Flag Football Injuries and How to Treat (and Avoid) Them


Brian C. Halpern, MD

Brian C. Halpern, MD

Chief of the Primary Care Sports Medicine Service, Hospital for Special Surgery
Associate Attending Physician, Hospital for Special Surgery
Clinical Associate Professor in Medicine, Weill Cornell Medical College
Professor, Department of Academic Orthopedic Surgery, NY College of Podiatric Medicine

The popularity of flag football continues to grow. All that is required are two teams, a field, and some equipment.

Flag football has long been very popular in the armed forces of the United States, with the Air Force even completing a 10-year descriptive study of flag football injuries from 1993-2002. They found that the leading cause of injury was due to contact with another player, which caused 42% of their reported injuries. The second leading group of issues included slips, trips, and falls, resulting simply from the act of running during the game. There were even some reported concussions.

Fifty percent of the injuries were to the lower extremities, such as the legs, knees, and ankles. All of these injuries were recorded only if they resulted in at least one day lost from work. Fractures accounted for the greatest percentage of these disabling injuries, followed by sprains and strains.

One of the typical injury patterns results in a knee ligament sprain. These can be mild, moderate, or severe, depending on the degree of ligament tear and other associated tissue damage. Treatment begins with RICE: rest, ice, compression, and elevation. Begin weight bearing as tolerated (putting weight on the area) and arrange a visit to a physician if there is evidence of swelling and/or difficulty with mobility. Sometimes an early return to participation is available with the use of appropriate bracing.

The approach to ankle and other joint sprains is similar, with RICE treatment and medical evaluation for more severe injuries with the possibility of fracture or dislocation.

One specific injury to the shoulder is the AC (acromioclavicular) separation, known simply as a shoulder separation. The athlete experiences pain and swelling at the collarbone, along with possible evidence of a bump. It can be difficult to move the arm as well and early evaluation by a physician is recommended. Ice and limiting arm and shoulder motion are helpful as first aid measures.

The different injury types are numerous and prevention should be a primary goal. Begin a preseason conditioning program that includes stretching, strengthening, and cardiovascular conditioning. Other more specific measures, as outlined in the U.S. Air Force study, include implementing and enforcing rules to minimize contact; training to improve balance; improving the playing field conditions; and, if necessary, protecting previously injured areas with bracing,.
 
Above all, flag football should be fun, and participation is the best reward.

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