Safety Considerations for Youth Football

Tough physical play is part of the appeal of American football, but the risk of both short- and long-term injury, especially to the head and brain, is high. So is football safe for kids to play, or not?

That depends on who you ask, and on the player, coach, and league overseeing the game. Does the coach have training in safer tackling techniques? What are the rules regarding contact during practices and games, use of safety equipment, and proper response to suspected concussions? Does the player have any pre-existing health conditions or prior concussions that make it more dangerous for him to play football? You should seek a doctor's advice on this question.

Pop Warner, a popular youth league for tackle football, forms teams based on players' ages and weights, in an effort to reduce lopsided match-ups between opposing players. The league also introduced changes in 2012 to try to improve player safety. It disallowed "full speed head-on blocking or tackling drills in which the players line up more than 3 yards apart" and reduced the amount of contact to a maximum of one-third of practice time (for example, no more than 40 minutes of a 2-hour practice can include scrimmages or drills that involve player-to-player contact). Initial research supports the success of these rule changes.

Modified Tackle Football

Another governing association, USA Football, is researching a program it calls "modified tackle." It is meant to serve as a bridge between non-contact flag football and traditional tackle football. (USA Football gets financial support from the National Football League). The differences between modified tackle and traditional tackle football are significant. They include:

• Smaller playing field (40 yards by 35 yards), so two games can be played side-by-side on one traditional-sized football field—and so players have less speed and momentum when they tackle
• Small-sided teams: 6-, 7-, or 8-person—which means fewer points of contact
• Every player starting in a two-point stance except for the center, who must be left uncovered
• No special teams
• No blitzing
• Starting all possessions with the ball on the 40-yard line, regardless of whether there was an interception, fumble, touchdown or turnover on downs
• Coaches are allowed on the field and in the huddle
• Running clock

Modified tackle is only a pilot program, in use in just a few areas. USA Football plans to look at how well it works to determine if it will become more widely available.

USA Football also runs a coach-education program called Heads Up Football, which trains adults to help kids learn to play and practice more safely. (Some Pop Warner programs participate in Heads Up Football too.) Initial research on these programs shows it might not be as effective as USA Football had hoped, with an insignificant reduction in a number of injuries.

If Your Child Wants to Play Football

Ideally, kids should stick with flag (or non-contact) football until they are at least 13 years old. One small study of retired NFL players have shown an association between cognitive impairment and playing tackle football prior to age 12. The advocacy group Practice Like Pros (made up of doctors and former professional players) also strongly recommends no contact before high school.

In football or any sport, you can also try to reduce the risk of injury by:

• Having your child use protective equipment, always. Make sure it is the right size and in good repair.
• Consulting a physician prior to play. A pre-participation physical exam can help uncover hidden dangers (like an undiagnosed heart condition). Your child's doctor can discuss any risks particular to your child, whether that means a chronic condition like asthma, a previous injury, or a neurological condition.
• Getting a baseline concussion test. This test, which must be administered by a trained professional, could help diagnose the severity of a concussion if one occurs and guide the recovery process. Unfortunately, most such tests are designed for kids ages 10 and up only.
• Making sure the athlete is physically ready to play, with strong, flexible muscles and joints. 
• Avoiding overtraining.