Head impact biomechanics studies have provided valuable insights into understanding collision sports and for informing evidence-based rule and policy changes. These have included changing the football kickoff, ice hockey body checking ages, and head-to-head hits in both sports. Given soccer's global popularity, and the growing public concern for the potential long-term neurological implications of collision and contact sports, studying soccer has the potential to impact many athletes and the sports medicine professionals caring for them.

ObjectiveTo improve tackling and blocking techniques to reduce concussion in high school American football players, and to evaluate the program’s feasibility and acceptance.DesignClustered quasi-experimental study.SettingHigh schools.ParticipantsVarsity American high school football players on three teams (two intervention; one control). Interventions All players wore in-helmet head impact accelerometers. “High-risk” intervention team players were selected and attended clinician-coach-player mentoring sessions designed to change playing technique. Accelerometer data were used for “high-risk” selection and during mentoring sessions to reinforce the technique-driven intervention.Outcome measuresThe change in top-of-head impacts and impacts with peak linear acceleration>60 g was compared between intervention and control subjects using linear risk models. Coaches and players completed post-season exit surveys.Main resultsNinety-seven players (70 intervention; 27 control) participated. Thirteen (19%) intervention players were identified as “high risk” and received mentoring. The mentored players’ high magnitude impacts (percent>60 g) in practices dropped 1.9 percent from pre-intervention to post-intervention. There was no change in non-mentored players. In post-season surveys, mentored players “strongly agreed” (56%) or “agreed” (44%) that the study improved their playing behaviours. Among intervention team coaches, three (43%) thought the study was “very effective” in changing football player behaviours about safe play, and the remaining four (57%) thought it was “effective.”ConclusionsThere is growing concern head impact frequency and severity may result in neurological issues for some athletes later in life. If head impact frequency and severity can be reduced through behavioural intervention, this can have a great public health impact.Competing interestsThis study is funded by a grant from the National Centre for Injury Prevention and Control (Grant #R49CE002479).

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