title: Gridiron football injuries.
abstract: OBJECTIVE
  To review the available football epidemiology literature to identify risk factors, facilitate injury prevention and uncover deficiencies that may be addressed by future research.
  
  
  METHODS
  A literature search of Sports Discus (1940-2003), Eric (1967-2003), EMBASE (1988-2003), MEDLINE (1966-2003), CINAHL (1984-2003), and Web of Science (1993-2003) identified the published articles on American football in athletes of high school age and younger.
  
  
  RESULTS
  Injury rate increases with the level of play (grade in school), player age, and player experience. The lower extremity (knee and ankle joints) is most frequently injured. Football injuries are much more common in games than in practice, and occur to players who are being tackled, tackling or blocking. Most injuries are mild, including contusion, strain and sprain. Rule changes with the prohibition of initial contact with the helmet or face-mask reduced catastrophic head and neck injuries.
  
  
  CONCLUSIONS
  Although no sport or recreational activity is completely risk-free, football epidemiology research is critical to injury prevention. The existing medical literature provides some valuable insights, but an increased emphasis on prospective research is required to test the efficacy of preventative measures. Quality research may contribute to a reduction in football injury risk by defining the role of player conditioning and strength training, coaching of safety fundamentals, avoidance of dangerous activities, as well as proper medical supervision and care. Sports medicine personnel, coaches, and officials must strive to minimize injuries through progressive education, improved coaching techniques, effective officiating, and equipment modifications.
authors.affiliation: The Mayo Clinic, Department of Orthopedic Surgery, Rochester, Minn., USA.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stuart
mesh_terms: D000293:Adolescent; D000367:Age Factors; D001265:Athletic Injuries / Q000453:epidemiology / Q000517:prevention & control; D002648:Child; D003288:Contusions / Q000453:epidemiology; D005538:Football / Q000193:education / Q000293:injuries* / Q000592:standards; D006801:Humans; D035002:Lower Extremity / Q000293:injuries; D012307:Risk Factors; D019876:Sports Equipment; D013180:Sprains and Strains / Q000453:epidemiology