Study: Fewer concussions in practice

Researchers in Pittsburgh, looking at football players ages 8-12, found significantly lower concussion risks during practices as compared to games in a study scheduled for publication in The Journal of Pediatrics.

The study is among the first to formally examine the incidence of sports-related concussion among football players in this age group. It was conducted jointly by the University of Pittsburgh and University of Pittsburgh Medical Center (UPMC) and funded by a grant from NFL Charities, a nonprofit organization established 40 years ago by the NFL owners. NFL commissioner Roger Goodell is the president of NFL Charities.

The study looked at 468 players on 18 youth football teams from suburban Pittsburgh and central Pennsylvania. Researchers found that practices were relatively concussion-free (0.24 incidences per 1,000 exposures). However, these youth players were 26 times more likely to suffer a concussion in a game (6.16/1,000 exposures) than in practice.

Sports-related concussions have been coined an "epidemic" by the Centers for Disease Control and Prevention, raising concerns about youth participation in collision sports such as football.

"This finding suggests that reducing contact-practice exposures in youth football, which some leagues have done recently, will likely have little effect on reducing concussion risk, as few concussions actually occur in practice," said Dr. Anthony Kontos, associate professor in the Department of Orthopaedic Surgery at the University of Pittsburgh School of Medicine. Kontos was the study's principal investigator and the assistant research director for the UPMC Sports Medicine Concussion Program.

"Instead of reducing contact-practice time, youth football leagues should focus on awareness and education about concussion," he said. "We believe that practice is when tackling technique can be taught and reinforced in a much safer environment than in games."

In 2012, Pop Warner football put in a rule which limits contact to one-third of practice time each week in what it said was part of its "continuing efforts to provide the safest playing environment for our young athletes." That came after a study at Virginia Tech and Wake Forest showed that most of the severe hits in youth football occurred during practice. Unlike this study, which examined incidence of concussions, the earlier study used sensors (accelerometers) in the padding of helmets, and measured force and impact. It did not measure incidence of concussion or whether those impacts caused a concussion. The authors of both studies recommend proper technique as a means of helping reduce injuries in youth football players.

Former NFL running back and current ESPN analyst Merril Hoge, a member of the Tackle Advisory Committee for USA Football and their Heads Up Football program (which is specifically targeted toward enhancing youth player safety), said he believes practice is a critical instructional time. "We are teaching accountability and responsibility," Hoge said. "If I teach kids proper technique when they're 8 or 9 years old, they can help me by teaching others when they're 11 and 12."

Dr. Micky Collins, executive and clinical director of the UPMC concussion program and an author on the study, said studies such as these are important to help guide policy for youth football organizations.

"Policies are being made currently to limit practice in youth players without science or data to guide them," Collins said. "What if limiting practice results in worse technique? Could this lead to more in-game injuries?"

Collins notes that while these findings are noteworthy, there is always more work to be done. For instance, this study was conducted regionally in the Pittsburgh area, but a broader, national study would be of interest. One question Collins would like to see specifically addressed via a formal study is the effectiveness of programs like Heads Up Football, which is part of USA Football's recent safety push.

As far as Hoge is concerned, the educational process encompassing proper methods of play as well as prompt recognition and management of concussion injuries can't hurt.

"It's important to educate coaches, parents, administrators and players of all ages," Hoge said. "We're all gatekeepers."