Injury Rates in Age-Only Versus Age-and-Weight Playing Standard Conditions in American Youth Football

Abstract

Background:American youth football leagues are typically structured using either age-only (AO) or age-and-weight (AW) playing standard conditions. These playing standard conditions group players by age in the former condition and by a combination of age and weight in the latter condition. However, no study has systematically compared injury risk between these 2 playing standards.Purpose:To compare injury rates between youth tackle football players in the AO and AW playing standard conditions.Study Design:Cohort study; Level of evidence, 2.Methods:Athletic trainers evaluated and recorded injuries at each practice and game during the 2012 and 2013 football seasons. Players (age, 5-14 years) were drawn from 13 recreational leagues across 6 states. The sample included 4092 athlete-seasons (AW, 2065; AO, 2027) from 210 teams (AW, 106; O, 104). Injury rate ratios (RRs) with 95% CIs were used to compare the playing standard conditions. Multivariate Poisson regression was used to estimate RRs adjusted for residual effects of age and clustering by team and league. There were 4 endpoints of interest: (1) any injury, (2) non–time loss (NTL) injuries only, (3) time loss (TL) injuries only, and (4) concussions only.Results:Over 2 seasons, the cohort accumulated 1475 injuries and 142,536 athlete-exposures (AEs). The most common injuries were contusions (34.4%), ligament sprains (16.3%), concussions (9.6%), and muscle strains (7.8%). The overall injury rate for both playing standard conditions combined was 10.3 per 1000 AEs (95% CI, 9.8-10.9). The TL injury, NTL injury, and concussion rates in both playing standard conditions combined were 3.1, 7.2, and 1.0 per 1000 AEs, respectively. In multivariate Poisson regression models controlling for age, team, and league, no differences were found between playing standard conditions in the overall injury rate (RRoverall, 1.1; 95% CI, 0.4-2.6). Rates for the other 3 endpoints were also similar (RRNTL, 1.1 [95% CI, 0.4-3.0]; RRTL, 0.9 [95% CI, 0.4-1.9]; RRconcussion, 0.6 [95% CI, 0.3-1.4]).Conclusion:For the injury endpoints examined in this study, the injury rates were similar in the AO and AW playing standards. Future research should examine other policies, rules, and behavioral factors that may affect injury risk within youth football.

Epidemiology of Sport-Related Concussions in High School Athletes: National Athletic Treatment, Injury and Outcomes Network (NATION), 2011–2012 Through 2013–2014

“…However, SRC rates did not differ among those in age-weight and age-only leagues. 34 These findings highlight the need to consider the association of competition level and possible size and skill mismatches among players with SRC risk.…”

Examining Play Counts and Measurements of Injury Incidence in Youth Football

“…26 Thus, our study is a secondary analysis of previously collected data and was approved by the Western Institutional Review Board (Puyallup, WA).…”

“…In the original study, 26 the examination of athlete-plays was exploratory, as no studies to our knowledge provided welldocumented instructions about collecting athlete-plays in a large sports setting. For the current study, we had to consider the factors involved in using a new measure that was not typically tracked by our data collectors (ATs, coaches, parents).…”

“…Leagues were selected if they met the requirements detailed in an earlier study. 26 Provision of ATs for each league and their requirements were also described in another study. 26 …”

“…Therefore, the purpose of our study was to describe injury incidence during the 2013 youth football season using 3 measures: injury risk, AE-based injury rates, and athleteplays-based injury rates using data from the Youth Football Surveillance Study. 26 Our research questions were as follows:…”