Tackle Techniques and Characteristics Associated With a Concussion in Tackling Players in the National Football League

Background: Concussions remain a major concern in football. A qualitative video review can provide contextual evidence supporting changes in rules and coaching techniques aimed at reducing the risk of players sustaining a concussion.Purpose: To identify tackling techniques and characteristics associated with concussions to the tackling player.Study Design: Case-control study; Level of evidence, 3.Methods: A qualitative review of 51 concussions sustained by tacklers in National Football League (NFL) games between the 2015 and 2019 seasons as well as 96 control tackles was performed using video from multiple perspectives. For each concussive case, 1 to 3 nonconcussive control tackles were matched based on player trajectory and closing speed as determined from on-field player tracking data from Next Gen Stats. Cases and controls were coded for 20 different tackle techniques and characteristics. The data were analyzed using conditional logistic regression models, and the results were expressed as odds ratios (ORs) with 95% confidence intervals (CIs) as well as adjusted and unadjusted P values.Results: Despite attempting to match cases and controls based on closing velocity, closing velocity was significantly associated with the concussion risk in every logistic regression model. Predictors that had the greatest effect on the increased risk of concussions were "tackler leading with helmet" (OR, 5.18 [95% CI, 1.87-14.33]; false discovery rate [FDR]-adjusted P = .0032) and "tackler primary loading" being the helmet as opposed to the shoulder (OR, 4.61 [95% CI, 1.41-15.05]; FDR-adjusted P = .0000). Important factors associated with a reduced concussion risk were the tackler's "head placed on correct side" of the ball carrier (OR, 4.17 [95% CI, 1.58-11.01]; FDR-adjusted P = .0088) and "ball carrier primary loading," with the torso having the lowest risk relative to all other body segments.Conclusion: The less a tackler involved his helmet in a tackle, the lower his risk of sustaining a concussion. This study supports teaching players to place their heads on the correct side of the ball carrier (neither into the ball carrier nor into the path of the ball carrier) when tackling to reduce their risk of a concussion, and players should target the torso of the ball carrier as their primary contact point.