Football

01 Overview

Football, also known as American football or gridiron football, is a team sport that is very physical in nature. Gameplay occurs on a field with a ball and a goal at each end. Being a contact sport, common injuries include injuries to the knee and head.

(see Section 04 - Prevention)
Athlete silhouette
View Common Injuries by clicking the blue dots on the silhouette

Concussions are a common injury among football players, especially among offensive linemen. Environmental factors such as weather and elevation may play a role in the risk of getting a head or face injury. Other important factors include level of play, player position, and protective equipment such as mouthguards.

Knee injuries, including anterior cruciate ligament (ACL) injuries are common in men’s football. Injuries to the knee have been increasing for athletes who play at the college level, often seen among offensive linemen.

Shoulder injuries, especially injuries that affect the acromioclavicular joint (AC) joint at the top of the shoulder, occur frequently at the professional football level. Many of these injuries are sustained on natural grass surfaces when athletes make passing plays.

Hamstring strain is a common injury seen in football practice. This may be due to movements that are made while slowing down too quickly during play.

Although ankle injuries are not the most common type of football injury, they can be prevented by using protective equipment such as lace-up braces. Ankle injuries are more commonly found among offensive linemen. Football players who practice on colder weather days are at an increased risk for ankle injuries.

02 Injury Statistics

Football injuries differ by level of play, player position, and whether an athlete is in a game or practice. Head injuries are common at all levels of play. Athletes who play at the college level are more likely to sustain injuries during competitive games rather than during practice. These injuries are often strains and sprains to the knee and ankle. Professional football players are at a high risk for shoulder injuries, specifically AC joint injuries.

Curious about the research on injuries?

It is estimated that...

03 Risk Factors

Playing surface (turf versus grass) can influence the body part injured, while colder weather may be related to an increase in injuries. The use of equipment such as lace up braces or mouth guards may protect football players from sustaining ankle and head/face injuries.

  • Playing Surface

    For professional players, the overall risk of injury is higher on artificial turf than on grass, however playing on natural grass may put players at risk for shoulder injuries. The risk of lower extremity injuries doubles for football players who have higher versus lower levels of rotation between their footwear and the playing surface.

  • Environmental Factors

    Ankle and head injuries are more common during practices and games played on colder days.

  • Player Position

    Head injuries are most commonly seen among offensive linemen, with quarterbacks being at highest risk for concussion.

  • Protective Equipment

    Lace-up braces are protective against ankle-related injuries among football players; however, they have not been proven effective for other lower extremity injuries. No difference in head injuries among football players has been detected based upon helmet brand.

04 How can I prevent injury?

Some muscle soreness or joint pain is expected when increasing your level of physical activity. It is important to listen to your body for persistent or worsening pain, and to know when to rest. Learn more about how to prevent injuries in football.

  • Participant & Parent

    Talk to your coach or organization about the prevention strategies below and how they might be incorporated into training and policies.

    Managing Concussion

    Concussions are one of the most common injuries in football. It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource for player and parents to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.

    Equipment

    Personal protective devices such as mouthguards and ankle supports can be used to reduce the risk of injury. Lace-up ankle braces have been shown to reduce the incidence of ankle injury in football.

    Helmet fit is an important factor in injury prevention. Consider how the helmet fits to reduce the risk for, and severity of, head injury.

    Strength Training and Neuromuscular Training Programs

    Lower body injuries are common in football. Based on studies done in other sports, the risk of all lower body injuries may be reduced by up to 50% by regularly participating in a balance training exercise program with a resistance-training component. This is also referred to as a neuromuscular training warm-up program. Completing a warm-up program has the ability to lower the chances of common injuries to the ankle and knee.

    ACC SportSmart
    The New Zealand government has supported the creation of a warm-up program based on the FIFA 11+. This program has been shown to reduce injuries in rugby and is useful in preventing injuries in a number of sports. The program has exercises for both the upper and lower body.

    Learn more about ACC SportSmart, which has training videos and other resources.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    Due to the physical demands of football, some athletes sustain shoulder injuries. The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder strong and reduce the risk of shoulder injuries. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent back injuries.

    For more exercises, visit http://fittoplay.org/.

    Other Considerations (about this section)

    Sport-related Physicals
    Football is a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

  • Coach & Teacher

    Talk to your organization or school about the prevention strategies below and how they might be incorporated into training and policies.

    Managing Concussion

    Concussions are one of the most common injuries in football. It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource for coaches and teachers to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.

    Coach Education Programs

    A comprehensive coach education program, such as Heads-Up Football, and guidelines to restrict contact during practices, such as Pop Warner, were shown to decrease the risk of injury during practice.

    Learn more about the Heads-Up Football program.

    Learn more about the Pop Warner program.

    Equipment

    Personal protective devices such as mouthguards and ankle supports can be used to reduce the risk of injury. Lace-up ankle braces have been shown to reduce the incidence of ankle injury in football.

    Helmet fit is an important factor in injury prevention. Consider how the helmet fits to reduce the risk for, and severity of, head injury.

    Strength Training and Neuromuscular Training Warm-up Programs

    Lower body injuries are common in football. Based on studies done in other sports, the risk of all lower body injuries may be reduced by up to 50% by regularly participating in a balance training exercise program with a resistance-training component. This is also referred to as a neuromuscular training warm-up program. Completing a warm-up program has the ability to lower the chances of common injuries to the ankle and knee.

    ACC SportSmart
    The New Zealand government has supported the creation of a warm-up program based on the FIFA 11+. This program has been shown to reduce injuries in rugby and is useful in preventing injuries in a number of sports. The program has exercises for both the upper and lower body.

    Learn more about ACC SportSmart, which has training videos and other resources.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    Due to the physical demands of football, some athletes sustain shoulder injuries. The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder strong and reduce the risk of shoulder injuries. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent back injuries.

    For more exercises, visit http://fittoplay.org/.

    Other Considerations (about this section)

    Sport-related Physicals
    Football is a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

    Facilities
    The Ontario Physical Education Association (OPHEA) provides recommendations for safely implementing flag/touch football in elementary schools.

    Learn more about implementing flag/touch football in elementary schools.

  • Official & Administrator

    Talk to your coaches, teachers, organization, or school about the prevention strategies below and how they might be incorporated into training and policies.

    Managing Concussion

    It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource to learn more about how to recognize, prevent, and manage a concussion. CATT also includes resources on how to respond to a potential concussion situation, as well as detailed Return to School and Return to Sport protocol.

    Coach Education Programs

    A comprehensive coach education program, such as Heads-Up Football, and guidelines to restrict contact during practices, such as Pop Warner, were shown to decrease the risk of injury during practice.

    Learn more about the Heads-Up Football program.

    Learn more about the Pop Warner program.

    Equipment

    Personal protective devices such as mouthguards and ankle supports can be used to reduce the risk of injury. Lace-up ankle braces have been shown to reduce the incidence of ankle injury in football.

    Helmet fit is an important factor in injury prevention. Consider how the helmet fits to reduce the risk for, and severity of, head injury. 

    Strength Training and Neuromuscular Training Warm-up Programs

    Lower body injuries are common in football. Based on studies done in other sports, the risk of all lower body injuries may be reduced by up to 50% by regularly participating in a balance training exercise program with a resistance-training component. This is also referred to as a neuromuscular training warm-up program. Completing a warm-up program has the ability to lower the chances of common injuries to the ankle and knee.

    ACC SportSmart
    The New Zealand government has supported the creation of a warm-up program based on the FIFA 11+. This program has been shown to reduce injuries in rugby and is useful in preventing injuries in a number of sports. The program has exercises for both the upper and lower body.

    Learn more about ACC SportSmart, which has training videos and other resources.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    Due to the physical demands of football, some athletes sustain shoulder injuries. The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder strong and reduce the risk of shoulder injuries. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent back injuries.

    For more exercises, visit http://fittoplay.org/.

    Other Considerations (about this section)

    Sport-related Physicals
    Football is a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce risk of injury. KidsHealth provides information about what sports physicals are, why they may be appropriate and where you may go to get them.

    Learn more about Kids Health Sports Physicals.

    Facilities
    The Ontario Physical Education Association (OPHEA) provides recommendations for safely implementing flag/touch football in elementary schools.

    Learn more about implementing flag/touch football in elementary schools.

  • Health Professional

    The role of health professionals in preventing football injuries has two main components:

    1. Providing ongoing education to players, parents, and coaches on effective injury prevention programs such as balance and resistance training; and
    2. Ensuring that injured players are completely healed and fit-to-perform before returning to football to prevent re-injury or chronic injury.

    Managing Concussion

    It is important to be aware of concussion signs and symptoms and know what to do if concussion is suspected. The Concussion Awareness Training Tool (CATT) is an online resource to learn more about how to diagnose and manage a concussion. CATT also includes resources on how to assess a potential concussion, as well as detailed Return to School and Return to Sport protocol.

    Coach Education Programs

    A comprehensive coach education program, such as Heads-Up Football, and guidelines to restrict contact during practices, such as Pop Warner, were shown to decrease the risk of injury during practice.

    Learn more about the Heads-Up Football program.

    Learn more about the Pop Warner program.

    Equipment

    Personal protective devices such as mouthguards and ankle supports can be used to reduce the risk of injury. Lace-up ankle braces have been shown to reduce the incidence of ankle injury in football.

    Helmet fit is an important factor in injury prevention. Consider how the helmet fits to reduce the risk for, and severity of, head injury.

    Strength Training and Neuromuscular Training Warm-up Programs

    Lower body injuries are common in football. Based on studies done in other sports, the risk of all lower body injuries may be reduced by up to 50% by regularly participating in a balance training exercise program with a resistance-training component. This is also referred to as a neuromuscular training warm-up program. Completing a warm-up program has the ability to lower the chances of common injuries to the ankle and knee.

    ACC SportSmart
    The New Zealand government has supported the creation of a warm-up program based on the FIFA 11+. This program has been shown to reduce injuries in rugby and is useful in preventing injuries in a number of sports. The program has exercises for both the upper and lower body.

    Learn more about ACC SportSmart, which has training videos and other resources.

    Oslo Sport Trauma Research Centre Neuromuscular Training
    Due to the physical demands of football, some athletes sustain shoulder injuries. The Oslo Sport Trauma Research Centre has developed exercises that specifically help keep the shoulder strong and reduce the risk of shoulder injuries. This resource includes videos and PDFs for download.

    Learn more about exercises to help prevent shoulder injuries.

    Learn more about exercises to help prevent back injuries.

    For more exercises, visit http://fittoplay.org/.

    Other Considerations (about this section)

    Sport-related Physicals
    Football is a physically demanding sport and some pre-existing conditions may increase the risk of injury. A sport-related physical evaluation at the beginning of each season ensuring fitness to play can help to reduce risk of injury. The American Academy of Pediatrics provides information about preparticipation physical evaluation.

    Learn more about Preparticipation Physical Evaluation.