AAP-endorsed guidance calls for fewer live contact practices in college football

College football teams should reduce the number of live contact practices year-round and provide contact-free recovery days every week, according to updated AAP-endorsed recommendations from the Sport Science Institute of the National Collegiate Athletic Association (NCAA), the organization that governs college sports.

Updated from 2014, the recommendations are designed to decrease concussions and repetitive head impact exposure during practice. They are based on consensus of NCAA members who attended a 2016 safety summit, including representatives from medical associations, football organizations and other groups in collegiate athletics.

The recommendations address practice for pre-season, inseason, postseason and spring. The document, Year-Round Football Practice Contact for College Student-Athletes — Recommendations, is available at http://on.ncaa.com/2ixDArU and is being released to administrators, health care professionals in athletics, and commissioners at NCAA-member schools and conference offices.

Highlights of the recommendations include the following:

• Preseason: Reduce live contact practices (defined as any practice that involves live tackling to the ground and/or live or full-speed blocking) from four to no more than three days a week. Hold a minimum of three noncontact/minimal contact practices in a given week, with one following a scrimmage. Discontinue twice-daily practices. Add a day off from practice during the week. Coaches may start the preseason period a week earlier to help compensate for lost practice time.
• Inseason: Hold three days of noncontact/minimal contact practices a week. There can be one day of live contact/tackling (instead of the two days allowed under previous guidance) and another day of live contact/thud. Thud refers to a drill where players wearing helmets and shoulder pads hit each other but stay on their feet.
• Postseason: If there are more than two weeks between the final regular season or conference championship game and a bowl or postseason game, allow up to three practices a week of live contact (including two thud). Add three days of noncontact/minimal contact practices a week, ensuring the day before and after live contact practices are noncontact/minimal contact.
• Spring season: Hold a noncontact/minimal contact practice every day after a live scrimmage.

Previous guidance did not differentiate postseason/bowl practice and inseason practice.

The NCAA recommendation to limit full contact practices is in agreement with the 2015 AAP policy Tackling in Youth Football (http://bit.ly/2ikEUyw) from the Council on Sports Medicine and Fitness.

William P. Meehan III, M.D., FAAP, a lead author of the policy, represented the Academy at the NCAA safety summit. He said he welcomes efforts to decrease the risk of trauma to the head during football.

“These regulations should translate to a decreased incidence of concussion and limit any potential effects of repetitive subconcussive blows to the head,” said Dr. Meehan, director of the Micheli Center for Sports Injury Prevention, Division of Sports Medicine at Boston Children's Hospital. “I am also encouraged by the fact that the NCAA based their recommendations on available evidence and involved many experts in their process.”

Pediatricians who care for collegiate athletes should be familiar with the changes to ensure they are being followed, especially if they serve as team physicians at NCAA colleges, Dr. Meehan noted.

“I hope these recommendations (also) lead to changes in other leagues for younger players, and lead to a reduction in the number of contact practices and drills that emphasize contact,” he said. “Pediatricians who advise leagues, serve as team physicians or care for athletes could influence this process.”

In addition to the Academy, 14 medical organizations endorsed the document, with one issuing an “affirmation of value.” Five football organizations endorsed the guidance.