By Martha A. Simpson, D.O., M.B.A.
Associate Professor of Family Medicine
Ohio University College of Osteopathic Medicine

SHOULDER-FIRST CONTACT IS THE SAFEST WAY TO PLAY FOOTBALL

Question: Our son has begun football practice at his high school, and I am worried about serious injury. One of the players in our son’s league had a serious neck injury last year. They thought he was going to be paralyzed, but luckily he had no permanent injury.

Answer: With football season on the horizon, many football fans are anxiously awaiting that first kickoff of the season. It’s an exciting time as young men prepare for head-to-head combat on the gridiron. In many ways high school football can be a very good thing. It teaches our youth a valuable lesson about teamwork, exercise and sportsmanship.

I also find it encouraging that last year there were only two fatalities in high school football nationwide -- the lowest in ten years. We need to work hard to make sure this trend continues, because without the proper precautions, football can still be a dangerous sport. I urge you to make sure that your son receives information on the proper ways to avoid injuries to himself and to the other players.

The most dangerous football injuries involve the head and neck. The most important thing to do to prevent these injuries is to make sure your son’s coaching staff teaches players not to “spear.” This means “head-down” contact with another player -- often by the tackler on a ball carrier. Make sure your son’s league enforces the rule against spearing. Though widely misunderstood, the anti-spearing rule is to protect the spearing player from paralysis. It’s not meant primarily to protect the person being speared. A spearing penalty should result in an automatic ejection from the game.

In one study, about three-quarters of the players with head and neck injuries were defensive backs who made a spearing tackle in the open field. The player lowered his head at the last second and made contact with the top of his helmet. That puts enormous pressure on the cervical spine. Initiating contact with the shoulder while keeping the head up is the safest way to play football.

It's essential that your son's team has a plan for what to do if a spine injury occurs during a game or during practice. Under no circumstances should somebody with a cervical spine injury be moved until he can be safely transported to the hospital. The neck should be immobilized, and the player's helmet should not be removed until the player is at the hospital.

Other injuries that are common among football players include facial injuries and heatstroke. Fortunately, the number of facial injuries has fallen since face masks and mouth guards have become required. Heatstroke deaths have decreased as well since the 1970s. In those days, some coaches believed that withholding water would make players tougher. Now, we know that's foolish thinking and that coaches should allow players to have as much water as they need and should give them periodic rest breaks.

For more information on football injury prevention, you can log on to the Web site of National Federation of State High School Associations, at www.nfhs.org, and then click on “Sports Medicine.”

Family Medicine® is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only. It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions. Past columns are available online at www.familymedicinenews.org.