title: Injuries can be prevented in contact flag football!
abstract: OBJECTIVE
  This original prospective cohort study was conducted in an attempt to significantly reduce the incidence and the severity of injuries in an intervention cohort as compared to a two-season historical cohort, and to provide recommendations to the International Federation of Football (IFAF) pertaining to prevention measures to make the game safer.
  
  
  METHODS
  A total of 1,260 amateur male (mean age: 20.4 ± 3.9 years) and 244 female (mean age: 18.5 ± 1.7 years) players participated in the study. Four prevention measures were implemented: the no-pocket rule, self-fitting mouth guards, ankle braces (for those players with recurrent ankle sprains) and an injury treatment information brochure. All time-loss injuries sustained in game sessions were recorded by the off-the-field medical personnel and followed up by a more detailed phone injury surveillance questionnaire.
  
  
  RESULTS
  There was a 54 % reduction in the total number of injuries and a significant reduction in the incidence rate and incidence proportion between the intervention cohorts as compared to the historical cohort (p < 0.001). There was no statistically significant reduction in the number of injuries in any of the body parts, except for in hand/wrist injuries related to the use of pockets (p < 0.001), as well as the severity of mild-moderate injuries (p < 0.05).
  
  
  CONCLUSIONS
  This study provided evidence that hand/wrist injuries can be significantly reduced in flag football. Recommendations to the IFAF include strict enforcement of the no-pocket rule, the use of soft headgear, comfortable-fitting ankle braces and mouth guards and additionally, to change game rules concerning blocking.
  
  
  METHODS
  II.
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium. sportmed@zahav.net.il.|Jerusalem Sports Medicine Center, Lerner Sports Center, Hebrew University, Mount Scopus, Jerusalem, Israel. sportmed@zahav.net.il.
authors.forename: Yonatan
authors.initials: Y
authors.lastname: Kaplan
authors.affiliation: Oslo Sports Trauma Research Center, Norwegian School of Sport Sciences, Oslo, Norway.
authors.forename: Grethe
authors.initials: G
authors.lastname: Myklebust
authors.affiliation: Department of Orthopedic Surgery, Meir Hospital, Kfar Saba, Israel.
authors.forename: Meir
authors.initials: M
authors.lastname: Nyska
authors.affiliation: Department of Orthopedic Surgery, Meir Hospital, Kfar Saba, Israel.
authors.forename: Ezequiel
authors.initials: E
authors.lastname: Palmanovich
authors.affiliation: Department of Physical Medicine and Orthopaedic Surgery, Ghent University, Ghent, Belgium.
authors.forename: J
authors.initials: J
authors.lastname: Victor
authors.affiliation: Department of Rehabilitation Sciences and Physiotherapy, Ghent University, Ghent, Belgium.
authors.forename: E
authors.initials: E
authors.lastname: Witvrouw
mesh_terms: D000293:Adolescent; D016512:Ankle Injuries / Q000517:prevention & control; D001265:Athletic Injuries / Q000517:prevention & control*; D001915:Braces; D003020:Clothing; D015331:Cohort Studies; D005260:Female; D005538:Football / Q000293:injuries*; D006266:Health Education; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009064:Mouth Protectors; D012008:Recurrence; D013180:Sprains and Strains / Q000517:prevention & control; D055815:Young Adult
keywords: Contact flag football; Intervention; Prevention; Sports injuries