National Athletic Trainers' Association (NATA) Issues Position Statement on Seriouis Risks Associated with Head-Down Contact and Spearing in Tackle Football

Statement Offers Guidelines That Decrease Risk of Cervical Spine Fractures and Dislocations in High School and College Football Players

DALLAS, August 9 – Summer is not even halfway over, and already high school and college football players are gearing up for the 2004 fall football season. With practice getting underway, the National Athletic Trainers’ Association (NATA) has issued a timely position statement to enlighten coaches, players and officials alike on the seriousness of head-down contact and spearing – dangerous techniques which can lead to catastrophic cervical spine injuries (CSIs). CSIs, resulting in quadriplegia (paralysis of all four extremities), are among the most devastating injuries to sustain. In football, the primary cause is axial loading, which can occur if a player accidentally initiates contact with the top of his football helmet (head-down contact), or intentionally uses the head-down contact technique (spearing). CSIs occur most often to defensive players, but ball carriers and blockers risk paralysis, as well, by lowering their heads at contact. The NATA, a not-for-profit organization representing and supporting 30,000 members of the athletic training profession, published the position paper in its Journal of Athletic Training, which can be seen in its entirety at . Lead author Jonathan F. Heck, MS, ATC, along with Kenneth S. Clarke, PhD, Thomas R. Peterson, MD, Joseph S. Torg, MD and Michael P Weis, PT, ATC spent three years researching, interpreting and writing the statement. Their objective was to present scientifically-proven concepts and recommendations to sports medicine professionals, certified athletic trainers (ATCs), coaches, players, officials and administrators who work with young athletes to help prevent such serious injuries. In 1976, the National Collegiate Athletic Association (NCAA) and the National Federation of State High School Associations (NFSHSA) changed their football rules to broaden the concept of spearing to include any deliberate use of the helmet as the initial point of contact against an opponent, thus making it illegal. In the first year after the rule change, the number of football injuries resulting in quadriplegia in high school and college players decreased by 53 percent. By 1984, the number dropped by 87 percent. “Such rules, plus improved coaching techniques, have been extremely effective,” says Heck. “However, head-down contact still occurs frequently. Among the reasons: the helmet-contact penalties are often not enforced adequately.” Film review has revealed roughly 40 head-down contacts per game during a high school season. In 2001, there were 20.837 penalties called in NCAA Division 1 football, of those, only 25 were helmet-contact penalties. Surveys of football officials have revealed they may not have a uniform understanding of the helmet-contact penalties. The NATA position statement presents a series of recommendations on everything from what the safest football contact position is, to what sports officials need to enforce. Among the highlights:

  • When initiating contact with their opponents, football players should use their shoulders or chests while keeping their heads up. This is the safest contact position because it allows the athletes to see when and how the impact will occur.
  • Correct contact techniques should be taught to football players at the earliest organized level (e.g., Pop Warner, Midget and Pee Wee football leagues).
  • Formal team educational sessions should be held at least twice per season; once before contact begins and once midway. Parents of high school players should be invited to first session.
  • Coaches need to teach, demonstrate and practice the shoulder/chest technique throughout the season to all their position players.
  • A football player’s technique must be corrected anytime he is observed lowering his head at contact.
  • Weekly film reviews of games should be used to illustrate proper head positions.
  • Showing football players Prevent Paralysis: Don’t Hit With Your Head (, See What You Hit ( or other educational videos that deal with catastrophic CSIs should be mandatory.
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