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AAP releases policy statement on tackling injuries in youth football
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WASHINGTON — Enforcement of proper tackling rules and availability of athletic trainers on the sidelines are recommended to reduce injuries in youth football, according to new a policy statement released by the AAP’s Council on Sports Medicine and Fitness.
The authors noted that while most injuries sustained during youth football are relatively minor, the incidences of severe injuries, catastrophic injuries and concussion are higher in football than most other team sports – and appear to increase with age.
To curtail these injuries among youth players, the AAP recommended that:
- Game officials and coaches enforce the rules of proper tackling, including zero tolerance for illegal, head-first hits;
- Athletic trainers be available on the sidelines, as evidence demonstrates they can moderate the number of injuries for players;
- Players decide whether the benefits of playing outweigh the risks of possible injury;
- Non-tackling leagues be expanded so athletes can choose to participate without the injury risks associated with tackling.
William Meehan, III
“Removing tackling would dramatically reduce the risk of serious injuries to players, but it would fundamentally change the sport of football,” statement co-author William Meehan, III, MD, a member of the AAP Council on Sports Medicine and Fitness, said in a press release. “The AAP encourages athletes to continue playing organized sports, while supporting coaches and officials in their work to reduce these injuries.”
In particular, the AAP noted that severe injuries and catastrophic injuries of the head and neck were associated with tackling, most often when players were employing improper or illegal techniques, such as spear tackling.
“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,” Meehan and colleagues wrote. “Stronger sanctions for contact to the head, especially of a defenseless player, should be considered, up to and including expulsion from the game.”
Greg Landry
Additionally, the authors cited the importance of athletic trainers at the sidelines during organized football games and practices, as their presence has been associated with a decreased incidence of sport-related injuries.
“There are some people who are calling for a ban on tackling in youth football and will not like our statement – we could not find any evidence that this is necessary,” statement co-author Greg Landry, MD, told Infectious Diseases in Children. “The injury rate in youth football is low, much lower when compared to high school and college football. [However,] we strongly feel that young football players be taught proper tackling technique and that spear tackling must be forbidden.”– by Bob Stott
Disclosure: The researchers report no relevant financial disclosures.
Perspective
Back to TopKevin D. Walter, MD, FAAP
These recommendations were needed for a variety of reasons. Pediatricians, sports medicine doctors and orthopedic surgeons who care for kids are all asked what age is best to begin hitting/contact. Prior to this statement, it has all been opinion. This statement is a dive into what literature has shown and provides a concept of what we need to know.
This policy statement highlights some areas of athletics that need to change. Coaches and officials need to get control of the kids who get it wrong by leading with their heads. They should penalize them down and maybe sit them out a play, a series, a quarter or a game. Athletes want to play and this will make them change their style.
Having athletic trainers available on the sideline is helpful, too. I am unsure their presence will necessarily decrease the risk of injury, but everyone will be more comfortable with identifying injuries, injury management and dealing with return to play.
Regarding possibly stopping participating due to potential risk, this should be a shared discussion between provider and the family, but certainly in the end it is the parents’ decision outside of recommendations made due to injury. I always encourage parents to have an open discussion with the kid about the risk of injuries and return to play and so forth.
I talk to parents about ensuring their kids’ coaches are appropriate — not interfere with coaching, but really investigate coaches, see their coaching style and make sure the coaches understand things like concussion. If the coach is unwilling to learn from available resources about preventing and identifying sports injuries and concussion, parents may want to have their child assigned to another team. On the football field, if there are a handful of coaches, at least one of them has to know what’s going on with concussion and I would expect all of them to have education for how to tackle in youth football.
I was pleased the recommendations discussed expanding non-tackling leagues and did not establish a specific age at which tackling is safe because we don’t know what that age is. I think the weakness of the recommendations is not the authors’ fault, but reflects the lack of available medical literature. Gaps exist in the research in this area at the youth level and I hope future research and discussion fills in some of these gaps.
References:
National Federation of State High School Associations Concussion in Sport program. http://nfhslearn.com/courses/61037/concussion-in-sports.
USA Football Heads Up program. http://usafootball.com/headsup.
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