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American football remains one of the most popular sports for young athletes. abstract
The injuries sustained during football, especially those to the head and neck,
have been a topic of intense interest recently in both the public media and
medical literature. The recognition of these injuries and the potential for long-
term sequelae have led some physicians to call for a reduction in the number
of contact practices, a postponement of tackling until a certain age, and even
a ban on high school football. This statement reviews the literature regarding
injuries in football, particularly those of the head and neck, the relationship
between tackling and football-related injuries, and the potential effects of
limiting or delaying tackling on injury risk.
approximately 250 000 youth football players 5 to 15 years of age in Pop Policy statements from the American Academy of Pediatrics benefit
Warner leagues alone, making football one of the most popular sports for from expertise and resources of liaisons and internal (AAP) and
external reviewers. However, policy statements from the American
younger athletes as well.2 The injuries sustained during football, especially Academy of Pediatrics may not reflect the views of the liaisons or the
those to the head and neck, have been a topic of intense interest recently organizations or government agencies that they represent.
in both the public media and the medical literature. Concerns about the The guidance in this statement does not indicate an exclusive course
of treatment or serve as a standard of medical care. Variations, taking
number of head and neck injuries, especially concussions and catastrophic into account individual circumstances, may be appropriate.
injuries, have led some athletes to stop playing football.3 More recently,
All policy statements from the American Academy of Pediatrics
the cumulative effects of concussions and the potential for a cumulative automatically expire 5 years after publication unless reaffirmed,
effect of subconcussive blows to the head, defined as those that do not revised, or retired at or before that time.
cause symptoms of concussion, have been hypothesized as a causative risk www.pediatrics.org/cgi/doi/10.1542/peds.2015-3282
factor for chronic traumatic encephalopathy (CTE). The recognition of DOI: 10.1542/peds.2015-3282
these injuries and the potential for long-term sequelae have led some
PEDIATRICS (ISSN Numbers: Print, 0031-4005; Online, 1098-4275).
physicians to call for a reduction in the number of contact practices,
a postponement of tackling until a certain age, and even a ban on high Copyright © 2015 by the American Academy of Pediatrics
school football.4–6 FINANCIAL DISCLOSURE: Dr. Meehan participates in research funded, in
part, by the National Football League Players Association and receives
Others, however, have argued that football is a generally safe sport that compensation from ABC-Clio Publishing, Wolters Kluwer, and Springer
carries with it the substantial benefits of regular exercise on health7,8 as International Publishing for his authored works. Dr. Landry has
indicated he does not have a financial relationship relevant to this
well as social and academic outcomes9–11 that outweigh the risks involved, article to disclose.
pointing out that the risk of catastrophic injury is low, that most POTENTIAL CONFLICT OF INTEREST: The authors have indicated they
concussions resolve within a few days or weeks, and that there are have no potential conflicts of interest to disclose.
e1421
The majority of concussions result
underreported in football
Badgeley et al studied the
N = 468
N = 340
200221
Kontos et al 201323
Linder et al 199524
Updated Information & including high resolution figures, can be found at:
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References This article cites 87 articles, 19 of which you can access for free at:
http://pediatrics.aappublications.org/content/136/5/e1419#BIBL
Subspecialty Collections This article, along with others on similar topics, appears in the
following collection(s):
Current Policy
http://www.aappublications.org/cgi/collection/current_policy
Council on Sports Medicine and Fitness
http://www.aappublications.org/cgi/collection/council_on_sports_me
dicine_and_fitness
Sports Medicine/Physical Fitness
http://www.aappublications.org/cgi/collection/sports_medicine:physi
cal_fitness_sub
Concussion
http://www.aappublications.org/cgi/collection/concussion_sub
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Pediatrics is the official journal of the American Academy of Pediatrics. A monthly publication, it
has been published continuously since 1948. Pediatrics is owned, published, and trademarked by
the American Academy of Pediatrics, 141 Northwest Point Boulevard, Elk Grove Village, Illinois,
60007. Copyright © 2015 by the American Academy of Pediatrics. All rights reserved. Print
ISSN: 1073-0397.