Descriptive Epidemiology of Game-Related Youth Flag Football Injuries

J Athl Train. 2023 Nov 1;58(11-12):1004-1009. doi: 10.4085/1062-6050-0427.22.

Abstract

Context: Flag football is promoted as a safer alternative to tackle football. This may be 1 reason why participation rates have risen by 39% over the past 3 years. Despite rising participation, epidemiologic research on sport-specific injuries and associated relative risk is lacking.

Objective: To prospectively document the epidemiology of injuries in youth flag football.

Design: Descriptive epidemiology study.

Setting: Regional and national youth flag football tournaments.

Patients or other participants: Athletes (N = 1939; 1744 boys and 195 girls), ages 6 to 12 years. An athletic trainer prospectively monitored the athletes for sport-related injury and exposures.

Main outcome measure(s): Athlete risks of injury and injury rates were calculated overall and by sex. Injury characteristics were reported for the total population and by sex.

Results: Forty-seven injuries to unique individuals were recorded in 1939 athletes with a total of 9228 athlete-exposures (AEs). The overall risk of injury was 2.4% (95% CI = 1.79%, 3.21%), with an overall injury rate of 5.1 per 1000 AEs (95% CI = 3.75, 6.77). Of the 47 injuries, 36 occurred in boys (8365 AEs), and 11 occurred in girls (863 AEs). A higher risk in girls was evidenced by both the injury risk ratio (2.73; 95% CI = 1.41, 5.30) and injury rate ratio of 2.96 (95% CI = 1.51, 5.82). The most common injury sites were the head/face/neck (n = 15, 31.9%), followed by the ankle/foot (n = 9, 19.1%). The most frequent types of injury were contusion (55.3%), sprain/subluxation (14.9%), and general trauma (10.6%); 74.5% of all injuries resulted from direct impact.

Conclusions: Although the competition injury rate for youth flag football was lower than the values from studies reporting comparable tackle football data, the frequencies by body part, type, and mechanism were similar. Given that most injuries were related to some form of impact and predominantly contusions, adopting minimal protective equipment or padding may reduce the numbers of these injuries.

Keywords: incidence; injury mechanism; injury rate; injury risk; youth injuries; youth sport.

MeSH terms

  • Adolescent
  • Athletes
  • Athletic Injuries* / epidemiology
  • Contusions*
  • Female
  • Football* / injuries
  • Humans
  • Incidence
  • Male
  • Schools
  • Sprains and Strains*
  • United States / epidemiology