Prevention of Football Injuries: A Review of the Literature

INTRODUCTION. Football has been a leading cause of military and civilian injury hospitalizations and outpatient care. This report provides detailed descriptions of epidemiologic risk factor studies of football-related injuries, and presents evidence supporting andor refuting the effectiveness of specific interventions to prevent football-related injuries. METHODS. Medical and public health literature 1970-2004 were searched to identify relevant articles. Search terms included football combined with intervention, prevention, injury, and derivations of these e.g., injuries. Quality of intervention papers was assessed using a standardized instrument. RESULTS. Two hundred twenty-four papers were reviewed 39 were case reportsseries and descriptive studies, 13 were laboratory studies, 31 were reviews, 15 were analytic epidemiologic studies, and 2 were intervention studies. Median quality scores of intervention papers ranged from 15-46 out of 100. CONCLUSIONS. Only one intervention, a ban on spearing, had scientifically-demonstrated effectiveness in preventing football-related injuries. Other measures such as holding games and practices on natural grass rather than artificial grass, preseason conditioning, and use of knee and ankle braces deserve future consideration and evaluation. To be of greatest benefit, future intervention studies should clearly describe the study population and exposures, provide rates of injury, control for confounding, and consider contemporary equipment and policies.