By Dev Mishra, M.D.?President, Sideline Sports Doc,?Clinical Assistant Professor of Orthopedic Surgery, Stanford University

Key Points:

  • Football kickoffs are the plays most likely to result in serious injury to players
  • The NFL, NCAA, and high school federations recognize this and have taken a number of steps to make kickoffs safer

Yes that?s right, I literally hold my breath on kickoffs when I?m standing on the sidelines. football kickoffFrom a fan?s standpoint there are few plays in football that are as exciting or have the same momentum creating potential. If the return man breaks a big gain, then the receiving team has the edge. If the coverage team pins the returner deep, then they have the advantage. Even at the high school level I?m surprised how many guys love to run down the field and hit somebody on a kickoff.

So why am I holding my breath and why am I surprised that guys want to do this? Because there is no play in football that results in more serious injuries than the kickoff.

A widely referenced study in 2009 highlighted the problem. The study authors evaluated a number of aspects of high school football injuries during the 2005-06 seasons including type of play (e.g. kickoff, punt, routine downs), place on field (e.g. middle of field vs. periphery of field), and time during the game. Injuries were categorized as mild, moderate, severe, and concussion.

During kickoff and punts a greater proportion of severe injuries occurred compared to all other phases of play. Thirty-three percent of injuries occurring during kickoff and punt were severe and 20 percent were concussions. Forty-four percent of the severe injuries were fractures.

The NFL, NCAA, and high school federations have certainly taken notice. No one wants another injury on a kickoff such as the ones sustained by Eric LeGrand or Kevin Everett. The NFL made the three man wedge illegal, limited the run-up distance for tacklers, and moved the kicking spot to the 35 yard line from the 30 yard line. As a result about half of NFL kickoffs are now touchbacks and it appears that injuries on kickoffs are down.

At the high school level several measures have also been enacted into rules designed to improve kickoff safety. First, at least four members of the kicking team must be on each side of the kicker, and, second, other than the kicker, no members of the kicking team may be more than five yards behind the kicking team?s free-kick line. Additionally, if one player is more than five yards behind the restraining line and any other player kicks the ball, it is a penalty. These changes are designed to reduce injuries by balancing the kicking team?s formation and to limit the speed achieved by the tacklers. The changes make a lot of sense to me but we don?t yet have data to prove effectiveness.

There is still a tendency- perpetuated by media coverage- to dwell on the negative aspects of youth sports and especially sports injuries. But from what I can see the NFL down to the youth football leagues are taking positive steps in improving player safety while still trying to preserve the traditions of the game. To be sure there is a long way to go but I am starting to think I might be able to breathe again on kickoffs some time soon.

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