The epidemiology of injuries in American Flag Football (AFF): Initial pilot study results

Abstract

Background: Although AFF is considered a non-tackle sport, many serious contact-type injuries are reported annually worldwide. Neither previous studies have investigated the epidemiology nor the prevention of injuries in this sport. Objective: To examine the epidemiology of sports injuries in the AFF league (AFFL) in Israel. Design: Descriptive epidemiology study. Setting: Sports field, amateur AFFL. Participants: Seven hundred and forty-six amateur male players. Methodology: All time-loss injuries sustained in game sessions were recorded by the off-the-field medical personnel over a one-season period. Detailed phone questionnaires were carried out 7-14 days following the injury. Results: Three hundred and twenty-nine games were played in the 2006/7 season. The number of athlete-exposures was 245,434. Although 70 injuries were reported over this period, 50 detailed questionnaires were fully completed, representing 44 individual players in total. Six of the 70 injuries involved players with multiple injuries. Overall, this represents an injury rate of 0.29 per 1000 athlete-exposures (95% CI: 0.35, 0.22). The estimated incidence per season of a player sustaining an injury is 8.6% (95% CI: 6.5%, 10.5%). All the injuries were traumatic, caused directly by either contact with the ground (22 or 46%) or involving another player (15 or 30%). Fourteen (28%) of the injuries occurred to the hand, 11 (22%) to the knee and 10 (20%) to the head/face. Only 3 (6%) of the players wore any type of protective equipment. Thirty (61%) occurred in the second half of the game. Six (12%) occurred not in accordance with regular game rules. In terms of injury type, 6 (12%) involved concussion-type injuries, 16 (36%) were dislocations, whilst 22 (44%) resulted in haematoma/contusions. Thirty-one (62%) involved the defensive line and receiver player-positions. Thirty-seven (74%) were moderate to severe in nature whilst only 2 (4%) were recurrent in nature. Five (11%) of the players participated in a pre-season conditioning program. Conclusions: These initial pilot study results reflect both the high number of moderate to severe type-injuries in this so-called “non-tackle” sport. Despite the fact that most of the injuries resulted from either direct contact with the ground or another player, very few players used any form of protective equipment. These results have accentuated the urgent need for protective measures to reduce injuries in the AFFL, and have formed the basis of the consecutive 2-season epidemiological study which is currently underway. A randomised controlled injury prevention trial will thereafter be introduced.