Prominent Sports Medicine physician Dr. Pietro Tonino of Loyola University Medical Center has some blunt advice for parents of high school athletes who want to play football this fall: Don't let them do it.
"When you have two human beings collide at a high rate of speed – especially if one of them is much bigger than the other – then significant injuries are quite possible," Tonino said. "I don't believe it is worth the risk. So I advise parents to try to steer their children to alternative sports. We are just beginning to understand the long-term consequences of injuries sustained at young ages."
The most common football injuries are knee injuries, especially to the anterior or posterior cruciate ligament (ACL/PCL). Other common injuries are ankle sprains, shoulder injuries and overuse injuries that cause back pain and patellar tendonitis (knee pain). And heat stroke is a significant risk during summer training camp.
A study published in the journal Pediatrics found that injury rates were similar in football and baseball. But while only 3 percent of baseball injuries were considered serious (fracture, dislocation, concussion), 14 percent of football injuries were considered serious.
Concussions, however, are Tonino's biggest concern. Tonino notes that a position statement from the American Medical Society for Sports Medicine says the developing brain differs physiologically from the adult brain. Young athletes may have a more prolonged recovery and are more susceptible to concussions accompanied by a catastrophic injury.
While helmets can prevent injuries such as cuts and fractures, helmets have not been shown to reduce the incidence and severity of concussions. This is particularly true if improper tackling techniques are used. "Lowering the head and leading with the head can cause serious head and neck injuries, regardless of the quality of the helmet," Tonino said.
But despite the high injury risk, there generally is inadequate medical supervision during football games and practices. For example, Tonino surveyed football programs in Chicago public high schools and found that only 10.6 percent had a physician on the sideline during games; 8.5 percent had an athletic trainer present; and 89.4 percent had a paramedic available. During practice, no school had a physician or paramedic present, and only one school had an athletic trainer available. The study was published in The Physician and Sports Medicine journal. (Tonino has served as a team doctor for high school, college and NFL football teams.)
Tonino did not let his own two sons play football, but he understands that many other parents will disagree with his advice. In such cases, he advises parents to carefully observe the football program:
- During summer training camp, practices should be held in early morning or early evening, if possible, to reduce the risk of heat injury.
- Keep an eye out for concussions. Does your child suffer from headaches, dizziness or difficulty concentrating?
- Attend a practice. Is there adequate water and ice for players?
- During games, is there a physician or athletic trainer on the sidelines?
- Get to know the coach. During practices, coaches often are the only ones who provide medical supervision.
Tonino is Sports Medicine program director and a professor in the Department of Orthopaedic Surgery & Rehabilitation at Loyola University Chicago Stritch School of Medicine.