Sports Rules Shift in Light of Concussion Research

Football players practice last year at Gilbert High School in Gilbert, Ariz.
Football players practice last year at Gilbert High School in Gilbert, Ariz.
—Pat Shannahan/The Arizona Republic/AP-File

Governing bodies target football players

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Emerging research on head injuries among young athletes is causing a sea change of policies—particularly for football players—aimed at reducing the number of impacts and the severity of such hits.

The National Federation of State High School Associations now requires youth-football players to leave the field for one play after losing their helmet. USA Hockey has banned full-body checking in leagues for children 12 and younger. And the Minnesota State High School League recently adopted stricter penalties for checking and head contact, after two teenagers were hospitalized from being hit from behind during hockey games.

Many of the new policies focus on reducing concussion risk factors in game-day situations. Far fewer, however, address practice, which can be more injurious.

A new joint studyRequires Adobe Acrobat Reader from Virginia Polytechnic Institute and Wake Forest University, for example, found that unlike in high school and college football, the hardest hits for youth-football players typically occur during practice.

The researchers placed instruments in the helmets of seven football players, ages 7 and 8, and examined a total of 748 impacts that they endured. They found that roughly 60 percent of all head impacts occurred in practice.

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Of the 38 high-level impacts (forces that were 40 or more times the pull of gravity) examined, 29 took place during practice.

Preliminary findings from the study were released back in October, and suggested that the frequency of the most-severe hits was substantially lower than in adult football. According to the latest findings, released last week, however, youth-football players endured "head accelerations in the range of concussion-causing impacts measured in adults."

The study's authors suggest changing the structure of youth-football practices to eliminate "high-impact drills that do not replicate the game situations." Instead, they suggest youth-football coaches focus on "practicing fundamental skill sets needed in football at these young ages."

The study, "Head Impact Exposure in Youth Football," was published online in the Annals of Biomedical Engineering.

Helmet Fit

The national federation recently changed eight rules for high school football, including one that requires players to leave the field for at least one down if they lose their helmet during a play.

That new rule does not apply, however, if a player loses his helmet as a direct result of an opponent's foul.

"It is the committee's hope that this serves notice for schools to properly fit players with helmets to reduce the incidence of these situations and remind the players not to take steps that alter the fit," said Julian Tackett, the commissioner of the Kentucky High School Athletic Association and the chairman of the NFHS football-rules committee, in a statement.

The new helmet rule targets one of the more easily modifiable risk factors in football, according to a group of experts who recently presented at the American Orthopaedic Society for Sports Medicine's Specialty Day.

Among the studies presented, Dr. Joseph S. Torg, a clinical professor of orthopaedic surgery and sports medicine at Temple University, in Philadelphia, and his colleagues examined dataRequires Adobe Acrobat Reader from 1,006 concussions. They found that youth-football players wearing properly fitted helmets, as reported by certified athletic trainers, were 80 percent less likely to lose consciousness when sustaining large, concussive hits to the head.

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Nationwide, high school athletes suffer concussions at a rate of 2.5 for every 10,000 exposures to the playing field, either for practice or competition, says a recent study in The American Journal of Sports Medicine. Of the 1,936 concussions examined, nearly half—47.1 percent—stemmed from football.

The players who participated in the Virginia Tech-Wake Forest study each sustained an average of 107 head impacts during the course of 9.4 practices and 4.7 games. An average player in the study received at least one hit above 10 times the force of gravity. For a 100-pound player, a hit 10 times the force of gravity would equate to feeling like a 1,000-pound hit.

Limiting Hits?

The Boston-based Sports Legacy Institute earlier this month called for all youth-sports organizations to alter their playing rules to limit the amount of head contact that student-athletes endure.

The organization suggested that no youth athlete should be allowed to receive more than 1,000 hits to the head exceeding 10 times the force of gravity in a season, and no more than 2,000 times in a year. Currently, youth-football players may already be averaging roughly 1,000 hits per season, with a mean force of 20 times the force of gravity, according to previous research.

"While most [youth] programs have taken positive steps on the concussion issue, few if any are actively working to limit exposure to subconcussive brain trauma," the institute said in its white paperRequires Adobe Acrobat Reader. "Today, children are exposed to levels of brain trauma that are considered dangerous and unacceptable for adults."

Vol. 31, Issue 22, Page 8

Published in Print: February 29, 2012, as Sports Rules Revised as Research Mounts on Head Injuries
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