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Pediatrics Group Declines To Endorse Outright Ban On Tackle Football

Supports contact limits, says not enough data to support delay in age at which tackling introduced, lists other measures to improve safety


Eight recommendations

After reviewing the available medical literature, the AAP ended up making eight recommendations regarding tackling in youth football:

1. Strictly enforce rules against spearing. A significant number of concussions and catastrophic injuries occur because of improper and illegal contact, such as spear tackling. The AAP statement bemoaned what it said was a "culture of tolerance" of head first, illegal hits, and called for a change in that culture to one of "zero tolerance" emphasizing protecting the heads of the tackler and players being tackled. The statement calls for consideration of "stronger sanctions" for contact to the head, especially of a defenseless player, up to and including expulsion from the game.

2. Weigh risks against benefits in participation decision. Because removal of tackling from football would lead to a fundamental change in the way the game is played, the group said it was up to "participants" in football to decide whether the potential health risks of sustaining injuries are outweighed by the recreational benefits associated with proper tackling (although the statement does not enumerate what those benefits are, and suggesting that the athletes themselves, not their parents, to decide whether to play tackle football was curious, to say the least)(For two blog posts by MomsTEAM's Brooke de Lench saying that it was ultimately up to parents to decide whether to allow their child to play tackle football, click here and here) 

3. Offer non-contact forms of football. Nontackling leagues for young athletes who enjoy the game of football and want to be physically active but do not want to be exposed to the collisions currently associated with the game, says the AAP, should be considered by football leagues and organizations. This would allow athletes to choose to participate in football without tackling and its associated risks, even after the age at which tackling is introduced, the statement said (Note, however, that data comparing injury rates between tackle and flag football, presented at the 2015 American Academy of Pediatrics National Conference and Exhibition suggests that injury rates in flag football may actually be higher) 

4. Limit contact practices. Although stating that the effect of repetitive head impacts (RHI) on long-term cognitive function, incidence of CTE, and other health outcomes remained "unclear," and that further research is needed, Meehan and Landry saw "no clear benefit" in RHI to the game of football or the health of football players. To reduce the risk of any long-term health problems from RHI,  the AAP thus endorsed efforts being made at the high school and youth level to reduce the number of impacts to the head that occur during participation in football (which emerging research, including a paper presented at the 2015 AAP National Conference and Exhibition and a 2015 studyin the Orthopaedic Journal of Sports Medicine suggests can reduce the risk of concussion)

5. Consider delay the age at which tackling is introduced.  Doing so, said the authors, would likely decrease the risk of injuries for the age levels at which tackling would be prohibited, but, once introduced, might expose athletes with no previous experience with tackling to collisions for the first time at an age at which speeds are faster, collision forces are greater, and injury risk is higher. Because such lack of experience with tackling and being tackled may lead to an increase in the number and severity of injuries once tackling is introduced, the AAP said that if rules banning tackling below a certain age were adopted, "they must be accompanied by coaches offering instruction in proper tackling technique as well as the teaching of the skills necessary to evade tackles and absorb being tackled."  


6. Promote neck strengthening.  Although recognizing that "definitive scientific evidence is lacking," the AAP endorsed strengthening of the cervical musculature as a way of reducing the risk of concussions in football by limiting the acceleration of the head after impact. Physical therapists, athletic trainers, or strength and conditioning specialists, with expertise in the strengthening and conditioning of pediatric athletes, are best qualified to help young football players achieve the neck strength that will help prevent injuries.


7. Staff games and practices with athletic trainers. Given their importance in the medical management of sport-related injuries and preliminary evidence suggesting an association between athletic trainers presence and a decreased incidence of sport-related injuries, efforts should be made by football teams to have athletic trainers at the sidelines during organized football games and practices.