Football-Related Deaths: Should you worry?

A Texas high school student and football player watches the game.

A Texas high school student and football player watches the game.

It’s that time of year again, when parents gear their sons up to play football with twice-daily summer football practices. And, unfortunately, a football-related death due to heat (and, in this case, obesity) already has been reported. Should you worry about your sons and their participation in this time-honored high school sport?

In 2004, a comprehensive report printed in The Seattle Times sought to reassure parents about high-school football safety. In this article, Dr. Frederick Mueller, who heads the National Center for Catastrophic Sport Injury Research at the University of North Carolina, stated, “It’s [high-school football] probably safer than kids getting in a car and driving on the highway.”

According to numbers compiled by Mueller’s center, the death rate for football players at the high-school level last year was 0.13 per 100,000 (there were no deaths last year in college football)…The death rate for male drivers between the ages of 15 and 24 years old, meanwhile, is 48.2 per 100,000, according to numbers published in 2001 by the University of Maryland Medical Center.

The article also compares the rate of death now compared to the beginning of the twentieth century, when the deaths of 18 players in 1905 led President Theodore Roosevelt to bring together leaders of some of the top football-playing schools in the country and revamp the rules to make the sport safer. Some have written that football might not exist today if not for Roosevelt’s involvement.

Another huge change in how high-school football was conducted came in the mid-1970s. “From 1966 to 1972, there was an average of 25 deaths directly related to football at the junior-high, high-school and college levels each year, with a high of 36 in 1968. Concern over those numbers led to rules in 1976 outlawing leading with the helmet while blocking or tackling. Most deaths were the result of either brain or spinal-cord injuries suffered during helmet-to-helmet contact. Throughout the country, coaches began teaching tackling with the shoulder and keeping the head up.”

According to the Seattle article, the decline in football deaths was almost immediate – from 18 in 1976 to four in 1979 (note that the same number of players died in 1976 as in 1905 as noted in the previous paragraphs). Since the introduction of that rule, there have never been more than 12 deaths directly related to playing football at all levels nationwide since 1986. Since 1986, the high has been eight, including zero in 1990 and one in 1994.

Other penalties have also been enacted through the years with safety in mind, such as the 1981 ruling to eliminate blocking below the waist and more strictly enforced penalties for roughing the passer and spearing in recent years. Equipment has also undergone a evolution that most observers say has also led to a safer game. Helmets, for instance, have been constantly updated and there has been little evidence that headgear problems have been a factor in recent deaths. As equipment and rules have changed to improve safety, however, players have continued to get bigger and stronger – thanks to similar improvements in weight training and nutrition and year-round workouts – throwing another complicating factor into the equation.

Despite this change in muscular development, The National Athletic Trainers Association (NATA) issued a report [PDF] in July this year that stated, “high school football players sustain greater head accelerations after impact during play than do college-level football players which can lead to concussions and serious cervical spine injuries.” The NATA report hypothesizes that physical maturation and the associated neck strength and endurance of the high school athletes might explain the discrepancy between their collegiate counterparts. On average college athletes weigh 33 pounds more than high school athletes, but they stand only 1.2 inches taller, suggesting collegiate athletes have a more developed musculature system that is better able to control head motion after impact.

Although high-school football is full body-on-body contact sport between young men who may not be physically developed to the collegiate level, it is the practices that worry parents. When two-per-day practices are conducted in August – known as the hottest month of the year in many places – the question arises to whether such grueling practices are necessary for high-school sports. This debate is getting just as hot as the weather, as a high school coach from Louisville, Kentucky, will go to trial today on charges of reckless homicide and wanton endangerment in the heat-exhaustion-related death of one of his players in 2008. CNN reports:

The Kentucky case is one of the recent heat-related fatalities in football that made headlines. Since 1995, 39 football players have died in heat-related deaths, triggering new practice guidelines, wrongful death lawsuits and even criminal charges. Last year, six football players died from heatstroke – four of them were high school students, according to the Annual Survey of Football Injury Research. “There is no excuse for any number of heatstroke deaths since they are all preventable with the proper precautions,” the report authors wrote.

To address heat concerns, the National Collegiate Athletic Association (NCAA) in 2003 prohibited two-a-days on consecutive days and during the first five days of practice. The NATA suggested similar guidance in June this year. Guidelines for high school football vary by state, however; additionally, many coaches have objected to the reduction of practices based upon the immature status of players – both physically and mentally – to be unable to prepare for games without the two-a-day regimen.

For more information about football injuries and what you might do to keep your sons safe while playing this sport, visit the NATA site. As in earlier years, the practice and the game for high school students may change with – hopefully – safer standards for high school football.

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