Summary of Studies Describing Incidence of Injuries in American Football
| Study . | Population . | Definition of Injury . | Methods . | Results . |
|---|---|---|---|---|
| Shankar et al 200718 | High school (and college) football players from 100 high schools | Occurred during organized practice or game | Prospective cohort study | Overall injury incidence 4.4/1000 AEs (higher rate observed for college players; 8.6/1000 AEs) |
| Required medical attention from athletic trainer or team physician | Injuries reported by athletic trainers | Game time incidence higher than practice (12.0 vs 2.6/1000 AEs) | ||
| Resulted in ≥1 d of restriction beyond day of injury | ||||
| Badgeley et al 201317 | High school football players from 100 high schools | Occurred during organized practice or game | Prospective cohort study | Overall injury incidence 4.08/1000 AEs |
| Required medical attention from athletic trainer or team physician | Injuries reported by athletic trainers | Game time incidence higher than practice (12.61 vs 2.35/1000AEs) | ||
| Resulted in ≥1 d of restriction beyond day of injury | ||||
| Included all fractures, concussions, and dental injuries | ||||
| Knowles et al 2006114 | High school athletes from 100 high schools | Resulted from participation in high school sport | Prospective cohort study | Overall injury incidence rate of 2.08/1000 AEs |
| Limited full participation day following injury or required medical attention | Injuries reported by athletic trainers or athletic directors | Football had the highest incidence of injury | ||
| Included all concussions, fractures, and eye injuries | ||||
| Turbeville et al 200314 | Middle school football players, grades 6–8, aged 10-15 y, N = 646 | Resulted in a player missing ≥1 practices/games | Prospective cohort study | Game time incidence of overall injuries higher than practice (8.84 vs 0.97/1000 AEs) |
| Included all head injuries resulting in alteration of consciousness requiring the player to leave practice/game | Football coach or athletic trainer reported injuries | Head was site of injury for 2% of all injuries | ||
| Neck/spine was site of injury for 3% of all injuries | ||||
| Concussion accounted for 12.5% of all injuries | ||||
| Dompier et al 200715 | Youth football players aged 9–14 y; N = 779 | Non–time-loss injuries did not require removal from participation | Prospective cohort study | Overall injury incidence of 17.8/1000 AEs |
| Time-loss injuries required removal from session or subsequent session | Athletic trainers present for practices and games, reported injuries | Time-loss injury only incidence 7.4/1000 AEs | ||
| Included all fractures, dental injuries, concussions, and injuries requiring referral | Injury rate increased with grade in school (4.3/1000 AEs for fourth/fifth graders, 14.4/1000 AEs for eighth graders) | |||
| Neck and head were sites of injury for 4.6% and 6.5% of injuries, respectively) | ||||
| Malina et al 200622 | Youth football players | Caused cessation of participation and prevented return to that session | Prospective cohort study | Overall injury incidence 10.4/1000 AEs |
| Aged 9–14 y; N = 678 | Included all fractures, dental injuries, and concussions | Athletic trainers reported injuries | No significant association between incidence of injury and height, weight, BMI, or estimated maturity status | |
| Incidence of injury increased with grade in school | ||||
| Stuart et al 200213 | Youth football players, aged 9–13 y; N = 915 | Occurred during a game, kept the player out for remainder of game, and required attention of a physician | Injuries reported by orthopedist in medical tent adjacent to the playing field | Game time incidence 8.47/1000 AEs (only assessed game time AEs) |
| Included all concussions, dental injuries, eye injuries, and nerve injuries | Older players in the higher grades more susceptible to injuries | |||
| Running backs at highest risk | ||||
| Radelet et al 200221 | Youth athletes in several sports, aged 7–13 y; N = 1659 | Brought coach on the field to check condition of a player, required removal from play, or required first aid | Coaches kept records, contacted weekly by researchers | Overall injury incidence in football was 15/1000 AEs |
| Overall injury incidence comparable to baseball and boys’ soccer, but lower than girls’ soccer | ||||
| Authors note, however, the reporting of injuries may have differed by sport, possibly underreported in football | ||||
| 8- to 10-y-old players injured more frequently than 5- to 7-y-old and 11- to 13-y-old players | ||||
| Kontos et al 201323 | Youth football players aged 8–12 y, N = 468 | Concussion defined as any mild closed head injury involving altered cognitive functioning or signs or symptoms or brief loss of consciousness after a blow to the head | Prospective cohort study | Concussion incidence was 1.8/1000 AEs |
| Coaches referred suspected concussions to medical professional for diagnosis | Game time incidence higher than practices (6.2 vs 0.24/1000 AEs) | |||
| Concussion incidence rate lower for the 8- to 10-y-old players than 11- to 12-y-old players (0.93 vs 2.53/1000 AEs) | ||||
| Linder et al 199524 | High school football players, aged 11–15 y; N = 340 | “Any sports-related mishap” occurring during practice or games, resulting in removal from practice or game and/or missing subsequent practice or game | Injuries recorded by coaches; data collected weekly by authors | 16% of participants were injured |
| Proportion of participants injured increased with Tanner stage |
| Study . | Population . | Definition of Injury . | Methods . | Results . |
|---|---|---|---|---|
| Shankar et al 200718 | High school (and college) football players from 100 high schools | Occurred during organized practice or game | Prospective cohort study | Overall injury incidence 4.4/1000 AEs (higher rate observed for college players; 8.6/1000 AEs) |
| Required medical attention from athletic trainer or team physician | Injuries reported by athletic trainers | Game time incidence higher than practice (12.0 vs 2.6/1000 AEs) | ||
| Resulted in ≥1 d of restriction beyond day of injury | ||||
| Badgeley et al 201317 | High school football players from 100 high schools | Occurred during organized practice or game | Prospective cohort study | Overall injury incidence 4.08/1000 AEs |
| Required medical attention from athletic trainer or team physician | Injuries reported by athletic trainers | Game time incidence higher than practice (12.61 vs 2.35/1000AEs) | ||
| Resulted in ≥1 d of restriction beyond day of injury | ||||
| Included all fractures, concussions, and dental injuries | ||||
| Knowles et al 2006114 | High school athletes from 100 high schools | Resulted from participation in high school sport | Prospective cohort study | Overall injury incidence rate of 2.08/1000 AEs |
| Limited full participation day following injury or required medical attention | Injuries reported by athletic trainers or athletic directors | Football had the highest incidence of injury | ||
| Included all concussions, fractures, and eye injuries | ||||
| Turbeville et al 200314 | Middle school football players, grades 6–8, aged 10-15 y, N = 646 | Resulted in a player missing ≥1 practices/games | Prospective cohort study | Game time incidence of overall injuries higher than practice (8.84 vs 0.97/1000 AEs) |
| Included all head injuries resulting in alteration of consciousness requiring the player to leave practice/game | Football coach or athletic trainer reported injuries | Head was site of injury for 2% of all injuries | ||
| Neck/spine was site of injury for 3% of all injuries | ||||
| Concussion accounted for 12.5% of all injuries | ||||
| Dompier et al 200715 | Youth football players aged 9–14 y; N = 779 | Non–time-loss injuries did not require removal from participation | Prospective cohort study | Overall injury incidence of 17.8/1000 AEs |
| Time-loss injuries required removal from session or subsequent session | Athletic trainers present for practices and games, reported injuries | Time-loss injury only incidence 7.4/1000 AEs | ||
| Included all fractures, dental injuries, concussions, and injuries requiring referral | Injury rate increased with grade in school (4.3/1000 AEs for fourth/fifth graders, 14.4/1000 AEs for eighth graders) | |||
| Neck and head were sites of injury for 4.6% and 6.5% of injuries, respectively) | ||||
| Malina et al 200622 | Youth football players | Caused cessation of participation and prevented return to that session | Prospective cohort study | Overall injury incidence 10.4/1000 AEs |
| Aged 9–14 y; N = 678 | Included all fractures, dental injuries, and concussions | Athletic trainers reported injuries | No significant association between incidence of injury and height, weight, BMI, or estimated maturity status | |
| Incidence of injury increased with grade in school | ||||
| Stuart et al 200213 | Youth football players, aged 9–13 y; N = 915 | Occurred during a game, kept the player out for remainder of game, and required attention of a physician | Injuries reported by orthopedist in medical tent adjacent to the playing field | Game time incidence 8.47/1000 AEs (only assessed game time AEs) |
| Included all concussions, dental injuries, eye injuries, and nerve injuries | Older players in the higher grades more susceptible to injuries | |||
| Running backs at highest risk | ||||
| Radelet et al 200221 | Youth athletes in several sports, aged 7–13 y; N = 1659 | Brought coach on the field to check condition of a player, required removal from play, or required first aid | Coaches kept records, contacted weekly by researchers | Overall injury incidence in football was 15/1000 AEs |
| Overall injury incidence comparable to baseball and boys’ soccer, but lower than girls’ soccer | ||||
| Authors note, however, the reporting of injuries may have differed by sport, possibly underreported in football | ||||
| 8- to 10-y-old players injured more frequently than 5- to 7-y-old and 11- to 13-y-old players | ||||
| Kontos et al 201323 | Youth football players aged 8–12 y, N = 468 | Concussion defined as any mild closed head injury involving altered cognitive functioning or signs or symptoms or brief loss of consciousness after a blow to the head | Prospective cohort study | Concussion incidence was 1.8/1000 AEs |
| Coaches referred suspected concussions to medical professional for diagnosis | Game time incidence higher than practices (6.2 vs 0.24/1000 AEs) | |||
| Concussion incidence rate lower for the 8- to 10-y-old players than 11- to 12-y-old players (0.93 vs 2.53/1000 AEs) | ||||
| Linder et al 199524 | High school football players, aged 11–15 y; N = 340 | “Any sports-related mishap” occurring during practice or games, resulting in removal from practice or game and/or missing subsequent practice or game | Injuries recorded by coaches; data collected weekly by authors | 16% of participants were injured |
| Proportion of participants injured increased with Tanner stage |