The American Academy of Pediatrics (AAP) has issued new recommendations to improve the safety of youth football players around the country. These guidelines come days after high-school football player Andre Smith from Chicago collapsed on the field and died the next day in the hospital. The medical examiner said the 17-year-old’s death was caused by "blunt force head injuries due to football.” 

Smith’s death was the seventh football-related youth death this year. Tackling or being tackled accounted for half of all football injuries among high-school players, according to the AAP. The organization issued several safety guidelines:

  • Officials and coaches must enforce the rules of proper tackling, including zero tolerance for illegal, head-first hits;
  • Players must decide whether the benefits of playing outweigh the risks of possible injury;
  • Non-tackling leagues should be expanded so athletes can choose to participate without the injury risks associated with tackling;
  • Skilled athletic trainers should be available on the sidelines, as evidence shows they can reduce the number of injuries for players.

Head and neck injuries are not the most common injuries, but they tend to be most severe and are often the results of poor or illegal tackling techniques. "There [are] too many head-to-head hits and leading with the head, known as spearing—that's been against the rules since 1976 and for some reason referees and coaches have gotten away from enforcing that rule," said pediatrician and co-author of the guidelines Greg Landry, MD, FAAP. And there is indication that forbidding spearing is effective: The fatality rate has reduced significantly from the ‘60s and ‘70s. In 1968, there were 38 deaths associated with poor tackling techniques alone.


Organizations such as the National Federation of State High School Associations have moved forward with creating their own guidelines for enforcing safe tackling techniques and reducing the amount of contact for players at practice.

Although these guidelines would pave the way for more overall safety, the APP does acknowledge the nature of the game would shift as well. "Removing tackling would dramatically reduce the risk of serious injuries to players, but it would fundamentally change the sport of football," said co-author William Meehan, III, MD, FAAP, a member of the AAP Council on Sports Medicine and Fitness.

Football will always be a violent game to a certain extent, and injuries come with the sport. However, by spreading awareness of safe tackling, we can only help make the game better for all. 


  1. American Academy of Pediatrics: Youth Football Injuries
  2. CBS News: New guidelines for youth football follow injuries, deaths
  3. National Federation of State High School Associations: Recommendations and Guidelines for Minimizing Head Impact Exposure and Concussion Risk in Football
  4. National Federation of State High School Associations: States Adopt Plans to Limit Contact in Football
  5. The University of North Carolina at Chapel Hill: Annual Survey of Football Injury Research