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AAP: Don't Ban Tackle in Kids' Football -- Go for Good Technique

— Lack of tackling experience when younger may lead to more severe injuries later

MedpageToday
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WASHINGTON -- Instead of banning tackling in youth football, which "fundamentally changes" the game, coaches should instruct players on proper tackling technique and implement reduced contact during practice, according a policy statement from the American Academy of Pediatrics (AAP).

It's the first time the AAP has addressed the issue of tackling in football in a policy statement. Lead authors , of Children's Hospital in Boston, and , of the University of Wisconsin in Madison, also noted that delaying the age at which kids are allowed to tackle in football would likely decreased the risk of serious injuries, but young athletes with no previous tackling experience may be at greater risk for more severe injuries.

Action Points

  • Note that this statement from the American Academy of Pediatrics calls for education regarding proper tackling technique, rather than banning contact in youth football.
  • Be aware that the "heads up" technique, where tackles are performed with the shoulder with the head in a raised position, is preferred.

The statement was presented at a plenary session at the American Academy of Pediatrics annual meeting and published simultaneously online in .

At the session, Landry said the AAP decided to address this issue because of calls for a ban on tackling in youth football. One of the most prominent advocates is Robert Cantu, MD, author of . Cantu advocated for holding off on tackle football until children reach age 14.

But while delaying the age at which tackling is introduced might help reduce injuries in the short-term, studies found that lack of experience in tackling when kids are younger might lead to more severe injuries when they are older. The, , and seemed to be higher in older players, according to the AAP statement.

, of the Henry Ford Medical Group in Detroit, said in an email to MedPage Today that there has been growing parental awareness of the potential physical and cognitive consequences of football injuries in recent years, likely due in part to a higher level of media attention.

"The increased emphasis on the identification of concussive injuries in schools, and the publicity surrounding the prevention of concussion has cast doubt in the minds of some parents whether to allow their children to participate in football at all," said Kappy, who was not involved with the AAP statement. "This growing hesitancy exists even within families where football participation has been a longstanding family tradition."

Landry pointed out that catastrophic injury rates in football are lower than in and . In an interview with MedPage Today, he emphasized that proper tackling technique is the key to lowering football injury rates.

"The injury rate in youth football is low, and it's going to get better when they implement the new tackling technique and reduce the number of contact practices," he said.

Youth football leagues that teach proper "heads up" tackling -- defined as initiating contact with the shoulder while the head is up -- and Pop Warner leagues, which have limited player contact during practice, saw a statistically significant difference in injuries compared with leagues still practicing improper (non-heads up) tackling procedures.

The AAP statement also recommended the expansion of non-tackling leagues for parents who want their kids to play football without being exposed to tackling, though there is little research on the subject. But Landry shared an update with MedPage Today about some research in progress.

"We just heard yesterday from a group at Iowa who studied the injury rate in flag football compared with the youth tackling league, and the injury rate in flag football is higher, so stay tuned," he said. "That's the kind of research we need to answer these questions, whether we want everybody to play flag football rather than tackle football."

Landry cautioned that the Iowa research has not been published and it did not have the numbers to assess concussion rates, which would obviously be a concern.

, of the Allegheny Health Network in Pittsburgh said that "as pediatricians, we need to encourage team sports, encourage physical activity -- no matter what the activity is -- and then trust our coaches, our parents, and our organizations to provide a safe, educational venue for them to get it."

Landry said that that the culture of football has changed over the years to include more head-first hits.

"It was such a gradual change; I think it caught us off-guard because now there's just too many head-to-head hits and that has to stop," he stated.

Disclosures

All AAP policy statements automatically expire 5 years after publication unless reaffirmed, revised, or retired at or before that time.

Meehan disclosed relevant relationships with the National Football League Players Association, ABC-Clio Publishing, Wolters Kluwer, and Springer International.

Landry disclosed no relevant relationships with industry.

Primary Source

Pediatrics

Meehan WP, et al "Tackling in youth football" Pediatrics 2015; DOI: 10.1542/peds.2015-3282.