Safety on the Gridiron

 

When autumn approaches in the south one constant is always true, it’s football season! While football is one of the most popular sports played by young athletes, it leads all other sports in the number of injuries.  This is due to high speeds and full contact.  As kids become bigger, stronger and faster, this trend will continue. Here are some common football injuries and ways they can help be prevented. 

  • Knee injuries to the ligaments and cartilage can occur due to the cutting motions in contact sustained on the football field.  In addition, offensive linemen are prone to knee injuries because they are in a position where they are holding a defender upright and their fellow players can be knocked into the sides of their knees. 
  • Shoulder injuries include labral tears. These are most common in offensive and defensive linemen due to the need to push up and out with their arms.  Another injury to shoulders is a separated shoulder, which is an injury to the end of the collarbone.  This occurs when landing on a shoulder from tackling or being tackled, as well as reaching for a ball and landing on the arm. 
  • Growth plate injuries in younger players can occur around the joints, usually in the ankle and wrist. These occur due to the lengthening of the bones occurring faster than the lengthening of the tendons. This pushes pressure through the weaker part of the bone, the growth plate. Other overuse injuries that occur in football players include tendonitis in various joints and low back pain. These injuries are usually due to over-training and a lack of good rest periods. 
  • Concussions are in the forefront of today’s media due to the severity of these injuries.  These usually occur due to head trauma inside the helmet.  Signs of concussions are headaches, dizziness, nausea, vomiting, drowsiness, difficulty concentrating, blurred vision, and loss of memory, all of which necessitate medical evaluation. 
  • Heat injuries due to high temperatures here in the south and dehydration can lead to significant cramping and even a heat stroke. 

While football injuries are serious and noted year after year, there are several ways to prevent most of them from occurring.  First and foremost, every young athlete should undergo a preseason medical history evaluation and physical examination by a medical doctor.  If there is any history of limb or joint injury, an accompanying evaluation by an orthopedic surgeon should be performed to assure the patient is physically fit for participation in sports. 

Prevention of knee injuries involves two key elements:  1) Strengthening of the quadriceps and, most importantly, the hamstrings helps avoid ligamentous injury to the knee. In the past, most high school physical workout programs have focused on quad strengthening and neglected hamstring strengthening. This was a reason we saw so many ACL ligament tears. A lot of high schools have now adopted a hamstring strengthening protocol to help avoid these ligamentous injuries. 2) For offensive linemen at the varsity level, the use of hinged braces is probably warranted to help prevent the side-to-side injuries that occur when other players fall into their knees.  Hinged braces certainly do not prevent every injury, but they have been shown to prevent collateral ligament injuries due to this type of activity.

Prevention of shoulder injuries involves a good strengthening protocol.  Rotator cuff strengthening and scapular, or shoulder blade, stabilizing activities can maintain the shoulder joint in its best anatomic position.  This provides better mechanical use of the shoulder and hopefully prevents a sliding mechanism that creates structural tears in the shoulder. Prevention of shoulder separation is certainly more difficult, but proper fitting shoulder pads and proper football technique can limit this injury. 

Prevention of growth plate and overuse injuries really involve stretching and proper rest and recovery.  Many young athletes never feel the need to stretch because they are so active.  However, as they grow, their bones are growing at a rate faster than their tendons. Therefore, to prevent a pull on the weaker part of the bone, the growth plate, stretching becomes vitally important. Proper rest and recovery can help prevent overuse injuries.  Using the same muscles over and over again throughout an entire year will lead to injuries at the joints. Resting these joints and using other muscles in different sporting activities is a great way to help prevent overuse injuries. 

Concussion injuries will occur in any contact sport, no matter how much prevention is sought after. However, a decrease in the number of concussions can be found in certain tackling techniques. Proper tackling technique is vitally important and, unfortunately, has not been taught as well as it has been in the past.  As kids have become stronger and faster, they have used their bodies as projectiles on the field to take down opponents as opposed to proper tackling technique.  Using a heads up tackling technique can significantly decrease head and neck injuries by allowing the helmet and shoulder pads to work in their appropriate designated way.  Most high school programs have adopted a heads up tackling program to assure kids know how to tackle correctly. 

A significant part at heat injury prevention is hydration, but it also involves an educated coaching and training staff. They are responsible for ensuring players are not in a climate situation that would be inadvisable to practice in. For athletes, staying active during the entire summer is also important. When they start practice in August heat, they will already be used to the temperatures and activity. 

Prevention is important; however, injuries will occur. If any of these injuries or conditions should occur, seek prompt medical attention.  Most high schools staff athletic trainers who can help diagnose and triage these problems.  Referral to an orthopedic surgeon for injuries or a medical doctor for concussions and heat injuries should not be delayed if necessary.