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Pediatricians: If You Can’t Take Tackling Out of Football, Limit It

4 Nov, 2015

By: Mary Helen Sprecher
New Policy Sets Forth Recommendations for Contact in Practice, Play

There have been a lot of hot-button issues in youth sports, but not many are hotter right now than concussions. Seeing cases of former pro football players who have died or who are now suffering from long-term brain injury as a result of their days on the field has brought the issue to national prominence.  And when even the legendary Mike Ditka publicly stated that he would discourage his kids from playing football, people sat up and took notice.

Now, the American Academy of Pediatrics has come out with a new policy regarding tackling in youth football. And like Ditka’s statement, it’s set to rankle traditionalists in the youth sports arena.

While the AAP stopped short of endorsing an outright ban on tackling, it did make some strict recommendations, summarized in an article in AAP News. These included recommendations that leagues and coaches limit the possibility of repetitive trauma to the head, that they teach proper tackling techniques and that they offer more options for children who want to play in non-tackling football leagues.

The policy statement’s most urgent recommendation is that leagues and referees consistently penalize contacts to the head because the most severe injuries in football are associated with improper or illegal tackling. Doctors noted that helmet use is not a vaccine against injury and in some cases, only increases the danger, since players, feeling almost invincible as a result of wearing the helmet, will use their heads as weapons.

In some cases (wait for it), doctors have advised ridding the sport of impacts to the head entirely. The logic used in the AAP’s recommendation here is that there is no known benefit to an impact to the head, and therefore, it does not need to be part of football. Doctors cite rugby as an example of a contact sport in which head-to-head impacts are rare because they would result in injury to both players.

The report’s authors bring up the possibility that youth leagues might allow only older players to play full-contact. The report does not provide a specific age range that would define an older player.

Even if that happens, say doctors, leagues still should teach proper tackling techniques to younger players in preparation for what they will experience as they get older.

“People have worried — and I think it’s a reasonable concern — that if you delay initiating contact until the teenage years, by the time they’re a teenager they’re big, fast and coordinated and can deliver a powerful impact,” said William P. Meehan III, M.D., FAAP, a lead author of the policy, and who is director of the Micheli Center for Sports Injury Prevention, Division of Sports Medicine at Boston Children's Hospital. “Is that really the first time you want to introduce tackling, in a high-risk situation?”

One way to achieve a middle ground might be to limit full-contact practice time, according to Gregory L. Landry, M.D., FAAP, another lead author of the policy, and a professor of pediatrics at the University of Wisconsin School of Medicine and Public Health.

“Coaches are taking a critical look at limiting the contacts the kids have in practice,” Dr. Landry said. “Teach them technique, give them some chance to practice, but limit that contact time.”

Some youth football programs already limit contact in practice; Pop Warner has a section of its rule book dedicated to this issue.

One recommendation of the AAP that has been warmly received by parents, at least, is its suggestion that teams should strive to have athletic trainers on the sidelines during organized football games and practices. However, it is worth noting that a recent lawsuit (which became known as the ‘soccer mom suit’) attempted to mandate medical personnel on the sidelines of all youth soccer games. A California judge said the plaintiff’s claim, that concussions were at ‘epidemic’ levels, was “incomprehensible.”

Reaction to the AAP’s policy has been mixed. While many thought the statements were reasonable, they cautioned parents and administrators from reading too much into it.

"Many people forget the big picture: that most youth head injuries come from riding bicycles, but nobody is talking about getting rid of them," noted Stefan Duma, a professor of biomedical engineering and mechanics at Virginia Tech, and author or co-author of a number of the small group of studies  published on injuries in youth football. Duma’s remarks, made to MomsBlog, called for considering all the factors rather than having a knee-jerk reaction. In Duma's view, "It is all about balance, and the fact that there is risk in all sports." He noted that, having studied youth football teams, some involving players as young as seven, "we very rarely see injuries at the lower levels." 

Other criticisms of the AAP policy have included the assumption that leagues should be offering lower-contact forms of play; opposition to this point has stated that it is the responsibility of parents (or in the cases of older athletes, the players themselves) to understand the risks and to seek out non-tackle leagues or sports.

The AAP policy is intended to provide guidance during what it calls “the emotional tug-of-war about whether football is safe enough, a scene that plays out in pediatricians’ offices every year."

“I hope this report reassures pediatricians in terms of allowing a child to play tackle football if he/she wants to do that,” Dr. Landry said.

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