A University of Hawaiʻi at Mānoa study of high school football injuries nationwide found that a rule designed to reduce dangerous hits to the head did not lead to an increase in leg injuries, a potential consequence student researchers set out to examine.
The targeting rule, adopted in 2014, prohibits players from initiating forceful contact above an opponent’s shoulders. John A. Burns School of Medicine (JABSOM) students Nolan Tanji, Cameron Nishida, Philip Lee and Sasha Rovinsky wanted to know whether efforts to avoid the head and neck were causing players to tackle lower and shifting injuries to the legs.
“We were just thinking as people are avoiding the head and neck, they’re going to be tackling lower in the body, so maybe the injury burden might be getting shifted lower in the body,” Tanji said.
Thousands of injuries analyzed
The researchers analyzed high school football injuries among athletes ages 14–18 using a national database containing emergency department data from more than 100 hospitals across the country. They compared injuries from the five years before the targeting rule with the five years after it took effect.
The team reviewed more than 14,000 entries to determine how the injuries occurred.
Researchers identified 7,315 lower-extremity injury cases before the rule and 5,611 afterward. When used to estimate national totals, the numbers declined from about 242,000 injuries to 193,000.
“It was really surprising,” Tanji said. “It was something that was the complete 180 from what we were expecting before analyzing the data.”
The researchers cautioned that the targeting rule cannot be credited with causing the decline. Changes in training, injury prevention and equipment technology may have contributed.
The study also found that knee injuries represented a slightly larger share of lower-extremity injuries after the rule took effect, while the proportion involving collisions between players increased. The researchers said those findings warrant further study.
The database included only injuries treated in emergency departments and did not identify which positions the injured athletes played.
“It’s not completely safe but, you know, it’s looking promising for the future in terms of injuries in football,” Tanji said.
