Football Players' Head-Impact Exposure After Limiting of Full-Contact Practices

Abstract

Context: Sporting organizations limit full-contact football practices to reduce concussion risk and based on speculation that repeated head impacts may result in long-term neurodegeneration.

Objective: To directly compare head-impact exposure in high school football players before and after a statewide restriction on full-contact practices.

Design: Cross-sectional study.

Setting: High school football field.

Patients or other participants: Participants were varsity football athletes from a single high school. Before the rule change, 26 athletes (age = 16.2 ± 0.8 years, height = 179.6 ± 6.4 cm, weight = 81.9 ± 13.1 kg) participated. After the rule change, 24 athletes (age = 15.9 ± 0.8 years, height = 178.3 ± 6.5 cm, weight = 76.2 ± 11.6 kg) participated. Nine athletes participated in both years of the investigation.

Main outcome measure(s): Head-impact exposure was monitored using the Head Impact Telemetry System while the athletes participated in football games and practices in the seasons before and after the rule change. Head-impact frequency, location, and magnitude (ie, linear acceleration, rotational acceleration, and Head Impact Telemetry severity profile [HITsp], respectively) were measured.

Results: A total of 15 398 impacts (592 impacts per player per season) were captured before the rule change and 8269 impacts (345 impacts per player per season) after the change. An average 42% decline in impact exposure occurred across all players, with practice-exposure declines occurring among linemen (46% decline); receivers, cornerbacks, and safeties (41% decline); and tight ends, running backs (including fullbacks), and linebackers (39% decline). Impact magnitudes remained largely unchanged between the years.

Conclusions: A rule change limiting full-contact high school football practices appears to have been effective in reducing head-impact exposure across all players, with the largest reduction occurring among linemen. This finding is likely associated with the rule modification, particularly because the coaching staff and offensive scheme remained consistent, yet how this reduction influences concussion risk and long-term cognitive health remains unknown.

Keywords: concussions; protective equipment; traumatic brain injuries.

Figure.

Heat maps depicting head-impact exposure for all players and position groups in 2013 (left) before the rule change and 2014 (right) after the rule change. Linemen showed the largest reduction in head impacts to the front of the helmet (38.8% reduction). Abbreviations: CB, cornerbacks; FB, fullbacks; LB, linebackers; RB, running backs; S, safeties; TE, tight ends; WR, wide receivers.