A Heads-Up for Football Safety

More than 38 million children, ages 5-18, play organized youth sports around the globe. In school sports, football is the leading cause of sports-related injuries for children in the US. According to the US Consumer Product Safety Commission, more than 920,000 athletes, age 18 and under, were treated for football-related injuries in 2007. And, thanks to some changes, it is safer than it used to be - especially for younger, lighter kids.

Thirty or more years ago, kids were often encouraged to block and tackle using their heads, a move called spearing. But that maneuver put youngsters at risk for potentially fatal head and neck injuries. Blocking and tackling with the head was the direct cause of 36 football deaths and 30 injuries involving permanent paralysis in 1968, according to the National Center for Catastrophic Sports Injury Research (NCCSI). In 1976, the rules were changed, barring leading with the head while blocking and tackling.

In the 2007 season, the latest period that statistics are available, four high school players' deaths were directly related to football, the NCCSI says. In addition, 4 high school players suffered serious injuries.

Football also may be indirectly responsible for fatal conditions such as heat stroke, fatal cardiac arrhythmia, head injuries, and asthma. In 2007, the NCCSI says, there were 9 deaths indirectly attributed to football; this figure included semi-professional, college, high school and youth teams.

Do not lead with the head

Coaches should tell players not to tackle or block with their heads or run head-down with the ball. Massachusetts neurosurgeon Robert Cantu, M.D., NCCSI's medical director, says players should always keep their heads up so they can see what they're hitting.

"Respect the helmet as a piece of protective equipment," he adds, "not as a weapon to use as the initial point of contact."

Other tips

The NCCSI and other experts also recommend these safety tips:

• Athletes should have a pre-practice physical exam, including an electrocardiogram (ECG), which can turn up hidden conditions.

• Teams should have insurance for catastrophic injury.

• Teams should have medical assistance on hand at practices and games.

• Teams should have an automatic external defibrillator at practices and games, as well as someone trained to use it.

• Coaches should teach conditioning exercises that will strengthen young athletes' necks. A strong neck makes it easier to hold the head up firmly when making a block or tackle.

• Coaches should inspect each player's equipment, especially the helmet, to see that it fits properly.

• Players should be given free access to water and electrolyte fluids (for example, Gatorade), and coaches should consider not holding outdoor practice in extreme heat and humidity.

• Teams should provide immediate medical care for a player who experiences or has symptoms of a head injury; this includes loss of consciousness, vision problems, headache, difficulty walking, disorientation and memory loss. The player should not return to practice or to a game on the day of the injury and should not return at all without clearance from medical authorities. The coach should never make the decision on whether the player is able to resume play.

• The coach or the team doctor should make players aware of the symptoms of possible head injury and should encourage players to tell them if they experience any of them, including headaches.