Are specific players more likely to be involved in high-magnitude head impacts in youth football?

Youth football attracts approximately 3.5 million participants every year, but concern has recently arisen about the long-term effects of experiencing repetitive head accelerations from a young age due to participation in football. The objective of this study was to quantify total involvement in high-magnitude impacts among individual players in youth football practices. The authors explored the relationship between the total number of high-magnitude accelerations in which players were involved (experienced either by themselves or by other players) during practices and the number of high-magnitude accelerations players experienced. A local cohort of 94 youth football players (mean age 11.9 ± 1.5, mean body mass 50.3 ± 16.4 kg) from 4 different teams were recruited and outfitted with helmet-mounted accelerometer arrays. The teams were followed for one season each for a total of 128 sessions (practices, games, and scrimmages). All players involved in high-magnitude (greater than 40g) head accelerations were subsequently identified through analysis of practice film. Players who experienced more high-magnitude accelerations were more likely to be involved in impacts associated with high-magnitude accelerations in other players. A small subset of 6 players (6%) were collectively involved in 230 (53%) high-magnitude impacts during practice, were involved in but did not experience a high-magnitude acceleration 78 times (21% of the 370 one-sided high-magnitude impacts), and experienced 152 (30%) of the 502 high-magnitude accelerations measured. Quarterbacks/running backs/linebackers were involved in the greatest number of high-magnitude impacts in practice and experienced the greatest number of high-magnitude accelerations. Which team a player was on was an important factor, as one team showed much greater head impact exposure than all others. This study showed that targeting the most impact-prone players for individualized interventions could reduce high-magnitude acceleration exposure for entire teams. These data will help to further quantify elevated head acceleration exposure and enable data-driven interventions that modify exposure for individual players and entire teams.