O3272: The Association of Previous Youth Tackle Football Participation with the Onset of Injuries in High School Football Players

Background: Opponents of youth tackle football argue it increases risk of injury in young players. In contrast, proponents suggest youth tackle football is necessary to teach proper techniques that may result in players sustaining fewer injuries later in high school (HS) football. Our objective was to investigate the association of previous youth tackle football participation with odds of sustaining acute contact-related injury in HS football players.

Methods: High school football players from 16 Wisconsin schools were recruited for a prospective study during the 2022 football season. Players completed preseason surveys regarding their previous tackle football participation and history of sport-related injury in the past year. Licensed Athletic Trainers at each school reported all injuries and football exposures for the players. Acute contact-related time loss injuries (INJ) were classified as Mild (1-7 days out), Moderate (8-21 days out), or Severe (> 22 days out). Poisson regression was utilized to model injury rates while accounting for age, school, and repeat injuries. Logistic regression was used to model injury severity while controlling for age and previous injury.

Results: 820 football players (Male: 99%, Age 15.7+2.0 yrs. Grades 9-12) were enrolled. 701 (86%) played tackle football before HS (median 3 yrs [IQR 1,4]), with 401 (48.9%) playing tackle football before 6th grade ( < 6th). Players participated in 52,172 football exposures (competition=18%, practice=82%) during the season. 213 players (26%) sustained 266 INJ that occurred most often with player to player contact (n=221, 83%), specifically tackling/being tackled (n=143, 54%) or blocking/being blocked (n=83, 31%). Most common injuries included ligament sprains (n=91, 34%), contusions (n=62, 23%), concussions (n=48, 18%), muscle-tendon strains (n=27, 10%), fractures (n=20, 8%) and dislocations/subluxations (n=13, 5%). Most common injury locations included head/face (n=52, 20%), wrist/hand (n=42, 16%], shoulder/clavicle (n=41 15%), knee (n=35, 13%) and ankle (n=30, 11%). Injured players missed a median 7 days [IQR 3,13] from football (Mild n=141 [53%], Moderate n=86 [32%], Severe n=39 [15%]). There was no difference in the number of players sustaining INJ by participation in tackle football before 6th grade (Yes < 6th: n=96 [23.9%], No < 6th: n=117 [27.9%], OR 0.97 [0.76-1.24], p = 0.817) or by the total years playing tackle football before HS (OR 0.99 [0.93-1.06 95%CI], p = 0.836, Figure 1). Injury severity was not different by total years playing tackle football before HS (OR 0.91 [0.81-1.02], p = 0.114, Figure 2).

Conclusion: Participation in youth tackle football before 6th grade and the total years playing tackle football before high school were not associated with an increased or decreased odds of sustaining acute contact-related injuries in high school football players. More research is needed to assess whether or not prior tackling experience is protective for high school players.