scholarly journals American Football: Watch Your Head!

2021 ◽  
Vol 9 ◽  
Author(s):  
Kelly Sarmiento ◽  
Dana Waltzman
Keyword(s):  
Young People ◽  
Brain Injuries ◽  
American Football ◽  
Football Players ◽  
Head Impacts ◽  
Or Practice ◽  
Tackle Football

Head impacts in American football may lead to brain injuries called concussions. To study head impacts in young people who play American football, we collected data using sensors in mouthguards worn by young American football players. The sensors counted the number of hits and bumps to the head (head impacts) that players of American tackle and flag football got during the football season. We found that tackle football players had about 15 times more head impacts during a game or practice than flag football players had, and 23 times more hard head impacts. Learning more about head impacts in young American football players can help scientists find ways to lower the chances of concussions and other injuries. That way, kids can enjoy the benefits of sports while keeping their brains safe.

scholarly journals Head Impact Exposures Among Youth Tackle and Flag American Football Athletes

2021 ◽  
pp. 194173812199232
Author(s):  
Dana Waltzman ◽  
Kelly Sarmiento ◽  
Owen Devine ◽  
Xinjian Zhang ◽  
Lara DePadilla ◽  
...  
Keyword(s):  
Cohort Study ◽  
Head Impact ◽  
American Football ◽  
Level Of Evidence ◽  
Head Impacts ◽  
High Magnitude ◽  
Increased Risk ◽  
Or Practice ◽  
Observational Prospective Cohort Study ◽  
Tackle Football

Background: Promoted as a safer alternative to tackle football, there has been an increase in flag football participation in recent years. However, examinations of head impact exposure in flag football as compared with tackle football are currently limited. Hypothesis: Tackle football athletes will have a greater number and magnitude of head impacts compared with flag football athletes. Study Design: Cohort study. Level of Evidence: Level 4. Methods: Using mouthguard sensors, this observational, prospective cohort study captured data on the number and magnitude of head impacts among 524 male tackle and flag football athletes (6-14 years old) over the course of a single football season. Estimates of interest based on regression models used Bayesian methods to estimate differences between tackle and flag athletes. Results: There were 186,239 head impacts recorded during the study. Tackle football athletes were 14.67 (95% CI 9.75-21.95) times more likely to sustain a head impact during an athletic exposure (game or practice) compared with flag football athletes. Magnitude of impact for the 50th and 95th percentile was 18.15 g (17.95-18.34) and 52.55 g (51.06-54.09) for a tackle football athlete and 16.84 g (15.57-18.21) and 33.51 g (28.23-39.08) for a flag football athlete, respectively. A tackle football athlete sustained 23.00 (13.59-39.55) times more high-magnitude impacts (≥40 g) per athletic exposure compared with a flag football athlete. Conclusion: This study demonstrates that youth athletes who play tackle football are more likely to experience a greater number of head impacts and are at a markedly increased risk for high-magnitude impacts compared with flag football athletes. Clinical Relevance: These results suggest that flag football has fewer head impact exposures, which potentially minimizes concussion risk, making it a safer alternative for 6- to 14-year-old youth football athletes.

Association Between Antemortem FLAIR White Matter Hyperintensities and Neuropathology in Brain Donors Exposed to Repetitive Head Impacts

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013012
Author(s):  
Madeline Uretsky ◽  
Sylvain Bouix ◽  
Ronald J. Killiany ◽  
Yorghos Tripodis ◽  
Brett Martin ◽  
...  
Keyword(s):  
White Matter ◽  
White Matter Hyperintensities ◽  
Microvascular Disease ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Head Impacts ◽  
Repetitive Head Impacts ◽  
Pathological Correlation ◽  
Daily Function

Background and Objectives:Late neuropathologies of repetitive head impacts from contact sports can include chronic traumatic encephalopathy (CTE) and white matter degeneration. White matter hyperintensities (WMH) on fluid attenuated inversion recovery (FLAIR) MRI scans are often viewed as microvascular disease from vascular risk, but might have unique underlying pathologies and risk factors in the setting of repetitive head impacts. We investigated the neuropathological correlates of antemortem WMH in brain donors exposed to repetitive head impacts. The association between WMH, and repetitive head impact exposure and informant-reported cognitive and daily function were tested.Methods:This imaging-pathological correlation study included symptomatic deceased men exposed to repetitive head impacts. Donors had antemortem FLAIR scans from medical records and were without evidence of CNS neoplasm, large vessel infarcts, hemorrhage, and/or encephalomalacia. WMH were quantified using log-transformed values for total lesion volume (TLV), calculated using the lesion prediction algorithm from the Lesion Segmentation Toolbox. Neuropathological assessments included semi-quantitative ratings of white matter rarefaction, cerebrovascular disease, p-tau severity (CTE stage, dorsolateral frontal cortex), and Aβ. Among football players, years of play was a proxy for repetitive head impact exposure. Retrospective informant-reported cognitive and daily function were assessed using the Cognitive Difficulties Scale (CDS) and Functional Activities Questionnaire (FAQ). Regression models controlled for demographics, diabetes, hypertension, and MRI resolution. Statistical significance was defined as p<0.05.Results:The sample included 75 donors: 67 football players and 8 non-football contact sport athletes and/or military veterans. Dementia was the most common MRI indication (64%). Fifty-three (70.7%) had CTE at autopsy. Log-TLV was associated with white matter rarefaction (OR=2.32, 95% CI=1.03,5.24, p=0.04), arteriolosclerosis (OR=2.38, 95% CI=1.02,5.52, p=0.04), CTE stage (OR=2.58, 95% CI=1.17,5.71, p=0.02), and dorsolateral frontal p-tau severity (OR=3.03, 95% CI=1.32,6.97, p=0.01). There was no association with Aβ. More years of football play was associated with log-TLV (b=0.04, 95% CI=0.01,0.06, p=0.01). Greater log-TLV correlated with higher FAQ (unstandardized beta=4.94, 95% CI=0.42,8.57, p=0.03) and CDS scores (unstandardized beta=15.35, 95% CI=-0.27,30.97, p=0.05).Discussion:WMH might capture long-term white matter pathologies from repetitive head impacts, including those from white matter rarefaction and p-tau, in addition to microvascular disease. Prospective imaging-pathological correlation studies are needed.Classification of Evidence:This study provides Class IV evidence of associations between FLAIR white matter hyperintensities, and neuropathological changes (white matter rarefaction, arteriolosclerosis, p-tau accumulation), years of American football play, and reported cognitive symptoms in symptomatic brain donors exposed to repetitive head impacts.

scholarly journals Similar head impact acceleration measured using instrumented ear patches in a junior rugby union team during matches in comparison with other sports

2016 ◽  
Vol 18 (1) ◽  
pp. 65-72 ◽  
Author(s):  
Doug A. King ◽  
Patria A. Hume ◽  
Conor Gissane ◽  
Trevor N. Clark
Keyword(s):  
Injury Risk ◽  
Linear Acceleration ◽  
Rugby Union ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Head Impacts ◽  
Impact Acceleration ◽  
The Impact ◽  
Rugby Players

OBJECTIVE Direct impact with the head and the inertial loading of the head have been postulated as major mechanisms of head-related injuries, such as concussion. METHODS This descriptive observational study was conducted to quantify the head impact acceleration characteristics in under-9-year-old junior rugby union players in New Zealand. The impact magnitude, frequency, and location were collected with a wireless head impact sensor that was worn by 14 junior rugby players who participated in 4 matches. RESULTS A total of 721 impacts > 10g were recorded. The median (interquartile range [IQR]) number of impacts per player was 46 (IQR 37–58), resulting in 10 (IQR 4–18) impacts to the head per player per match. The median impact magnitudes recorded were 15g (IQR 12g–21g) for linear acceleration and 2296 rad/sec2 (IQR 1352–4152 rad/sec2) for rotational acceleration. CONCLUSIONS There were 121 impacts (16.8%) above the rotational injury risk limit and 1 (0.1%) impact above the linear injury risk limit. The acceleration magnitude and number of head impacts in junior rugby union players were higher than those previously reported in similar age-group sports participants. The median linear acceleration for the under-9-year-old rugby players were similar to 7- to 8-year-old American football players, but lower than 9- to 12-year-old youth American football players. The median rotational accelerations measured were higher than the median and 95th percentiles in youth, high school, and collegiate American football players.

Posturing Responses in Concussions Sustained by Elite American Football Players

2020 ◽  
Vol 25 (4) ◽  
pp. 203-207
Author(s):  
Scott L. Bruce ◽  
Kyra Dorney
Keyword(s):  
Current Literature ◽  
Brain Injuries ◽  
National Football League ◽  
National Collegiate Athletic Association ◽  
American Football ◽  
Football Players ◽  
Loss Of Consciousness ◽  
Inclusion Criteria ◽  
Association Football ◽  
Football Game

Current literature indicates loss of consciousness occurs in about 10% of concussions. Posturing presentations represent brain injuries and a loss of consciousness. The purpose of this study was to observe video evidence of football-game-related concussions to determine the rate in which a posturing presentation occurs in reported concussion. Over the course of three National Football League and three National Collegiate Athletic Association football seasons, 103 videos of 805 reported concussions met the inclusion criteria; 35 videos demonstrated a posturing presentation, for a rate of 33.98%. Our study indicates that the published statistic regarding loss of consciousness (occurring only about 10% of the time) may be too conservative.

scholarly journals Repetitive Head Impacts in Youth Football: Description and Relationship to White Matter Structure

2019 ◽  
Vol 11 (6) ◽  
pp. 507-513 ◽  
Author(s):  
Kurt J. Nilsson ◽  
Hilary G. Flint ◽  
Yong Gao ◽  
Leslie Kendrick ◽  
Steve Cutchin ◽  
...  
Keyword(s):  
White Matter ◽  
Diffusion Tensor ◽  
Brain Magnetic Resonance Imaging ◽  
The Body ◽  
Football Players ◽  
Head Impacts ◽  
Number Magnitude ◽  
Youth Football ◽  
Total Magnitude ◽  
Tackle Football

Background: Few studies have examined white matter with diffusion tensor imaging in 8- to 12-year-old collision sport (CS) athletes. Hypothesis: Youth CS athletes will demonstrate change in brain fractional anisotropy (FA) after a season of CS compared with an age-matched noncollision sport (NCS) cohort, and the number, magnitude, and location of hits will correlate with changes in the brain determined via FA for CS athletes. Study Design: Prospective cohort study. Level of Evidence: Level 3. Methods: Thirty-five 8- to 12-year-old males in a youth tackle football league (CS) and 12 males from local swim teams (NCS) were recruited. Participants underwent brain magnetic resonance imaging with FA before and after the football season. Number, magnitude, and direction of head impacts were recorded for CS participants throughout the season. Results: A total of 1905 hits were recorded in the CS group for the season, 341 (17.9%) collected during 7 games and 1564 (82.1%) observed during 31 practices. No significant interaction between group (CS and NCS) and time (pre- and postseason) was observed for FA ( P > 0.05). Correlation analysis revealed a significantly positive and moderate relationship between increase of left cingulate cortex (CgC) FA from pre- to postseason and the total magnitude of lateral head impacts ( r = 0.40; P = 0.03). Conclusion: There was no significant change in FA measurement of white matter integrity in a cohort of 8- to 12-year-old males after a season of youth football, nor was any difference detected in FA between youth football players and an age-matched cohort of swimmers. There was a significant correlation between total magnitude of hits sustained by youth football players and an increase in FA in the left CgC; whether this is adaptive or pathologic remains unknown. Clinical Relevance: These data can be used within the body of knowledge to counsel patients regarding the known risks of youth tackle football regarding brain health.

scholarly journals Injury rates of the German Women’s American Football National Team from 2009 to 2011

2012 ◽  
Vol 4 (3) ◽  
pp. 28
Author(s):  
Marco Ezechieli ◽  
Stephan Berger ◽  
Christian-Heige Siebert ◽  
Oliver Miltner
Keyword(s):  
Injury Rate ◽  
The Body ◽  
American Football ◽  
Fracture Dislocation ◽  
Football Players ◽  
Injury Rates ◽  
World Championship ◽  
National Team ◽  
Injury Data ◽  
Or Practice

American football is one of the leading causes of athletic-related injuries. Injury rates in female elite players are mostly unknown. We hypothesized that the injury rates of female was comparable to those in men’s football during practice, as well as games. From 2009 to 2011, injury data were collected from the German female national team during training camps, World Championship 2010 and International friendly matches. The injury was categorized by location on the body and recorded as fracture/dislocation, strain, concussion, contusion or other injury. Injury rates were determined based on the exposure of an athlete to a game or practice event. The injury rate was calculated as the ratio of injuries per 1000 athlete exposures (AE). The rate of injury was significantly higher during games (58.8/1000 AE) than practices [16.3/1000 AE, (P&lt;0.01)]. Furthermore, the injury rate in the tryouts was significantly higher (24.05/1000 AE) compared to other training sessions with the national team (11.24/1000 AE). Our findings show that the injury rates in female elite American football players can be compared to those described for male players. Higher injury rates during matches than in training should also be underlined.

scholarly journals High-magnitude head impact exposure in youth football

2017 ◽  
Vol 20 (6) ◽  
pp. 604-612 ◽  
Author(s):  
Eamon T. Campolettano ◽  
Ryan A. Gellner ◽  
Steven Rowson
Keyword(s):  
Open Field ◽  
Body Mass ◽  
Head Impact ◽  
Football Players ◽  
Head Impacts ◽  
Video Recordings ◽  
Youth Football ◽  
High Magnitude ◽  
Or Practice ◽  
The Impact

OBJECTIVEEven in the absence of a clinically diagnosed concussion, research suggests that neurocognitive changes may develop in football players as a result of frequent head impacts that occur during football games and practices. The objectives of this study were to determine the specific situations in which high-magnitude impacts (accelerations exceeding 40g) occur in youth football games and practices and to assess how representative practice activities are of games with regard to high-magnitude head impact exposure.METHODSA total of 45 players (mean age 10.7 ± 1.1 years) on 2 youth teams (Juniors [mean age 9.9 ± 0.6 years; mean body mass 38.9 ± 9.9 kg] and Seniors [mean age 11.9 ± 0.6 years; mean body mass 51.4 ± 11.8 kg]) wore helmets instrumented with accelerometer arrays to record head impact accelerations for all practices and games. Video recordings from practices and games were used to verify all high-magnitude head impacts, identify specific impact characteristics, and determine the amount of time spent in each activity.RESULTSA total of 7590 impacts were recorded, of which 571 resulted in high-magnitude head impact accelerations exceeding 40g (8%). Impacts were characterized based on the position played by the team member who received the impact, the part of the field where the impact occurred, whether the impact occurred during a game or practice play, and the cause of the impact. High-magnitude impacts occurred most frequently in the open field in both games (59.4%) and practices (67.5%). “Back” position players experienced a greater proportion of high-magnitude head impacts than players at other positions. The 2 teams in this study structured their practice sessions similarly with respect to time spent in each drill, but impact rates differed for each drill between the teams.CONCLUSIONSHigh-magnitude head impact exposure in games and practice drills was quantified and used as the basis for comparison of exposure in the 2 settings. In this cohort, game impact rates exceeded those for practice. Back players, who were often positioned in the open field, were shown to experience elevated levels of head impact exposure relative to players at other positions. The analysis also suggests that practice intensity, which may be influenced by coaching style, may also affect high-magnitude head impact exposure. Future studies should investigate this aspect as a factor affecting head impact exposure.

scholarly journals Defining Exposures in Professional Football: Professional American-Style Football Players as an Occupational Cohort

2019 ◽  
Vol 7 (2) ◽  
pp. 232596711982921 ◽  
Author(s):  
Rachel G. Grashow ◽  
Andrea L. Roberts ◽  
Ross Zafonte ◽  
Alvaro Pascual-Leone ◽  
Herman Taylor ◽  
...  
Keyword(s):  
American Football ◽  
Epidemiological Methods ◽  
Football Players ◽  
Professional Football ◽  
Head Impacts ◽  
Adverse Health Outcomes ◽  
Acute Injuries ◽  
Full Complement ◽  
Occupational Cohort

Studies of professional American football players have shown that football-related activities lead to acute injuries and may have long-term adverse health outcomes including osteoarthritis, neurocognitive impairment, and cardiovascular disease. However, the full complement of what constitutes professional football exposure has yet to be effectively articulated. Most likely, professional football exposure encompasses a multifaceted array of experiences including head impacts and joint stresses, long-term pain medication use, dietary restrictions, and strenuous training regimens. To study the health of professional American football players, characterizing the group as an occupational cohort and taking advantage of methods established within the discipline of occupational epidemiology may be beneficial. We conducted a narrative review of existing football research, occupational epidemiological methods papers, and occupational medicine studies. Here we describe the traditional occupational epidemiological approach to assessing exposure in a novel cohort and show how this framework could be implemented in studies of professional football players. In addition, we identify the specific challenges associated with studying an elite athletic occupational group, including the healthy worker effect and other types of selection and information biases, and explore these in the context of existing studies of football-related health. The application of well-established occupational epidemiological methods to professional football players may yield new insights into the effects of playing exposure and may provide opportunities for interventions to reduce harm.

Behavioral Tackling Interventions Decrease Head Impact Frequency in American Football Players: A Critically Appraised Topic

2020 ◽  
pp. 1-7
Author(s):  
Ashley E. Evans ◽  
Madeline Curtis ◽  
Marguerite (Meg) Montjoy ◽  
Erica Beidler
Keyword(s):  
High School ◽  
Injury Prevention ◽  
Head Impact ◽  
American Football ◽  
Football Players ◽  
Clinical Question ◽  
Impact Frequency ◽  
Bottom Line ◽  
Head Impacts ◽  
Different Types

Context: The rate of sport-related concussion diagnosis has significantly increased in recent years, which has created a need for injury prevention initiatives. There have been efforts put forth by researchers and American football organizations to teach athletes how to tackle properly in order to decrease the number of subconcussive head impacts and concussions. Clinical Question: Does the implementation of a behavioral tackling intervention decrease the head impact frequency in American football players? Clinical Bottom Line: There is moderate SORT Level B evidence to support the use of behavioral tackling interventions as a means for reducing head impact frequency in football athletes. All four included studies found a significant reduction in head impacts following a behavioral tackling intervention with study findings ranging from a 26–33% reduction in impact frequency. These findings were consistent in youth, high school, and college football players and for different types of behavioral tackling interventions. Therefore, these results indicate that behavioral tackling interventions have the potential to reduce the number of head impacts sustained by American football players, which may ultimately lead to a reduction in concussion occurrence as well.

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