Injury Prevention Methods Related to the Athlete

Each athlete brings into the football experience unique characteristics which could predispose the athlete to injury.

It is often advised that very young children should not play football. The National Youth Sports Safety Foundation recommends that children under six not play the sport. Collision sports like ice hockey and tackle football should not be allowed until age 10.

But even then, The different levels of performance within a given age group are often the result of different levels of physical maturity rather than differences in skill. Classification on the basis of chronological age is not always satisfactory during adolescence. Maturity assessment as a basis for matching athletes for football makes sense, since more physically-mature children can inflict considerable physical harm to their less mature chronological peers. Youth who are not sufficiently mature should be advised to go into one of the many sports in which there is less risk of injury.

One aspect of maturity assessment is periodic height measurement during a season to identify periods of rapid growth in athletes. Rapid growth is assumed to be a risk factor for injury because children’s muscles and tendons grow at a slower rate than their bones. The muscles and tendons cannot keep up and become tight, resulting in a temporary loss of flexibility. Some experts recommend reducing the amount and intensity of training during growth spurts.

The use of a pre-participation physical exam is one of the most critical aspects of injury prevention in amateur sports programs.The purposes of the exam are to (1) detect conditions which could make football playing life-threatening or disabling and (2) detect medical or musculoskeletal conditions that could predispose to injury or illness during practice or competition. Ideally, the evaluation would be performed at least six weeks prior to preseason practice, to allow time for correction of identified problems, such as use of specific strengthening or flexibility exercises.

Ask your physician for the manual Preparticipation Physical Evaluation, a practical, comprehensive guide for conducting a physical. It was developed cooperatively by the American Academy of Family Physicians, the American Academy of Pediatrics, the American Medical Society for Sports Medicine and the American Osteopathic Academy of Sports Medicine. It includes specific questions that can be asked in the medical history as well as instructions for conducting sports-related musculoskeletal screening.

Preventive Measures Related to the Sports Setting

Helmets: Helmets should be fitted by a knowledgeable person experienced in the process. During fitting, the player’s hair should be at normal length and should be wet, to best simulate the actual condition of the hair during play. If a player changes his hair style during the season, especially if he shaves his head, the helmet should be re-fitted.

Checking the fit: The best fit resists motion of the helmet on the head. To test the fit, the jaw pads should be removed and the athlete should flex his neck, resisting efforts to rotate the helmet from side to side. If the skin on the forehead does not move with the helmet, the helmet is not snug enough. Also, the helmet should be rotated up and down to be sure that the front edge of the shell does not come down on the bridge of the nose and that the rear side of the shell does not impinge on the nape of the neck. Helmets should be comfortable but snug.

All helmets should have a nose bumper guard. Jaw pads of proper thickness will help minimize side-to-side rotation of the helmet. There should be no space between the jaw pads and the jaw and cheek. A four-point chin strap should always be used, with equal tension on all four attachments and no slack in the straps. Bandanas or other head covering under the helmet should not be allowed.

Face Masks: If the helmet is fitted without a face mask or if the mask is changed, the fit should be rechecked after one has been attached. The sides of the shell may be slightly spread or pulled in by the mask, distorting the shell and changing the fit. The width of the mask should therefore match the width of the shell as closely as possible. The mask should be 1-1/2" from the nose. If the cage mask is fitted too closely to the face, the face can be cut when the cage is driven back during violent contact.

The face opening should be small enough to keep forearms and shoes out. If the bar style is fitted too low it doesn't’t protect the facial area sufficiently. If it is fitted too high it obstructs vision.

After a helmet has been properly fitted, it should be marked with the athlete’s name or number, to avoid it getting mixed up with other helmets. Periodic refitting may be necessary due to haircuts, compression of pads or loss of air from compartments.

Pads: Shoulder pad manufacturers design different styles of pads for different team positions. Before a shoulder pad is fitted, the position for which it was designed should be determined.

Once a pad is fitted, it should always be used by the particular player it was fitted for. The shoulder pads should be constantly inspected for cracks, frayed strings and straps, loose rivets and other possible failures.

Hip, thigh and knee pads should be large enough to cover the respective areas. The pants are important in maintaining proper placement of these pads. The pants should be tight enough to prevent thigh pads from sliding.

No hard fiber pads should be worn on the arm at or below the elbow.

Field Conditions: Maintenance of playing fields is one of the most basic strategies for preventing injuries. Turf should be well-maintained. Practice and playing fields should be well-lighted and free of holes, broken glass and other hazardous debris.

Structural Hazards: Locker rooms, weight rooms and shower rooms should be sanitary, well-lighted and free of hazardous debris, with ground fault circuit interrupters when there is water near electrical outlets. Sporting events can be the occasion of injuries among spectators as well as athletes. Out-of bounds buffer zones between spectators and the playing field should be adequate to prevent collisions. Goal posts should be padded to prevent injuries from high speed collisions.

Injury Prevention Measures Related to Management of Practice and Competitions

The coach has overall responsibility for the safety of the athletes. It is his or her responsibility to teach safety principles to athletes; to see that athletes are properly conditioned; to require proper warm-up; to teach appropriate techniques; to avoid unsafe environmental situations; and to prevent players from competing beyond their fatigue level. The National Council of Athletic Training recommends that all coaches be certified in first aid and CPR and know current rules and regulations of football.

Coaches should teach athletes information on safety by giving the players check lists and lectures and showing training films, if they are available. Communication on safety be documented. Requirements for documenting that safety information has been provided would remind coaches, administrators and officials that safety instruction is an important part of the athletic program. Safety principles should also be presented to parents, so they can reinforce messages from coaches.

Warm Up: The National Athletic Trainers Association recommends a minimum of 15 minutes of warm-up before any game or practice and a cool-down period afterward. Athletes should also warm up for five minutes during any prolonged breaks in activity (half-time, etc.).

Practice Issues: Pre-season practices are considered injury-prone times. Controlled activities could be emphasized at this time and coaching staff should be particularly vigilant of technique. Because a significant percent of injuries occur during contact practice drills, the National Youth Sports Safety Foundation recommends that a reduction in the amount of contact practice should be considered. Such a reduction is particularly feasible as the season progresses, after athletes have mastered appropriate techniques for blocking and tackling.

Parents’ Responsibilities: Parents should be aware about the inherent risks of football and injury prevention methods. Parents who understand safety principles-correct blocking and tackling procedures, the importance of correctly fitted equipment, the importance of training for coaches, etc.- are in unique positions to monitor and advocate for injury prevention practices in an athletic program. Parents should be free to speak up if they see something that seems unsafe. Other roles that are important for parents include (1) being sure any injury is reported to the athletic program staff, and (2) reinforcing compliance with treatments or rehabilitation after injury.