Source: sadlersports.com - AYF Study: 2005-15 Concussion Trends in Youth Tackle Football
Author: John M. Sadler
Provides perspective for impact of education, getting head out of tackle, and practice restrictions
The latest American Youth Football (AYF) study on concussion trends reveals that education of administrators, coaches, parents, and players is having a positive impact on the identification of and more aggressive response to concussions. On the other hand, popular initiatives to remove the head from the tackle and practice contact restrictions may have a more limited role than portrayed by various groups due to the high percentage of concussions that would not be impacted by these measures. Nevertheless, these initiatives are important components of a broad based brain injury/concussion risk management program.
Updated statistics based on Accident insurance claims for 2005-15 seasons
AYF is the largest youth football organization in the U.S. and represents a wide cross section of players aged five to 15. The data in this study is based on Accident insurance claims filed with the endorsed AYF insurance program through Sadler Sports & Recreation Insurance. An injury questionnaire consisting of some 20 questions is completed by the authorized team official as a part of the claims filing process and the answers are input into a database. A variety of reports can be produced to drill down to answer specific questions about concussions. The study includes 3,855 injuries reported from 2005 through 2015 of which 434 are concussions. This study is a representative sample of concussion trends occurring not only in AYF, but in youth tackle football as a whole.
Concussions as a percentage of total injuries
What this tells us about the positive impact of concussion education
| 2015 | 14.48% |
| 2014 | 16.18% |
| 2013 | 16.41% |
| 2012 | 15.99% |
| 2011 | 11.55% |
| 2010 | 7.73% |
| 2009 | 8.20% |
| 2008 | 6.36% |
| 2007 | 5.88% |
| 2006 | 3.80% |
| 2005 | 6.72% |
| Total All Years | 11.26% |
Notice the spike in concussions reported in 2011 and continuing through 2015. This coincides with the media reports of the NFL class action lawsuit, other concussion related lawsuits, autopsies indicating CTE in deceased pro football players, and anecdotal stories of disabled pro athletes. This also coincides with the beginning of widespread and heavily publicized educational efforts on behalf of the Center for Disease Control and various football-sanctioning and governing bodies on concussion recognition, removal-from-play, medical response, and return-to-play protocols.
It appears that the media attention and educational efforts to train administrators, coaches, parents, and players are having a positive impact in that concussions are taken more seriously and reported more frequently than in past years. Suspected concussions are resulting in increased rates of emergency room and doctor office visits, and diagnosed concussions are resulting in more follow up care as pertains to return-to-play protocols. Overall, Accident insurance carriers are experiencing increased claims payouts for concussion care.
Concussion by situation (physical cause at point of contact)
What this tells us about initiatives to remove the head from the tackle and to limit contact at practice
| Tackled by player | 23% |
| Contact with ground | 23% |
| Collision with opponent | 18% |
| Tackling player | 7% |
| Blocked by player | 7% |
| Collision with teammate | 6% |
| Blocking player | 5% |
| Other | 3% |
| Total | 100% |
The initiative to take the head out of contact as detailed by the Seahawks Tackling video or Heads Up Football (HUF) is very important, but not the magic silver bullet to solve the concussion problem in youth tackle football.
For argument’s sake, assuming that the initiative to remove the head from the tackle is 100% effective in reducing concussions (Datalys study by Kerr on HUF refutes this – see paragraph below), this would result in a reduction of concussions by 30% (sum of tackled by player 23% plus tackling player 7%). If heads-up blocking is added to this equation, that would result in a total reduction of 42% (add blocked by player 7% plus blocking player 5%). The other 58% of concussion claims that occur due to contact with ground, collision with opponent, collision with teammate, and other would not be touched by this initiative.
The above analysis assumes that HUF is 100% effective in reducing concussion claims arising from tackling and blocking. To the contrary, the Datalys study by Kerr in Table 2 indicates that HUF-only leagues have slightly higher concussion rates that non-HUF leagues. Let’s hope that future concussion studies with more participants reach a different conclusion.
On the other hand, the initiative to limit contact at practice would likely have a larger impact in reducing concussions among more categories of physical causes of loss, including contact with ground, collision with opponent, and collision with teammate.
Concussion by activity being performed
| Tackling | 33% |
| Running with ball | 30% |
| Blocking | 15% |
| Running w/out ball | 6% |
| Shedding blocker | 5% |
| Passing | 3% |
| Catching ball | 2% |
| Recovering fumble | 1% |
| Other | 5% |
| Total | 100% |
Concussion by event type (practice or game)
What this tells us about initiatives to remove the head from the tackle and to limit contact at practice
| Practice | 32% |
| Game | 65% |
| Other | 3% |
| Total | 100% |
Since most concussions occur during games and not practices, the initiative to limit contact at practice would only impact those 32% of concussions that occur during practice. With regard to the initiative to remove the head from the tackle, it’s easier to get the head out of the tackle in controlled practice drills as opposed to live action during games, and as a result, its effectiveness should be expected to be diminished as well.
Concussion by position played
| Running back | 20% |
| Linebacker | 16% |
| Defensive line | 16% |
| Quarterback | 10% |
| Offensive line | 8% |
| Secondary | 7% |
| Receiver | 4% |
| Practice drills | 4% |
| Kickoff returner | 2% |
| Kickoff blocker | 2% |
| Kickoff tackler | 2% |
| Punt tackler | 1% |
| Punt return blocker | 1% |
| Other | 7% |
| Total | 100% |
Concussion by type of play from perspective of injured participant
| Offense | 42% |
| Defense | 42% |
| Receiving kickoff | 4% |
| Other practice | 3% |
| Kicking off | 2% |
| Punting | 1% |
| Kicking field goal/extra point | 1% |
| Other | 5% |
| Total | 100% |
The kickoff accounts for 6% of total concussion injuries: 4% when receiving kickoffs plus 2% when kicking off. That statistic does not seem to be out of proportion with the total percentage of plays in a typical game that are kickoffs. Pop Warner recently banned kickoffs for ages 10 and under starting with the 2016 season due to perceived risks. Based on our statistics, banning kickoffs would not appear to reduce concussion rates.
Concussion and absence from play
| 2011-2015 | 2005-2010 | |
| 1 to 3 Weeks | 44% | 46% |
| 3+ Weeks | 27% | 15% |
| 1 to 7 Days | 11% | 18% |
| None | 2% | 7% |
| Unknown/Not Answered | 16% | 15% |
| Total | 100% | 100% |
The period from 2011 to 2015 shows increased absence from play, i.e. later return-to-play times, presumably due to following suggested return-to-play protocols. The 3+ weeks category shows a significant increase with significant decreases in the “1 to 7 Days” and “None” categories. This is further evidence that increased educational initiatives are having a positive impact on concussion treatment.
Concussion and weight of injured player compared to other players
| About-average weight | 78% |
| Below-average weight | 10% |
| Above-average weight | 6% |
| Significantly below-average weight | 1% |
| Significantly above-average weight | 1% |
| Other | 4% |
| Total | 100% |
It appears that players of below-average weight are only slightly more susceptible to concussions than players in the other weight categories. Players classified as significantly below-average weight have the same percentage of concussions as players of significantly-above average weight.
Conclusions about concussions from the study of Accident insurance claims
The higher rates of concussion reporting and more aggressive medical care and return-to-play protocols seem to validate that concussion education is having a positive impact. Initiatives to get the head out of the tackle and to limit contact at practice, while not game changers in themselves, are important components of a broad based concussion/brain injury risk management program as they have the potential to reduce a significant percentage of concussions and subconcussive impacts. Our statistics indicate that practice restrictions may play a larger role than removing the head from the tackle. Additional studies with more participants are required before firm conclusions can be drawn on these concussion reducing initiatives.
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