced at its National Conference & Exhibition taking place in Washington, D.C., the AAP recommended:

• Officials and coaches must enforce the rules of proper tackling, including zero tolerance for illegal, head-first hits.
• Players must decide whether the benefits of playing outweigh the risks of possible injury.
• Non-tackling leagues should be expanded so athletes can choose to participate without the injury risks associated with tackling.
• Skilled athletic trainers should be available on the sidelines, as evidence shows they can reduce the number of injuries for players.

Delaying the introduction of tackling until a certain age may reduce the risk of injury for ages when tackling is prohibited, but this could lead to even higher rates of injury when tackling is later introduced if players have their first tackling experiences when they are older, stronger and bigger, according to the AAP.

"It's this paradox," said pediatrician Greg Landry, M.D., FAAP, "that makes it so important for leagues to teach proper tackling technique and skills to avoid and absorb tackles, even if no tackling occurs throughout the seasons."

Landry, a co-author of the policy statement and member of the AAP Council on Sports Medicine and Fitness, presented the policy statement during a plenary session on Oct. 25. The statement, "Tackling in Youth Football," will be published in the November 2015 issue of Pediatrics.

The AAP policy is based on a review of scientific research on injuries in football, particularly those of the head and neck, and the relationship between tackling and football-related injuries. The most commonly injured body parts in football for all ages are the knee, ankle, hand and back. The head and neck sustain a relatively small proportion of overall injuries, but are usually involved when injuries are severe, and are often the result of illegal tackling techniques, such as spear tackling, which is when a player leads with the head. Research has shown that tackling or being tackled accounted for half of all football injuries among high school players and that the injury rate for youth football is considerably lower than the rates for high school and college players.

Coaches should strive to reduce the number of impacts to players' heads, and should offer instruction in proper tackling techniques. Neck strengthening may help reduce injuries, though definitive evidence is lacking.

With more than 1.1 million high school players plus approximately 250,000 youth football players ages 5 to 15 years old in Pop Warner leagues alone, American football remains one of the most popular sports for young athletes.

"Removing tackling would dramatically reduce the risk of serious injuries to players, but it would fundamentally change the sport of football," said co-author William Meehan III, M.D., FAAP, a member of the AAP Council on Sports Medicine and Fitness. "Parents and players will need to decide whether the health risks associated with tackling are outweighed by the recreational benefits of the game. The AAP encourages athletes to continue playing organized sports, while supporting coached and officials in their work to reduce these injuries."