Football (Care of the Young Athlete)

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Football is a fast-paced, aggressive, contact
team sport that is very popular among America’s youth. Football programs
exist for players as young as 6 years all the way through high school, college,
and professional.

Injuries are common because of the large number of
athletes participating. However, the risk of injuries can be reduced. The
following is information from the American Academy of Pediatrics (AAP) about how
to prevent football injuries. Also included is an overview of common football
injuries.

Injury prevention and safety tips

  • Supervision. Athletes
    should be supervised and have easy access to drinking water and have
    body weights measured before and after practice to gauge water loss.

  • Equipment. Safety gear
    should fit properly and be well maintained.

    • Shoes. Football
      shoes should be appropriate for the surface (turf versus
      cleats). Laces should be tied securely.

    • Pants. Football
      pants should fit properly so that the knee pads cover the knee
      cap, hip pads cover the hip bones, the tailbone pad covers the
      tailbone, and thigh pads cover a good share of the thigh. Pads
      should not be removed from the pants.

    • Pads. Shoulder pads
      should be sized by chest measurement. They must be large enough
      to extend 3/4 to 1 inch beyond the
      acromioclavicular joint. Athletes should have adequate range of
      motion, and the pads should not ride up into the neck opening
      when raising the arms.

    • Helmets. The helmet
      should be fitted so that the eyebrows are 1 to
      11/2 inches below the helmet’s
      front rim. The back of the helmet should cover the back of the
      head, and the athlete’s ear openings should be in the
      center of the helmet ear openings. Jaw pads should be snug
      against the athlete’s jaw. The chin strap should be
      centered over the chin and tightened to prevent movement of the
      helmet on the head. The helmet padding and chin strap should be
      tight enough to prevent any rotation of the helmet on the head.
      Face masks should be attached to the helmets. Additional
      protection can be provided by a clear Plexiglas shield.

    • Mouth guards can
      help prevent oral or facial injuries but not concussions.

  • Environment. A safe playing
    field is level and cleared of debris, equipment, and other obstacles.
    Field goal posts should be padded.

  • Emergency plan. Teams
    should develop and practice an emergency plan so that team members know
    their roles in emergency situations. The plan would include first aid
    and emergency contact information. All members of the team should
    receive a written copy each season. Parents also should be familiar with
    the plan and review it with their children.

Common injuries

Ankle injuries

Ankle sprains are some of the most common
injuries in football. They can prevent athletes from being able to play.
Ankle sprains often happen when an athlete gets blocked or tackled with the
foot firmly in place, causing the ankle to roll in (invert). An ankle sprain
is more likely to happen if an athlete had a previous sprain, especially a
recent one.

Treatment begins with rest, ice,
compression, and elevation (RICE). Athletes should see a doctor as soon as
possible if they cannot walk on the injured ankle or have severe pain.
X-rays may be needed.

Regular icing (20 minutes) helps with pain
and swelling. Weight bearing and exercises to regain range of motion,
strength, and balance are key factors to getting back to sports. Tape and
ankle braces can prevent or reduce the frequency of ankle sprains and enable
an athlete to return to activity more quickly.

Finger injuries

Finger injuries occur when the finger is
struck by the ball or an opponent’s hand or body. The “jammed
finger” is often overlooked because of the myth that nothing needs to
be done, even if it is broken. If fractures that involve a joint or tendon
are not properly treated, permanent damage can occur.

Any injury that is associated with a
dislocation, deformity, inability to straighten or bend the finger, or
significant pain should be examined by a doctor. X-rays may be needed. Buddy
tape may be all that is needed to return to sports; however, this cannot be
assumed without an exam and x-ray. Swelling often persists for weeks to
months after a finger joint sprain. Ice, nonsteroidal anti-inflammatory
drugs, and range of motion exercises are important for treatment.

Knee injuries

Knee injuries commonly occur from cutting,
pivoting, landing from a jump, or contact with another athlete. If the
athlete feels a pop or shift in the knee, then it’s most likely a
ligament injury.

Treatment begins with RICE. Athletes should
see a doctor as soon as possible if they cannot walk on the injured knee.
Athletes should also see a doctor if the knee is swollen, a pop is felt at
the time of injury, or the knee feels loose or like it will give way.

Medial collateral ligament sprains can be
treated in a hinged brace and allowed to return to play. Athletes who return
to play with a torn anterior cruciate ligament (ACL) risk further joint
damage. Athletes with an ACL tear should not return to their sport until the
ligament has been reconstructed and they have been cleared by the
surgeon.

Shoulder injuries

Shoulder injuries can occur from diving for
a ball or from blocking or tackling.

Athletes usually feel their shoulder pop out
of place when it is dislocated. Most of the time the shoulder goes back into
the joint on its own; this is called a subluxation (partial
dislocation). If the athlete requires help to get it back in, it is called a
dislocation. Risk of dislocation recurrence is high for
youth participating in football. Shoulder strengthening exercises,
stabilization braces and, in many cases, surgery may be recommended to
prevent recurrence.

Pain from repetitive use is common in
football, usually due to weak muscles of the back and trunk. Often
rehabilitation exercises and rest from excessive blocking or tackling drills
are all that is necessary to treat this type of pain.

Eye injuries

Eye injuries commonly occur in football
usually due to a finger poking through the face mask. Any injury that
affects vision or is associated with swelling or blood inside the eye should
be evaluated by an ophthalmologist. The AAP recommends that children
involved in organized sports wear appropriate protective eyewear.

Low back pain

Spondylolysis, stress fractures of the bones
in the lower spine, is due to overuse from high-impact and repetitive
arching of the back. Symptoms include low back pain that feels worse with
back extension activities. Treatment of spondylolysis includes rest and
physical therapy to improve flexibility and low back and core (trunk)
strength, and possibly a back brace. Athletes are advised to limit
repetitive arching of the spine (blocking and weight lifting) and
high-impact activities (running and jumping). Athletes with low back pain
for longer than 2 weeks should see a doctor. X-rays are usually normal so
other tests are often needed to diagnose spondylolysis. Successful treatment
requires early recognition of the problem and timely treatment.

Head injuries

Concussions occur if the head or neck hits
the ground, equipment, or another athlete. A concussion is any injury to the
brain that disrupts normal brain function on a temporary or permanent
basis.

The signs and symptoms of a concussion range
from subtle to obvious and usually happen right after the injury but may
take hours to days to show up. Athletes who have had concussions may report
feeling normal before their brain has fully recovered. With most
concussions, the player is not knocked out or unconscious.

Prematurely returning to play after a
concussion can lead to another concussion or even death. An athlete with a
history of concussion is more susceptible to another injury than an athlete
with no history of concussion. If a concussion has occurred, it is again
important to make sure the helmet was fitted properly. If the concussion
occurred due to the player leading with the head to make a tackle, he should
be strongly discouraged from continuing that practice.

All concussions are serious, and all athletes with suspected
concussions should not return to play until they see a doctor.

Remember

Football injuries can be prevented when fair
play is encouraged and the rules of the game are enforced. Also, athletes should
use the appropriate equipment and safety guidelines should always be
followed.