Kickoff, Punting Take a Toll

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SUNDAY, Sept. 6 -- High school football players are most likely to sustain severe injuries during kickoff and punting, a new study suggests.

To determine if there were certain aspects of a football game that were the most dangerous, researchers from Nationwide Children's Hospital in Columbus, Ohio, analyzed data from the 2005-2006 National High School Sports Injury Surveillance Study.

Overall, about 20 percent of football-related injuries were considered severe, according to the study published in the current issue of Research in Sports Medicine.

The number of severe injuries varied, depending on the phase of the game. During kickoff and punt, 33 percent of injuries were severe. Of those, 20 percent were concussions.

Overall, about 44 percent of injuries deemed severe were bone fractures.

Researchers found injuries sustained at the beginning or middle of a game tended to be more severe compared to injuries at the end or during overtime, suggesting that changes of intensity of play throughout a game can impact the risk of severe injury.

About 16 percent of injuries occurred during the beginning of the game, 54 percent occurred during the middle and 30 percent occurred toward the end.

"Not only does the time in competition affect injuries but also the phase of play," said study author Dawn Comstock, principal investigator at the Center for Injury Research and Policy at Nationwide Children's Hospital. "During kickoff and punting, a greater proportion of severe injuries occurred, compared to all other phases of play."

Researchers also looked at how field location, time of competition and phase of play impacted injury severity. About three-quarters of injuries occurred in the middle of the field.

"Although more injuries occurred in the middle of the field, injury severity and diagnosis varied little by field location," Comstock said.