PREVENTION
Preventing Catastrophic Injuries in Sports
Every year a number of athletes sustain serious injuries to the brain or spinal cord. In fact, 10% of all brain injuries and 7% of all new cases of paralysis are related to sports. Football, cheerleading, gymnastics, ice hockey, and pole vaulting have the highest incidence of catastrophic injuries.
FOOTBALL. Compared to other high school and college sports, football has the highest number of severe head and neck injuries per year. Following are recommendations for injury prevention in football:
- No “spear” tackling (tackling an opponent using the crown of the head). In 1976 this type of tackling was banned. This has led to a significant decrease in the number of severe neck and spinal cord injuries.
- Helmet fitting:
- Helmet should turn minimally when attempting to rotate it on head.
- There should be no space between pads and face and back of head.
- Helmet should sit one to two fingerbreadths above eyebrows and should not come over eyes when pressure is applied to top of helmet.
- Hair should be same length at time of helmet fitting as it will be throughout the season.
- Four-point chin strap is more secure than two-point.
- Certain types of face masks offer more protection against facial and eye injuries than others.
- Mouth guards are required for all high school and college players.
- Other protective equipment:
- Shoulder pads must fit securely to chest
- Neck rolls and collars have not been shown to absolutely decrease the risk of injuries such as “burners” or “stingers”.
CHEERLEADING. Compared to many other sports, cheerleading has a low overall rate of injury but there is a high risk of serious injuries. The basket toss and the pyramid are especially risky stunts. The cheerleader at the top of the pyramid is most frequently injured. Guidelines introduced to reduce injuries include:
- Limiting the height and complexity of a pyramid. Pyramids are limited to two levels in high school.
- Specifying positions for spotters (person who remains on the ground to assist and catch the top person in the pyramid).
- Suspended person is not allowed to be inverted and cannot rotate on dismount.
- Stunts should be restricted during wet conditions.
- Landing mats should be used for complex stunts.
BASEBALL and SOFTBALL. Serious injuries in baseball are often caused by player collisions, a pitcher hit by a batted ball, or a batter hit by a pitched ball. Methods for preventing these types of injuries include:
- When an outfielder and infielder are racing for a ball, the outfielder should call off the infielder.
- When two infielders are running for a ball, the pitcher should call out who should catch the ball.
- Head-first sliding has not been shown to be more effective than feet-first sliding and should not be used at the high school and college levels. Head-first sliding is not allowed in Little League.
- Protective screens for baseball pitchers should be used during practice sessions.
- Youth baseball players should be taught to turn their chest away from wild pitches. This is to prevent a heart complication known as commotio cordis.
SOCCER. Injury prevention strategies include:
- Goalposts should be secured at all times.
- Padded goalposts can help reduce injury rates.
- Children should use smaller soccer balls to reduce head impact.
- Don’t use leather or water-soaked soccer balls because of their heavier weight.
- Teach proper heading technique. Contact should be made with the forehead, with the neck muscles contracted. Teach players to hit the ball, not to be hit by the ball.
SWIMMING. Most serious swimming injuries are caused by diving into the shallow end of the pool. To prevent injury, swimmers should only dive into the deep end of the pool during practice sessions.
WRESTLING. Coaches should emphasize safe and legal wrestling techniques. Proper rolling techniques, such as avoiding landing on the head, should be emphasized during practice sessions.
Reference:
Boden BP. Direct Catastrophic Injury in Sports. J Am Acad Orthop Surg 2005;13:445-454
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