Kathleen E. Bachynski, M.P.H.
N Engl J Med 2016; 374:405-407
At least 11 U.S. high-school athletes died playing football during the fall 2015 season. Their deaths attracted widespread media attention and provided fodder for ongoing debates over the safety of youth tackle football. In October 2015, the American Academy of Pediatrics (AAP) issued its first policy statement directly addressing tackling in football. The organization’s Council on Sports Medicine and Fitness conducted a review of the literature on tackling and football-related injuries and evaluated the potential effects of limiting or delaying tackling on injury risk. It found that concussions and catastrophic injuries are particularly associated with tackling and that eliminating tackling from football would probably reduce the incidence of concussions, severe injuries, catastrophic injuries, and overall injuries.
But rather than recommend that tackling be eliminated in youth football, the AAP committee primarily proposed enhancing adult supervision of the sport. It recommended that officials enforce the rules of the game, that coaches teach young players proper tackling techniques, that physical therapists and other specialists help players strengthen their neck muscles to prevent concussions, and that games and practices be supervised by certified athletic trainers. There is no systematic evidence that tackling techniques believed to be safer, such as the “heads-up” approach promoted by USA Football (amateur football’s national governing body), reduce the incidence of concussions in young athletes. Consequently, the AAP statement acknowledged the need for further study of these approaches. The policy statement also encouraged the expansion of nontackling leagues as another option for young players.
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