Almost 250,000 children and adolescents in the US were treated in emergency departments for sports-related injuries that included concussion or traumatic brain injury in 2009. Now, the American Academy of Pediatrics have issued new guidelines to improve safety for youths who play one of the most popular sports: football.

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The AAP recommend a "zero tolerance" approach to head-first, illegal tackling in youth football.

The new policy statement, which was recently presented at the American Academy of Pediatrics (AAP) National Conference & Exhibition in Washington, DC, is published in the journal Pediatrics.

Almost 30 million children and adolescents in the US take part in sports, with football being one of the most popular; around 28% of children aged 5-14 play the game, and there are more than 1.1 million high school football players in the US.

However, there are ongoing concerns about the injuries sustained by young football players and how these may impact long-term health. Medical News Today recently reported on a study that identified a rare brain disease called chronic traumatic encephalopathy (CTE) in deceased NFL players, which can occur when a person endures repeated blows to the head over a period of time.

While the most commonly injured body parts among football players are the knee, ankle, hand and back, the most severe injuries involve those to the head and neck. The AAP say head and neck injuries in football most commonly occur through illegal tackling techniques, such as spear tackling, in which a player launches their entire body in a "spear-like" manner against an opponent.

Due to increasing evidence of the long-term risks head and neck injuries may pose for football players, doctors have called for a number of changes to be made to the sport, including a reduction in the number of contact practices during the game and a postponement of tackling until youths reach a certain age.

A 'zero tolerance' approach to illegal tackling

To reach their recommendations, co-lead author Dr. Greg Landry, a member of the AAP Council on Sports Medicine and Fitness, and colleagues conducted a review of studies investigating football injuries - especially those of the head and neck.

In particular, the authors looked at the link between tackling and football-related injuries, as well as the possible outcomes that postponing tackling or removing it completely may have for players.

Based on their review, the AAP recommend that all officials and coaches for American football enforce the appropriate rules for tackling and adopt a "zero tolerance" approach for head-first, illegal hits, such as spear tackling.

"There is a culture of tolerance of head first, illegal hits," they note. "This culture has to change to one that protects the head for both the tackler and those players being tackled."

The authors concluded that removing tackling from football completely would likely reduce the number of overall injuries players sustain. However, they acknowledge that this would significantly change the way in which the game is played. As such, they suggest the participants themselves must decide whether the recreational benefits of tackling during play outweigh the injury risks.

Delaying age for tackling may increase later injury risk

Delaying the age at which tackling is introduced to football would likely reduce injury risk up until that point, according to the authors. However, they note that once the technique is initiated, athletes who have no prior experience of tackling would be exposed to first-time collisions at faster speeds and greater forces, putting them at greater risk for injury.

"Therefore, if regulations that call for the delaying of tackling until a certain age are to be made, they must be accompanied by coaches offering instruction in proper tackling technique as well as the teaching of the skills necessary to evade tackles and absorb being tackled," say the authors.

The AAP recommend an expansion for non-tackling football leagues, giving youths the option to participate in football without the injury risks associated with tackling.

What is more, the authors recommend the presence of skilled athletic trainers at all organized football games and practices, based on studies that show this may reduce the number of injuries players sustain.

Commenting on the new policy statement, co-lead author Dr. William Meehan III, also a member of the AAP Council on Sports Medicine and Fitness, says:

"The AAP encourages athletes to continue playing organized sports, while supporting coaches and officials in their work to reduce these injuries."

Earlier this year, MNT reported on a study that linked playing football before the age of 12 to poorer memory in adulthood among NFL players.