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PubMedDate not supplied

The healthy worker effect in professional football.

We investigated the "healthy athlete effect" (HAE) in American professional football. Ages of death of professional football players who debuted prior to 1940 were obtained and differences between those ages and age-adjusted life expectancies were examined to determine if longevity increased with career length, controlling for birth year, body mass index (BMI), position, and type. Professional football players (N=1,512) lived an average of 6.1 (+/- 11.9 SD) years longer than age-matched controls from the general public. Career length significantly and incrementally increased longevity of players from an average of 5.5 years for players playing one season to 6.7 years for players playing 4 or more seasons. Both birth year and BMI had a statistically significant association with longevity, but position type did not. These data provide strong support for the healthy worker effect (HWE) in professional football.

Body Mass Index↗
PubMed1993

Coxsackievirus B2 infection and aseptic meningitis: a focal outbreak among members of a high school football team.

In an investigation of a school outbreak of enterovirus-like illness and aseptic meningitis, an IgM antibody assay was used to identify persons with evidence of recent coxsackie virus B2 infection. During September and October 1989, 81 (25%) of 319 students and staff reported an enterovirus-like illness; of these, 17 (21%) also had aseptic meningitis. Attack rates for enterovirus-like illness were highest among varsity football team members (53%), and most of this illness occurred between 6 and 15 October. Coxsackie virus B2 was isolated from 2 varsity football players. IgM antibody studies confirmed that coxsackie virus B2 was the cause of the outbreak in the varsity football team and suggested it was not responsible for much of the disease in other students and staff: 63% of football team members were seropositive compared with 12% for other students in grades 6-12. This report illustrates the value of an IgM antibody assay in the investigation of enterovirus outbreaks to distinguish infection from illness.

Adolescent↗
PubMed2002

Performance, biochemical, and endocrine changes during a competitive football game.

PURPOSE: This study represents the first time that anaerobic power performance was examined during an actual intercollegiate American football game. In addition, biochemical and endocrine responses also were examined to assess the physiological stress imposed by this competitive contest. METHODS: Twenty-one members of a NCAA Division III football team were divided into two groups. Group one (ST) were starters (N = 11). The second group (RS) consisted of red-shirt players (N = 10). Blood samples were obtained 24 h (Pre1) and 2.5 h (Pre2) before the game and within 15 min of game conclusion (IP). Anaerobic power measures were recorded approximately 10 min before kickoff (pre) and following the first (Q1), second (Q2), third (Q3), and fourth (Q4) quarters. RESULTS: Peak force (PF) and power (PP) in both squat and countermovement jumps decreased (P < 0.05) from pre to Q2 in both ST and RS; however, all variables returned to baseline levels by Q4. When averaged across trials, PF and PP in both jumps were greater (P < 0.05) in ST than RS. No significant changes in testosterone concentrations with respect to time or between groups were seen. Cortisol concentrations were significantly higher for ST at IP than RS. No significant changes in creatine kinase, alanine aminotransferase, urea, or uric acid were observed in either group from Pre2 to IP. In addition, no between group differences were seen in these variables. Myoglobin and aspartate aminotransferase significantly increased from Pre2 to IP in ST, and a significant difference in myoglobin concentrations was seen between the groups at IP. CONCLUSIONS: Performance, biochemical, and endocrine changes in these NCAA Division III football players reflected the stress and muscle damage that occurs as a result of a competitive American football game.

Adult↗
PubMed1999

Sports-specific concerns in the young athlete: football.

There are over 1.5 million males playing American football at all levels in the United States. American football is the most common participant sport among high-school-aged males. Owing to its high rate of injury per exposure hour, American football injuries are commonly treated in the emergency department during the autumn sports season. This article will review the history, epidemiology, and specific injury patterns seen in American football, with a focus on head and shoulder injuries.

Adolescent↗
PubMed1997

Medical care for mass gatherings at collegiate football games.

BACKGROUND: Many articles have reviewed medical care at mass gatherings, but few have specifically looked at care provided during football games. Some of the largest gatherings occur at various stadiums during football season. METHODS: We analyzed the medical care provided for the spectators at Williams-Brice Stadium for the University of South Carolina 1995 football season. The average attendance per game was 69,427; seven home games were played. Six physician/nurse/paramedic/paramedic teams provided medical care using prehospital equipment. RESULTS: Medical care was given to 526 individuals, an average of 1.08 +/- 0.37 per 1,000 spectators per game. Records of 465 persons (88%) were available for review. The most common complaints were headache (48%), trauma (16%), gastrointestinal distress (10%), and environmental (7%). Nineteen patients (4%) required transport to nearby hospitals for further evaluation. CONCLUSIONS: These results reflect patients with medical complaints seen during one collegiate football season in South Carolina. We believe this information can be used in planning medical care needs at other mass gatherings.

Adult↗
PubMed1999

Medical coverage of high school football in Wisconsin in 1997.

OBJECTIVE: The goals of this study were to assess the health care available to Wisconsin high school football players and to assess high schools' compliance with safety requirements of the Wisconsin Interscholastic Athletic Association (WIAA). DESIGN: The design was a cross-sectional survey-based study. SETTING: The setting consisted of WIAA high schools. PARTICIPANTS: Athletic directors of WIAA high school football programs participated in the survey. MAIN OUTCOME MEASURES: The main outcome measures were the prevalence of medical coverage by physicians, certified athletic trainers, and ambulance personnel at football games and practice and the prevalence of compliance with WIAA requirements. RESULTS: Seventy-seven percent (302/392) of surveys were returned. Thirty-six percent of schools had a designated team physician. Eighty-seven percent had a trainer, and 86% were certified athletic trainers (Athletic Trainer Certified, ATC). At practice and scrimmage, 79% had an ambulance available or on call, 52% had a trainer present, and 28% had a physician on call. At football games, 71% had an ambulance, 67% a certified athletic trainer, 48% an emergency medical technician, and 45% a physician present. Regarding WIAA requirements, 9% had no accessible phone, 27% had no written emergency plan of action, 92% had gloves, and 92% had blood spill kits. Larger schools had better compliance with WIAA requirements than did smaller schools. CONCLUSION: Health care coverage was provided mainly by trainers and ambulance personnel, although physicians were routinely present at almost half of all games. Failure to comply with WIAA medical coverage requirements was not infrequent. This study forms the basis for an informational intervention, providing an opportunity to correct deficits.

Cardiopulmonary Resuscitation↗
PubMed2001

Creatine supplementation in high school football players.

OBJECTIVE: To describe creatine supplementation patterns and behaviors associated with creatine supplementation in high school football players. DESIGN: A cross-sectional, multisite, anonymous, descriptive survey was conducted between October 1999 and February 2000. SETTING: 37 public high schools in Wisconsin. SUBJECTS: A total of 1,349 high school football players, grades 9-12. MAIN OUTCOME MEASURES: Self-reported prevalence of creatine use, as well as perceived benefits and risks. In addition, sources of information and influence regarding creatine supplementation were assessed. RESULTS: 30% of the respondents reported using creatine. Creatine use was lowest in the 9th grade (10.4%) and highest in the 12th grade (50.5%). 41% of the players at small schools stated they used creatine compared with 29% of the players in large schools. Enhanced recovery following a workout was the most likely perceived benefit of creatine supplementation, while dehydration was cited most often as a risk of creatine use. Users were encouraged to take creatine most often by their friends while their parents discouraged creatine use. CONCLUSIONS: Creatine use is widespread in high school football players. High school football players who use creatine may not be aware of the risks and benefits associated with creatine supplementation. Sports medicine professionals who work with this population need to educate athletes, coaches, and parents about the use of creatine as a performance-enhancing supplement.

Adolescent↗
PubMed2003

Comparison of reporting systems to determine concussion incidence in NCAA Division I collegiate football.

OBJECTIVE: To determine the incidence of concussion during the 2001 Division I-A college football season through utilization of the Internet. DESIGN: Prospective Internet survey. SETTING: Internet Web site. PARTICIPANTS: Head athletic trainers from Division I-A collegiate football programs. MAIN OUTCOME MEASURES: During the 2001-2002 football season, head athletic trainers from 87 Division I-A football programs agreed to use an Internet Web site to submit weekly data on the number of athlete exposures and concussions. RESULTS: A total of 373 concussions were reported over the course of a season in both practices and games combined. Of these concussions, 256 (68.6%) occurred during games, and 117 (31.4%) occurred during practice. The injury rate per 1,000 athletic exposures was 5.56 in games and 0.25 in practices. There were 230 grade 1 (61.7%), 134 grade 2 (35.9%), and 9 grade 3 (2.4%) concussions reported. There was a significant (p < 0.01) difference found between the total concussion injury rate and game concussion injury rate when comparing the Internet and the NCAA injury data collection methods. CONCLUSIONS: The results of this study suggest an underreporting of concussions using the NCAA Injury Surveillance System and demonstrate that the Internet is a simple and effective tool for data collection.

Adult↗
PubMed2004

Head injuries presenting to emergency departments in the United States from 1990 to 1999 for ice hockey, soccer, and football.

STUDY OBJECTIVE: To examine the number and rates of head injuries occurring in the community as a whole for the team sports of ice hockey, soccer, and football by analyzing data from patients presenting to US emergency departments (EDs) from 1990 to 1999. DESIGN: Retrospective analysis. MAIN OUTCOME MEASURES: Data compiled for the US Consumer Product Safety Commission using the National Electronic Injury Surveillance System were used to generate estimates for the total number of head injuries, concussions, internal head injuries, and skull fractures occurring on a national level from the years 1990 to 1999. These data were combined with yearly participation figures to generate rates of injuries presenting to the ED for each sport. RESULTS: There were an estimated 17,008 head injuries from ice hockey, 86,697 from soccer, and 204,802 from football that presented to US EDs from 1990 to 1999. The total number of concussions presenting to EDs in the United States over the same period was estimated to be 4820 from ice hockey, 21,715 from soccer, and 68,861 from football. While the rates of head injuries, concussions, and combined concussions/internal head injuries/skull fractures presenting to EDs per 10,000 players were not always statistically similar for all 3 sports in each year data were available, they were usually comparable. CONCLUSION: While the total numbers of head injuries, concussions, and combined concussions/skull fractures/internal head injuries presenting to EDs in the United States are different for ice hockey, soccer, and football for the years studied, the yearly rates for these injuries are comparable among all 3 sports.

Athletic Injuries↗
PubMed2005

Analysis of real-time head accelerations in collegiate football players.

OBJECTIVE: To measure and analyze head accelerations during American collegiate football practices and games. METHODS: A newly developed in-helmet 6-accelerometer system that transmits data via radio frequency to a sideline receiver and laptop computer system was implemented. From the data transfer of these accelerometer traces, the sideline staff has real-time data including the head acceleration, the head injury criteria value, the severity index value, and the impact location. Data are presented for instrumented players for the entire 2003 football season, including practices and games. SETTING: American collegiate football. SUBJECTS: Thirty-eight players from Virginia Tech's varsity football team. MAIN OUTCOME MEASUREMENTS: Accelerations and pathomechanics of head impacts. RESULTS: : A total of 3312 impacts were recorded over 35 practices and 10 games for 38 players. The average peak head acceleration, Gadd Severity Index, and Head Injury Criteria were 32 g +/- 25 g, 36 g +/- 91 g, and 26 g +/- 64 g, respectively. One concussive event was observed with a peak acceleration of 81 g, a 267 Gadd Severity Index, and 200 Head Injury Criteria. Because the concussion was not reported until the day after of the event, a retrospective diagnosis based on his history and clinical evaluation suggested a mild concussion. CONCLUSIONS: The primary finding of this study is that the helmet-mounted accelerometer system proved effective at collecting thousands of head impact events and providing contemporaneous head impact parameters that can be integrated with existing clinical evaluation techniques.

Acceleration↗
PubMed2006

Incidence and player risk factors for injury in youth football.

OBJECTIVE: To estimate the incidence of injuries in youth football and to assess the relationship between player-related risk factors (age, body size, biological maturity status) and the occurrence of injury in youth football. DESIGN: Prospective over two seasons. SETTING: Two communities in central Michigan. PARTICIPANTS: Subjects were 678 youth, 9-14 years of age, who were members of 33 youth football teams in two central Michigan communities in the 2000 and 2001 seasons. METHODS: Certified athletic trainers (ATCs) were on site to record the number of players at all practices and home games (exposures) and injuries as they occurred. A reportable injury (RI) was defined by the criteria used in the National Athletic Trainers' Association (NATA) survey of several high school sports. Estimated injury rates (95% confidence intervals) per athlete exposures (AE) and per number of athletes were calculated for practices and games by grade. Player risk factors included age, height, weight, BMI and estimated maturity status. MAIN OUTCOME MEASURE: Estimated injury rates and relative risks of injury during practices and games by grade; logistic regression to evaluate relationships between player-related risk factors and risk of injury. RESULTS: A total of 259 RIs, 178 in practice and 81 in games, were recorded during the two seasons. Practice injury rates increased with grade level, while game injury rates were similar among fourth through fifth grade and sixth grade players and about twice as high among seventh and eighth grade players. The majority of RIs during the two seasons was minor (64%); the remainder was moderate (18%) and major (13%). Injured fourth through fifth grade players were significantly lighter in weight and had a lower BMI; otherwise, injured and non-injured players within each grade did not differ in age, body size and estimated biological maturity status. Logistic regressions within grade revealed no significant associations between injury and age, height, BMI, and maturity status. CONCLUSION: Game injury rates are higher than practice injury rates, and the incidence of injury tends to increase with grade level. Age, height, BMI and maturity status were not related to the risk of injury in youth football players.

Adolescent↗
PubMed2004

Renal trauma in Australian rules football: an institutional experience.

BACKGROUND: Australian rules football is the most popular team sport in Australia. Literature on severe abdominal injuries in this sport is limited. The present study aims to review cases of renal trauma in Australian football at our institution. METHODS: A retrospective study was performed. All men admitted to our institution with renal trauma or haematuria associated with Australian football from July 1995 to July 2001 were analysed. RESULTS: There were 13 cases of renal trauma; two were grade V injuries requiring nephrectomy. CONCLUSION: Renal injury will be intermittently encountered owing to the popularity of Australian football. Renal injuries are often difficult to assess and early recognition, management and referral to a district hospital is crucial.

Abdominal Pain↗
PubMed2004

Incidence of cerebral concussions associated with type of mouthguard used in college football.

Controversy exists among sports dentists as to whether or not a 'custom made' mouthguard is more effective in reducing the incidence of cerebral concussion than the boil-and-bite 'non-custom made' mouthguard. While members on each side remain steadfast in their opinion, not a single epidemiological study has been conducted to investigate the effect of type of mouthguard worn on the incidence of cerebral concussion. The aim of this study was to determine if there was a difference between the type of mouthguard worn and the incidence of cerebral concussions among National Collegiate Athletic Association (NCAA) Division I-A football players. During the 15-week 2001 college football season, trainers entered, via an interactive web site, weekly data for each game and practice sessions for the preceding week. Eighty-seven (76%) out of a possible 114 Division I teams participated. A total of 506 297 athletic exposures were recorded; 369 brain concussions were reported. The incidence of cerebral concussions per 1000 exposures was 0.73. Utilizing a risk ratio with a 95% confidence interval, no statistical difference occurred in the incidence of cerebral concussions between football players wearing custom made versus non-custom made mouthguards (0.990,1.750). In this study, there was no advantage of wearing a custom made mouthguard over a boil-and-bite mouthguard to reduce the risk of cerebral concussion in football players.

Brain Concussion↗
PubMed2005

Sweat and sodium losses in NCAA football players: a precursor to heat cramps?

This observational study was designed to determine whether football players with a history of heat cramps have elevated fluid and sodium losses during training. During a "two-a-day" training camp, five Division I collegiate football players (20.2 +/- 1.6 y, 113 +/- 20 kg) with history of heat cramps (C) were matched (weight, age, race and position) with a cohort of teammates (19.6 +/- 0.6 y, 110 +/- 20 kg) who had never cramped (NC). Change in body weight (adjusted by fluid intake) determined gross sweat loss. Sweat samples (forearm patch) were analyzed for sodium and potassium concentrations. Ad libitum fluid intake was measured by recording pre- and post-practice bottle weights. Average sweat sodium loss for a 2.5-h practice was projected at 5.1 +/- 2.3 g (C) vs. 2.2 +/- 1.7 g (NC). When averaged across two practices within the day, fluid intake was similar between groups (C: 2.6 +/- 0.8 L vs. NC: 2.8 +/- 0.7 L), as was gross sweat loss (C: 4.0 +/- 1.1 L vs. NC: 3.5 +/- 1.6 L). There was wide variability in the fluid deficit incurred for both C and NC (1.3 +/- 0.9 vs. 0.7 +/- 1.2%) due to fluid intake. Sweat potassium was similar between groups, but sweat sodium was two times higher in C versus NC (54.6 +/- 16.2 vs. 25.3 +/- 10.0 mmol/L). These data indicate that sweat sodium losses were comparatively larger in cramp-prone football players than in NC. Although both groups consumed sodium-containing fluids (on-field) and food (off-field), both appeared to experience an acute sodium deficit at the end of practices based on sweat sodium losses. Large acute sodium and fluid losses (in sweat) may be characteristic of football players with a history of heat cramping.

Adult↗
PubMed2004

Non-participation in sports injury research: why football players choose not to be involved.

OBJECTIVE: To ascertain the reasons behind players not participating in a sports safety research project. METHODS: During the preseason, 10 Australian football clubs volunteered 23 teams to participate in a protective equipment randomised controlled trial, the Australian Football Injury Prevention Project (AFIPP). All players from these teams were invited to participate. Players who did not agree to participate in AFIPP were surveyed about their reasons for non-involvement. RESULTS: 110 football players (response rate 63.6%) completed the non-responder survey and cited the two main reasons behind non-involvement in the project as "I did not know about the project" (39.4%) and "I was not at training when the research team visited" (36.5%). CONCLUSIONS: and implications: Preseason may not be the best time for maximal player recruitment in community based sports safety research. Enhanced communication between researchers and players at community level football clubs during the recruitment phase is likely to improve response rates.

Adult↗
PubMedDate not supplied

Epidemiology of concussion in collegiate and high school football players.

Despite evolutionary changes in protective equipment, head injury remains common in football. We investigated concussion in football and associated epidemiologic issues such as 1) incidence of injury, 2) common signs and symptoms, and 3) patterns in making return-to-play decisions. We received 242 of 392 surveys (62%) that were sent to high school and collegiate certified athletic trainers at the beginning of three football seasons. Of the 17,549 football players represented, 888 (5.1%) sustained at least one concussion, and 131 (14.7% of the 888) sustained a second injury during the same season. The greatest incidence of concussion was found at the high school (5.6%) and collegiate division III (5.5%) levels, suggesting that there is an association between level of play and the proportion of players injured. Players who sustained one concussion in a season were three times more likely to sustain a second concussion in the same season compared with uninjured players. Contact with artificial turf appears to be associated with a more serious concussion than contact with natural grass. Only 8.9% of all injuries involved loss of consciousness, while 86% involved a headache. Overall, 30.8% of all players sustaining a concussion returned to participation on the same day of injury.

Adolescent↗
PubMed2006

Rotator cuff contusions of the shoulder in professional football players: epidemiology and magnetic resonance imaging findings.

BACKGROUND: No published reports have studied the epidemiology and magnetic resonance imaging findings associated with rotator cuff contusions of the shoulder in professional football players. PURPOSE: To determine a single professional football team's incidence, treatment, and magnetic resonance imaging appearance of players sustaining rotator cuff contusions of the shoulder. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: From 1999 to 2005, a North American professional football team's injury records were retrospectively reviewed for athletes who had sustained a rotator cuff contusion of the shoulder during in-season participation. Those patients who had magnetic resonance imaging of the shoulder with a 1.5-Tesla magnet were reviewed by a musculoskeletal radiologist and graded according to the appearance and severity of clinical injury. RESULTS: Twenty-six players had a rotator cuff contusion. There was an average of 5.5 rotator cuff contusions per season (47% of all shoulder injuries). The predominant mechanism of injury was a direct blow in 70.3%. Magnetic resonance imaging findings included peritendon edema at the myotendinous junction, critical zone tendon edema, and subentheseal bone bruises. Treatment consisted of a protocol involving modalities and cuff rehabilitation in all patients. Six patients had persistent pain and weakness for a minimum of 3 days and were given a subacromial corticosteroid injection. Overall, 3 patients (11.4%) required later surgical treatment on the shoulder. CONCLUSION: Rotator cuff contusions accounted for nearly half of all shoulder injuries in the football players in this study. Magnetic resonance imaging is an extremely useful tool in determining severity of injury and integrity of the rotator cuff. The majority of athletes are able to return to sports with conservative treatment; a minority of shoulders might progress to more severe injuries such as rotator cuff tears.

Adult↗
PubMedDate not supplied

Rotational ligamentous injuries to the ankle in football.

It is the author's belief that supination injuries with tear of the talofibular ligament are the most frequent ankle ligamentous injuries encountered on the football field (Figure 4). However, the author believes that the more significant injury is the rupture of the tibiofibular ligament and interosseous ligament incurred in pronation and external rotation. (Figure 5). Twenty time-loss injuries of significance, encountered over a five year period in one football team, are presented. The mechanism of injury and the force encountered at the ankle during an interruption of the normal sequence of running and turning on the football field are presented. It is the author's opinion that rigid immobilization of the more significant injury is necessary in order to return the participant to active athletics within a reasonable length of time. It is hoped that this report will stimulate others to closely evaluate ankle injuries occurring on the football field.

Ankle Injuries↗