Background:

Interventions designed to reduce the risk for head impacts and concussion in youth football have increased over the past decade; however, understanding of the role of regular game play on head impact exposure among youth tackle and flag football athletes is currently limited.

Purpose:

To explore head impact exposure among youth tackle and flag football athletes (age range, 6–14 years) during both practices and games.

Study Design:

Cohort study; Level of evidence, 2.

Methods:

Using the Vector MouthGuard sensor, the authors collected head impact data from 524 tackle and flag youth football athletes over the course of a football season. Quantities of interest were estimated from regression models using Bayesian methods.

Results:

For impacts ≥10g, a tackle football athlete had an estimated 17.55 (95% CI, 10.78–28.96) times more head impacts per practice compared with a flag football athlete (6.85 [95% CI, 6.05–7.76] and 0.39 [95% CI, 0.24–0.62] head impacts, respectively). Additionally, a tackle football athlete had an estimated 19.48 (95% CI, 12.74–29.98) times more head impacts per game compared with a flag football athlete (13.59 [95% CI, 11.97–15.41] and 0.70 [95% CI, 0.46–1.05] head impacts, respectively). Among tackle football athletes, the estimated average impact rate was 6.51 (95% CI, 5.75–7.37) head impacts during a practice and 12.97 (95% CI, 11.36–14.73) impacts during a game, resulting in 2.00 (95% CI, 1.74–2.29) times more ≥10g head impacts in games versus practices. Tackle football athletes had 2.06 (95% CI, 1.80–2.34) times more high-magnitude head impacts (≥40g) during a game than during a practice. On average, flag football athletes experienced an estimated 0.37 (95% CI, 0.20–0.60) head impacts during a practice and 0.77 (95% CI, 0.53–1.06) impacts during a game, resulting in 2.06 (95% CI, 1.29–3.58) times more ≥10g head impacts in games versus practices. Because of model instability caused by a large number of zero impacts for flag football athletes, a comparison of high-magnitude head impacts is not reported for practices or games.

Conclusion:

This study provides a characterization of the head impact exposure of practices and games among a large population of youth tackle and flag football athletes aged 6 to 14 years. These findings suggest that a greater focus on game-based interventions, such as fair play interventions and strict officiating, may be beneficial to reduce head impact exposures for youth football athletes.