Tackling in Youth Football

Brenner, Joel S.; LaBella, Cynthia R.; Brooks, M. Alison; Diamond, Alex B.; Kelly, Amanda K. Weiss; LaBotz, Michele; Logan, Kelsey; Loud, Keith J.; Moffatt, Kody; Nemeth, Blaise A.; Pengel, Brooke; Hennrikus, William

doi:10.1542/peds.2015-3282

Cited by 66 publications

(17 citation statements)

References 94 publications

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“…3-5,16 Despite this, only 50% of responding Oregon high schools had an AT available, nearly identical to a recent estimate. 18 Many schools either have no AT or do not have ATs at all venues; thus, initial emergency response will likely fall on coaches.…”

Section: Discussionsupporting

confidence: 54%

“…Ideally, the institution would have an onsite healthcare professional, such as an athletic trainer (AT), available to provide care during all sports-related emergencies as well as to assist the institution plan for emergency situations. While many advocate for an AT be present at least at high-risk sports events in case of emergency, 3,5,16 only 70% of high schools nationally provide any form of AT services to student-athletes. 18 Additionally, even in schools with an AT, he or she will not always be available for immediate emergency care because of multiple teams practicing at various times and locations.…”

mentioning

confidence: 99%

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Sports-Related Emergency Preparedness in Oregon High Schools

Johnson

Norcross

Bovbjerg

et al. 2017

Sports Health: A Multidisciplinary Approach

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Background:Best practice recommendations for sports-related emergency preparation include implementation of venue-specific emergency action plans (EAPs), access to early defibrillation, and first responders—specifically coaches—trained in cardiopulmonary resuscitation and automated external defibrillator (AED) use. The objective was to determine whether high schools had implemented these 3 recommendations and whether schools with a certified athletic trainer (AT) were more likely to have done so.Hypothesis:Schools with an AT were more likely to have implemented the recommendations.Study Design:Cross-sectional study.Level of Evidence:Level 4.Methods:All Oregon School Activities Association member school athletic directors were invited to complete a survey on sports-related emergency preparedness and AT availability at their school. Chi-square and Fisher exact tests were used to analyze the associations between emergency preparedness and AT availability.Results:In total, 108 respondents (37% response rate) completed the survey. Exactly half reported having an AT available. Only 11% (95% CI, 6%-19%) of the schools had implemented all 3 recommendations, 29% (95% CI, 21%-39%) had implemented 2, 32% (95% CI, 24%-42%) had implemented 1, and 27% (95% CI, 19%-36%) had not implemented any of the recommendations. AT availability was associated with implementation of the recommendations (χ2 = 10.3, P = 0.02), and the proportion of schools with ATs increased with the number of recommendations implemented (χ2 = 9.3, P < 0.01). Schools with an AT were more likely to implement venue-specific EAPs (52% vs 24%, P < 0.01) and have an AED available for early defibrillation (69% vs 44%, P = 0.02) but not more likely to require coach training (33% vs 28%, P = 0.68).Conclusions:Despite best practice recommendations, most schools were inadequately prepared for sports-related emergencies. Schools with an AT were more likely to implement some, but not all, of the recommendations. Policy changes may be needed to improve implementation.Clinical Relevance:Most Oregon high schools need to do more to prepare for sports-related emergencies. The results provide evidence for sports medicine professionals and administrators to inform policy changes that ensure the safety of athletes.

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Section: Discussionsupporting

confidence: 54%

mentioning

confidence: 99%

Sports-Related Emergency Preparedness in Oregon High Schools

Johnson

Norcross

Bovbjerg

et al. 2017

Sports Health: A Multidisciplinary Approach

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“…Some research shows older players tend to have an increased injury rate. 4 , 6 – 8 , 10 , 12 , 14 – 15 , 20 , 22 Not all studies agree with this assumption. 18 The prominent age-related finding of this study was a conditional risk of concussion by grade and type of exposure for injured players ( Table 4 ).…”

Section: Discussionmentioning

confidence: 98%

“…A recent American Academy of Pediatrics Policy Statement on tackling in youth football recommended nontackling leagues should be expanded. 4 We hypothesize that youth flag football has a lower injury rate than youth tackle football.…”

mentioning

confidence: 99%

Youth Football Injuries: A Prospective Cohort

Peterson

Kruse

Meester

et al. 2017

Orthopaedic Journal of Sports Medicine

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Background:There are approximately 2.8 million youth football players between the ages of 7 and 14 years in the United States. Rates of injury in this population are poorly described. Recent studies have reported injury rates between 2.3% and 30.4% per season and between 8.5 and 43 per 1000 exposures.Hypothesis:Youth flag football has a lower injury rate than youth tackle football. The concussion rates in flag football are lower than in tackle football.Study Design:Cohort study; Level of evidence, 3.Methods:Three large youth (grades 2-7) football leagues with a total of 3794 players were enrolled. Research personnel partnered with the leagues to provide electronic attendance and injury reporting systems. Researchers had access to deidentified player data and injury information. Injury rates for both the tackle and flag leagues were calculated and compared using Poisson regression with a log link. The probability an injury was severe and an injury resulted in a concussion were modeled using logistic regression. For these 2 responses, best subset model selection was performed, and the model with the minimum Akaike information criterion value was chosen as best. Kaplan-Meier curves were examined to compare time loss due to injury for various subgroups of the population. Finally, time loss was modeled using Cox proportional hazards regression models.Results:A total of 46,416 exposures and 128 injuries were reported. The mean age at injury was 10.64 years. The hazard ratio for tackle football (compared with flag football) was 0.45 (95% CI, 0.25-0.80; P = .0065). The rate of severe injuries per exposure for tackle football was 1.1 (95% CI, 0.33-3.4; P = .93) times that of the flag league. The rate for concussions in tackle football per exposure was 0.51 (95% CI, 0.16-1.7; P = .27) times that of the flag league.Conclusion:Injury is more likely to occur in youth flag football than in youth tackle football. Severe injuries and concussions were not significantly different between leagues. Concussion was more likely to occur during games than during practice. Players in the sixth or seventh grade were more likely to suffer a concussion than were younger players.

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“…In 1998, the American Medical Association released a statement supporting the need to create an Athletic Medical Unit “in every school that mounts a sports program” and that a recommended member of the unit be “preferably a NATA BOC certified athletic trainer” (American Medical Association 2018 ; Lyznicki et al 1999 ). The American Academy of Family Physicians also supports this position, encouraging high schools to include an athletic trainer as an integral part of the high school athletic program (American Academy of Family Physicians 2018 ); the American Academy of Neurology, too, recommends that “a certified athletic trainer should be present at all sporting events, including practices, where athletes are at risk for concussion.” (American Academy of Neurology 2018 ) The American Academy of Pediatrics recommends efforts should be made by football teams to have athletic trainers at the sidelines during organized football games and practices (Tackling in Youth Football 2015 )…”

Section: Discussionmentioning

confidence: 99%

Injuries in girls’ soccer and basketball: a comparison of high schools with and without athletic trainers

et al. 2018

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BackgroundSports injuries impose physical and economic burdens on high school athletes, yet only 37% of high schools have access to a fulltime certified athletic trainer (AT). Although intuitively there are multiple benefits of AT coverage, research demonstrating the measurable effect of AT coverage on rates and patterns of injury is limited. Our objective was to investigate the epidemiology of girls’ basketball and soccer injuries in high schools with and without an AT.MethodsWe compared data captured by two similar sports injury surveillance systems during the 2006/07–2008/09 academic years. High School Reporting Information Online (RIO) included a national sample of schools with ATs, and the Sports Injury Surveillance System (SISS) included a sample of Chicago public high schools without ATs.ResultsOverall injury rates were higher in schools without ATs than schools with ATs in girls’ soccer (RR: 1.73, 95% CI: 1.51–2.00) and basketball (RR: 1.22, 95% CI: 1.03–1.45). Recurrent injury rates were even higher in schools without ATs compared to schools with ATs in soccer (RR: 6.00 95% CI: 4.54-7.91) and basketball (RR: 2.99, 95% CI: 2.12–4.14). Conversely, concussion rates were higher in schools with ATs than schools without ATs in soccer (RR: 8.05, 95% CI: 2.00–32.51) and basketball (RR: 4.50, 95% CI: 1.43–14.16). Other injury patterns were similar between the two samples.ConclusionsThis study demonstrated the effectiveness of AT coverage of high school girls’ soccer and basketball, both in reducing overall and recurrent injury rates and in identifying athletes with concussions. Future studies should evaluate the effect of ATs on other high school sports and on youth sports to determine if these findings are generalizable across sports and age groups.

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Tackling in Youth Football

Cited by 66 publications

References 94 publications

Sports-Related Emergency Preparedness in Oregon High Schools

Sports-Related Emergency Preparedness in Oregon High Schools

Youth Football Injuries: A Prospective Cohort

Injuries in girls’ soccer and basketball: a comparison of high schools with and without athletic trainers

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