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 AAP Addresses Issues Relating to Concussions in Youth Football

Landry_Greg.jpgBy Greg L. Landry, MD, FAAP
Faculty, University of Wisconsin School of Medicine and Public Health
Co-author of the AAP policy statement and member of the AAP Council on Sports Medicine and Fitness

There has been increased media attention paid to the injuries associated with American football, particularly catastrophic injuries and sport-related concussions. The incidence of these injuries is higher in American football than most other team sports, in part, because of tackling. Because of the concern for injuries in tackle football, some are calling for a ban on tackling in youth football. On Oct. 25, the American Academy of Pediatrics (AAP) released a Policy Statement, Tackling in Youth Football, which reviews the medical literature regarding injuries associated with tackling and offers recommendations. 

In the policy statement the AAP determined that there was inadequate evidence to ban tackling in youth football. In most studies of injuries in youth football, the injury rate is lower than the rates reported in studies of older players. Removing tackling from football altogether would likely lead to a decrease in injuries but would be a fundamental change in the way the game is played. The authors pointed out that a ban could lead to older players learning proper tackling techniques when they are bigger, stronger and faster and this could lead to an increase in injuries to the older players. Furthermore, the statement emphasizes the importance of learning proper tackling technique with the head up and calls for zero tolerance for head to head hits and leading with the head. Efforts should continue to make the game safer at all levels. Coaches should do everything possible to reduce the number of impacts to the head. The AAP encourages communities to offer non-tackling football leagues where parents prefer to not have their son or daughter exposed to the collisions associated with the tackling leagues. There is no data on youth flag football and studies should be performed in the future to ensure that flag football has a lower risk for injury compared to tackle football. Although definitive scientific evidence is lacking, strengthening the cervical musculature will likely reduce the risk of concussions in football by limiting the acceleration of the head after impact. The final recommendation from the AAP was to encourage football programs to hire athletic trainers when possible as they may be able to reduce injury rates and can improve management of injuries when they occur.

Team sports have many benefits for youth and offer another opportunity for physical activity. Parents should attend youth football practices and games and make sure that the coaches are teaching good tackling technique with the head up. Full contact practices should be kept to a minimum. There should be a culture of zero tolerance for leading with the head and head to head hits.