Introduction: There has been growing awareness of cognitive impairment in professional contact sport athletes, namely chronic traumatic encephalopathy (CTE) in the National Football League. CTE may be the result of multiple concussions or sub-concussive hits. While data on the professional, collegiate, and high school level exists, data at the youth-football level is scarce. Thus far, the only data available is based on a limited study of 7 youth-football players who were found to have an average of 107 hits per player over the course of a season. (Duma, 2012)

Methods: Accelerometers were installed in the helmets of 22 Pop Warner football players in Chicago and data regarding frequency and magnitude of hits that those players sustained over the course of a truncated season was collected.

Results: Number of players: 22; Average age: 12.7 years-old; Average weight: 129.4 lbs.; Games followed: 6; Practices followed: 5. A total of 504 hits were recorded. Average hits per player through a season was 68.9 (Range: 5-260). The average hits per player in a game was 38.7 (Range 0-150), while the average hits per player in a practice session was 30.2 (Range: 0-110).

Conclusions: The Pop Warner Football league recently passed new regulations in an attempt to reduce the number of hits players sustained during play. In our study, we found fewer hits per player than were reported by Duma et al. This could be related to the regulations or an indication that the true number of impacts per player in youth football is lower than reported. Nevertheless, exposure to sub-concussive impacts certainly occurs even at the level of youth football with potential implication to future development of cognitive impairment, though this could potentially be reduced or minimized through improved regulations in play.

Patient Care: This study will improve our understanding of sub-concussive hits and their relationship to future development of CTE. In particular, it increases the awareness of the large exposure window football players have, often starting at the youth football level.

Learning Objectives: By the conclusion of this session, participants should be able to: 1) understand the curent literature data on frequency of head impacts in youth-league football 2) understand the cumulative burden of head impact in the development of chronic traumatic encephalopathy

References: Daniel RW, Rowson S, Duma SM. Head Impact Exposure in Youth Football. Ann Biomed Eng. 2012 Apr;40(4):976-981.