SIOUX FALLS, S.D. — Fast speed, quick turns and hard hits. It's no secret that football can be a dangerous sport to play.

But while research has focused on the risks and costs for adult athletes, less is known about what it means for kids to strap on shoulder pads, don helmets on their developing brains and hit the gridiron. Now, some new, pathbreaking research is beginning to tackle that question -- and offer clues on what could make the game safer for young athletes.

Sanford Health chronicled the results from a unique set of tests in a study recently published in the journal of the American College of Sports Medicine. From 2012-2019, a Sanford Research team used helmet-mounted impact sensors to track the number and severity of head hits received over eight seasons by a youth football team in Sioux Falls, where the Sanford Health health system is based.

What they found surprised them.

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Over the eight-year period, head impacts dropped 79%. While the study didn't claim to prove what caused the large reduction in head impacts, there were big clues in what did and didn't change for the team over the years of research, said Dr. Thayne Munce, the study's principal investigator.

  • What didn't change: equipment and coaching staff. Researchers used the same set of measuring equipment and the same helmets from year to year, and the team's coaching staff remained the same.
  • What changed: training and the players receiving it. Coaching staff adopted USA Football's Heads Up Football program during the first year of the Sanford Research study, and continued to use it in following years.

"I expected the numbers would decrease, but not to the extent we did," he said.

The takeaway from the research: It's possible to reduce the number of head impacts youth football players take, and it seems that changing how players are trained and coached might be an effective way of doing so.

"That suggests there are some things that are changing in the game for the better, regarding coaching education and awareness, instruction, teaching," Munce said. "And the way the kids are playing the game seems to actually be changing and is different now than it was even 10 years ago."

Munce picked who to study based on having a unique in with the team, South Dakota Junior Football: he was a one-time player, under the current coach.

Sanford Health researchers mounted sensors in the helmets of of youth football team in South Dakota over eight years to measure head impacts in real time. (Submitted / Sanford Health)
Sanford Health researchers mounted sensors in the helmets of of youth football team in South Dakota over eight years to measure head impacts in real time. (Submitted / Sanford Health)

"I had that personal relationship, (and) Sanford Health has worked very closely with South Dakota Junior Football for a number of years," he said. "That allowed them to say, 'Yeah, you can come in and do some research,' which not a lot of leagues are open to, particularly in a sport like football, because you might be a little concerned about what the research might find."

The helmet-mounted sensors include six accelerometers embedded in the padding of a football helmet. Every time the helmet accelerates or decelerates, that's tracked in real time on the sideline, with data kept coded and hence confidential.


"Very remarkable changes, very real changes we've seen."

- Dr. Thayne Munce


"So when they get hit in the head, within a couple of seconds, we get a signal on our laptop which shows us which player received an impact, where that impact occurred on that player's head and what the magnitude of that impact is," Munce said.

Initially Munce and his team didn't even know how often youth players got hit in the head. What they found early on, is on average, players were getting hit in the head about 10 times per practice and 16 times per game, or about 260-275 impacts a season.

Sanford Health researchers on the sidelines of football fields used real-time monitoring equipment, including helmet-mounted sensors, to measure the head impacts taken by a South Dakota youth football team over eight years. (Submitted / Sanford Health)
Sanford Health researchers on the sidelines of football fields used real-time monitoring equipment, including helmet-mounted sensors, to measure the head impacts taken by a South Dakota youth football team over eight years. (Submitted / Sanford Health)

But over the years -- as new training was regularly implemented -- those numbers began to drop, and drop fast. Now a player gets two hits per practice and five impacts per game.

'Very remarkable changes, very real changes we've seen,' he said.

Munce tips his hat to the Heads Up Football training, which largely centers on teaching players how to tackle in ways that avoid head impacts, for providing the catalyst for the reduction in impacts he tracked over the years.

"I'm just really glad through research like ours that we can help evaluate what's taken place in the game and help provide course corrections if necessary and help inform," he said. "Our goal is to provide evidence to help inform decisions and guidelines that people would make. That's where our role as researchers fall into all this."

USA Football is aware of the study and its conclusions, said Steve Alic, a spokesman for the program, the governing body of amateur football in the US.

"It is encouraging that these findings appear to support the point that coach education changes behavior for the better – that’s a win for youth football athletes and their families," he said.

The Heads Up Football program is now part of USA Football's Football Development Model, which helps coaches teach players based on their age, the skill they're learning, and the way they're playing the game, Alic said. About 100,000 coaches get certified under USA Football’s nationally accredited coach certification by the start of each season.

Earlier this year, USA Football released recommendations for youth football play, aligned with its development model, that is backed by broad support from a number of sports medicine and youth sports professional organizations, Alic said.

For more details: Read the study, “Head Impact Exposure of a Youth Football Team over Eight Consecutive Seasons,” online in "Medicine & Science in Sports & Exercise," the official journal of the American College of Sports Medicine.