Head Impact Exposure in Youth Football: Comparing Age- and Weight-Based Levels of Play

Approximately 5,000,000 athletes play organized football in the United States, and youth athletes constitute the largest proportion with similar to 3,500,000 participants. Investigations of head impact exposure (HIE) in youth football have been limited in size and duration. The objective of this study was to evaluate HIE of athletes participating in three age-and weight-based levels of play within a single youth football organization over four seasons. Head impact data were collected using the Head Impact Telemetry (HIT) System. Mixed effects linear models were fitted, and Wald tests were used to assess differences in head accelerations and number of impacts among levels and session type (competitions vs. practices). The three levels studied were levels A (n = 39, age = 10.8 +/- 0.7 years, weight = 97.5 +/- 11.8 lb), B (n = 48, age = 11.9 +/- 0.5 years, weight = 106.1 +/- 13.8 lb), and C (n = 32, age = 13.0 +/- 0.5 years, weight = 126.5 +/- 18.6 lb). A total of 40,538 head impacts were measured. The median/95th percentile linear head acceleration for levels A, B, and C was 19.8/49.4g, 20.6/51.0g, and 22.0/57.9g, respectively. Level C had significantly greater mean linear acceleration than both levels A (p = 0.005) and B (p = 0.02). There were a significantly greater number of impacts per player in a competition than in a practice session for all levels (A, p = 0.0005, B, p = 0.0019, and C, p < 0.0001). Athletes at lower levels experienced a greater percentage of their high magnitude impacts (>= 80g) in practice, whereas those at the highest level experienced a greater percentage of their high magnitude impacts in competition. These data improve our understanding of HIE within youth football and are an important step in making evidence-based decisions to reduce HIE.