Sports Medicine

, Volume 12, Issue 2, pp 132–147 | Cite as

Common American Football Injuries

  • Jeffrey A. Saal
Injury Clinic

Summary

As many as 1.5 million young men participate in American football in the United States. An estimated 1.2 million football-related injuries are sustained annually. Since the 1970s epidemiological studies have shown that the risk of injury is higher in older athletes and lower in teams with more experienced coaches and more assistant coaches. 51% of injuries occurred at training; contact sessions were 4.7 times more likely to produce injuries than controlled sessions. Injury rates were reduced by wearing shorter cleats and preseason conditioning.

Overall, lower extremity injuries accounted for 50% of all injuries (with knee injuries accounting for up to 36%). Upper extremity injuries accounted for 30%. In general, sprains and strains account for 40% of injuries, contusions 25%, fractures 10%, concussions 5% and dislocations 15%.

Cervical spine injuries have the potential to be catastrophic, but they declined dramatically in the decade 1975 to 1984, due to the impact of rule changes modifying tackling and blocking techniques and improved fitness, equipment and coaching. Appropriate diagnostic evaluation of cervical injuries is mandatory.

The evidence supporting prophylactic knee bracing is not compelling and does not mandate compulsory or routine use.

Return to play criteria include: full range of motion; normal strength; normal neurological evaluation; no joint swelling or instability; ability to run and sustain contact without pain; no intake of pain medication; player education about preventive measures and future risks. These criteria should be strictly observed.

In addition to ankle and knee rehabilitation, lumbar spine injuries present a challenge for the physician. Repetitive flexion, extension and torsional stresses predispose the lumbar spine to injury. Rehabilitation consists of pain control and training. The training phase aims to eliminate repetitive injuries by minimising stress at the intervertebral joint.

Football is a high risk sport. Coaches, players, trainers and physicians must all become aware of the proper means to prevent injuries.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Adams MA, Hutton WC. Gradual disc prolapse. Spine 10: 524–531, 1985PubMedCrossRefGoogle Scholar
  2. Anderson G, Seman SC, Rosenfeld RT. The Anderson knee stabler. Physician and Sportsmedicine 7: 125–127, 1979Google Scholar
  3. Blyth CS, Mueller FO. An Epidemiologic Study of High School Football Injuries in North Carolina, 1968–1972. US Government Printing Office, Washington, DC, 1974aGoogle Scholar
  4. Blyth CS, Mueller FO. Football injury survey, part III. Injury rates vary with coaching. Physician and Sportsmedicine 2: 45–50, 1974bGoogle Scholar
  5. Cahill BR, Griffith EH. Effect of preseason conditioning on the incidence and severity of high school football knee injuries. American Journal of Sports Medicine 6: 180–184, 1978PubMedCrossRefGoogle Scholar
  6. Cahill BR, Griffith EH. Exposure to injury in major college football. A preliminary report of data collection to determine injury exposure rates and activity risk factors. American Journal of Sports Medicine 7: 183–185, 1979PubMedCrossRefGoogle Scholar
  7. Culpepper MI, Niemann KMW. High school football injuries in Birmingham, Alabama. Southern Medical Journal 76: 873–878, 1983PubMedCrossRefGoogle Scholar
  8. Cyron BM, Hutton WC. The fatigue strength of the lumbar neural arch in spondylolysis. Journal of Bone and Joint Surgery 60-B: 234–238, 1978PubMedGoogle Scholar
  9. Farfan HF. Effects of torsion on the intervertebral joints. Canadian Journal of Surgery 12: 336–341, 1969Google Scholar
  10. Farfan HF, Cossette JW, Robertson GH. The effects of torsion on the lumbar intervertebral joints: the role of torsion in the production of disc degeneration. Journal of Bone and Joint Surgery 52: 468–497, 1970PubMedGoogle Scholar
  11. Ferguson RJ, McMaster JH, Stanitski CL. Low back pain in college football linemen. Journal of Sportsmedicine and Physical Fitness 2: 63–69, 1974Google Scholar
  12. Gallagher SS, Finison K, Guyer B. The incidence of injuries among 87,000 Massachusetts children and adolescents: results of the 1980–1981 statewide childhood injury prevention program surveillance system. American Journal of Public Health 74: 1340–1347, 1984PubMedCrossRefGoogle Scholar
  13. Goldberg B, Rosenthal PP, Nicholas JA. Injuries in youth football. Physician and Sportsmedicine 12: 122–130, 1984Google Scholar
  14. Hale RW, Mitchell W. Football injuries in Hawaii 1979. Hawaii Medical Journal 40: 180–183, 1981PubMedGoogle Scholar
  15. Halpern B, Thompson N, Curl WW, Andrews JR, Hunter SC, Boring JR. High school football injuries: identifying the risk factors. American Journal of Sports Medicine 15: 316, 1987PubMedCrossRefGoogle Scholar
  16. Hansen BL, Ward JC, Diehl RC. The preventive use of the Anderson knee stabler in football. Physician and Sportsmedicine 12: 75–81, 1985Google Scholar
  17. Hewson GF, Mendini RA, Wang JB. Prophylactic knee bracing in college. American Journal of Sports Medicine 14: 262–266, 1986PubMedCrossRefGoogle Scholar
  18. Hockberger RS. Blunt head injury: a spectrum of disease. Annals of Emergency Medicine 15: 202–207, 1986PubMedCrossRefGoogle Scholar
  19. Hoshina H. Spondylosis in athletes. Physician and Sportsmedicine 8: 75–79, 1980Google Scholar
  20. Hutton WC, Stott JRR, Cyron BM. Is spondylolysis a fatigue fracture? Spine 2: 202–210, 1977CrossRefGoogle Scholar
  21. Jackson DW. Low back pain in young athletes: evaluation of stress reaction and discogenic problems. American Journal of Sports Medicine 7: 364–366, 1979PubMedCrossRefGoogle Scholar
  22. Jackson DW, Wiltse LL, Cirincoine RJ. Spondylolysis in the female gymnast. Clinical Orthopedics 117: 68–73, 1976Google Scholar
  23. Jennett B, Teasdale G. Predicting outcome in individual patients after severe head injury. Lancet 197: 1031–1034, 1976CrossRefGoogle Scholar
  24. Levy D, Bates D, Caronna J. Prognosis in nontraumatic coma. Annals of Internal Medicine 94: 293–301, 1981PubMedGoogle Scholar
  25. McCabe J, Angelos M. Injury to the head and face in patients with cervical spine injury. American Journal of Emergency Medicine 2: 333–335, 1984PubMedCrossRefGoogle Scholar
  26. McCarrol JR, Miller JM, Ritter MA. Lumbar spondylolisthesis in college football players: a prospective study. American Journal of Sports Medicine 14: 404–406, 1986CrossRefGoogle Scholar
  27. Micheli LJ. Back injuries in dancers. Clinics in Sports Medicine 2: 473–474, 1983PubMedGoogle Scholar
  28. Moretz A, Rashkin A, Grana WA. Oklahoma high school football injury study: a preliminary report. Journal of Oklahoma State Medical Association 71: 85–88, 1978Google Scholar
  29. Mueller FO, Blyth CS. North Carolina high school football injury study: equipment and prevention. Journal of Sportsmedicine 2: 1–10, 1974Google Scholar
  30. Olson OC. The Spokane study: high school football injuries. Physician and Sportsmedicine 7(2): 75–82, 1979Google Scholar
  31. Ommaya A, Gennarelli T. Cerebral concussion and traumatic unconsciousness: correlation of experimental and clinical observations on blunt head injuries. Brain 97: 633–654, 1974PubMedCrossRefGoogle Scholar
  32. Powell JW (Ed.) Summary of injury patterns for seven seasons 1980–1986. Department of Physical Education, San Diego State University, 1987Google Scholar
  33. Pritchett JW. High cost of high school football injuries. American Journal of Sports Medicine 8: 197–199, 1980PubMedCrossRefGoogle Scholar
  34. Robey JM, Blyth CS, Mueller FO. Athletic injuries: application of epidemiologic methods. Journal of the American Medical Association 217: 184–189, 1971PubMedCrossRefGoogle Scholar
  35. Rovere GD, Haupt HA, Yates CS. Prophylactic knee bracing in college football. American Journal of Sports Medicine 15: 111–116, 1987PubMedCrossRefGoogle Scholar
  36. Russel R, Nathan P. Traumatic amnesia. Brain 69: 280–298,1946CrossRefGoogle Scholar
  37. Saal JA. Rehabilitation of football players with lumbar spine injury (Part 1 of 2). Physician and Sportsmedicine 16: 61–74, 1988aGoogle Scholar
  38. Saal JA. Rehabilitation of football players with lumbar spine injury (Part 2 of 2). Physician and Sportsmedicine 16: 117–125, 1988bGoogle Scholar
  39. Saal JA. Rehabilitation of the injured athlete. In DeLisa JA (Ed.) Rehabilitation medicine: principles and practice, pp. 840–864, JB Lippincott, Philadelphia, 1988cGoogle Scholar
  40. Saal JA, Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy: an outcome study. Spine 14: 431–437, 1989PubMedCrossRefGoogle Scholar
  41. Stanitski CL. Low back pain in young athletes. Physician and Sportsmedicine 10: 77–91, 1982Google Scholar
  42. Symonds. C Concussions and its sequelae. Lancet 2: 1–5, 1962CrossRefGoogle Scholar
  43. Teitz CC, Hermanson RK, Kronmal RA. Evaluation of the use of braces to prevent injury to the knee in collegiate football players. Journal of Bone and Joint Surgery 69A: 2–9, 1987Google Scholar
  44. Thompson N, Halpern B, Curl WW, Andrews JR, Hunter SC, McLeod WD. High school football injuries: evaluation. American Journal of Sports Medicine 15:117–124, 1987PubMedCrossRefGoogle Scholar
  45. Wilmot C, Cope DN, Hall K, Acker M. Occult head injury: its incidence in spinal cord injury. Archives of Physical Medicine and Rehabilitation 66: 227–231, 1985PubMedCrossRefGoogle Scholar
  46. Yarnell P, Lynch S. Retrograde memory immediately after concussion. Lancet 1: 863–864, 1970PubMedCrossRefGoogle Scholar
  47. Yarnell P, Lynch S. The ‘ding’ amnestic states in football trauma. Neurology 23: 196–197, 1973PubMedCrossRefGoogle Scholar

Copyright information

© Adis International Limited 1991

Authors and Affiliations

  • Jeffrey A. Saal
    • 1
    • 2
    • 3
  1. 1.San Francisco Spine Institute at Seton Medical CenterDaly CityUSA
  2. 2.Santa Clara UniversitySanta ClaraUSA
  3. 3.San Francisco Forty-NinersSan FranciscoUSA

Personalised recommendations