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The Prevention of Injuries in American Flag Football

The Prevention of Injuries in American Flag Football

Yonatan Kaplan, PhD, MSc(Med), BSc(Physio), ISRAEL Grethe Myklebust, NORWAY Meir Nyska, MD, Prof., ISRAEL Ezequiel Palmanovich, MD, ISRAEL Jan M. K. Victor, MD, PhD, BELGIUM Erik Witvrouw, PT, PhD, BELGIUM

Jerusalem Sports Medicine Institute, Lerner Sports, Jerusalem, ISRAEL

2013 Congress   Paper Abstract   2013 Congress   Not yet rated


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Summary: Implementation of the prevention program significantly reduced the incidence rate of injuries.


American flag football (AFF) is a non-tackle, contact sport. Many moderate-severe contact-type injuries have been reported. In the 2007-9 playing seasons, the authors conducted a two-season prospective injury surveillance study (historical cohort). This study revealed a high incidence of injuries to the fingers (caught in the opposing player's pockets), face, knee, shoulder and ankle. The objective of this study was to introduce a one-season, injury prevention program in an attempt to significantly reduce the incidence and the severity of sports-related injuries in AFF, as compared to a historical cohort.


A prospective injury prevention study was conducted in Kraft Stadium, Jerusalem, Israel. There were 724 amateur male (mean ± SD age, 20.00 ± 3.05 yrs) and 114 female (mean ± SD age, 21.20 ± 7.23 yrs) players. Four prevention measures were implemented: The no-pocket rule, self-fitting mouth guards, ankle braces (for those players with recurrent ankle sprains) and an injury treatment information brochure. An injury surveillance questionnaire was administered to record all time-loss injuries sustained in game sessions.


The two-tailed t-test, as well as the Levene's test for equality of variances, showed a highly statistically significant reduction in the number of finger injuries, and ankle sprains (p<0.01). There was no statistically significant difference in the severity of injuries. The rate of compliance with the intervention methods ranged from between 40-60%.


Implementation of the prevention program significantly reduced the incidence rate of injuries. Further development of prevention strategies is needed. This should involve the strict enforcement of the no-pocket rule, appropriate head gear, self-fitting mouth guards, the use of ankle braces and changing the blocking rules of the game.