An Analysis Football's
By JonHeck,Mt A.T.,C., ATR.,Stockton StateUniversity
Thecervical spineiniury resulting contactwith the facemaskfrom their have occurred each year.
in paralysis is one of the most spearing rule. However,on the high Following this premise, the
injuriesin all of sports.
devastating It school level initiating contactwith reduction in cervical spine injuries
has a tremendousimpact on the any part of the helmet(includingthe could be accomplishedin two rvavs.
athlete and his family through face mask) is illegal (8). The 1976rule Officials enforcing the spearing rule
astronomicalmedical costs,dramatic change has caused a dramatic during football games and coaches
lifestyle changes, and a lifetime of reduction in the number of teaching and practicing correct
dependenry on others. Becausethe quadriplegic injuries occurring each contacttechniqueswith players. The
paralysis is permanent and year. In high school football it has effectiveness of the spearing rule
rehabilitation limited, prevention of gone from a high of 25 cases of would therefore depend heavily on
the cervical spine injury is the only paralysis in 1976 to a low of four in officials and coaches.
acceptable managementplan. 1984, which represents an 82Ea
Torg et al (5-11) have identified decrease(Z). Since 1981the number EFFECTIVENESSOF THE RULE
the mechanism of cervical spine of occurrences remained constant
has Has the spearing rule been a-.
injury (fracture, dislocation, betweenfour and nine per vear. effective as possible? Although the
subluxation) and subsequent spinal The number of cervical spine level of injury reduction i:
cord damage in football as axial fractures,/ dislocations without impressive, I believe the ans$'er t;
loading. Axial loading occurs when quadriplegia occurring each year are no. In reality officials have ntt
an athlete flexes his neck to 30 equally important because spinal enforced the spearing rulcs. In a
degreesand makes contact with the cord iniury is secondaryto cervical study I did of a New Jerseyfootbali
top or crown of his helmet. This vertebra damage. Each incident of team's 1989seasonofficials called no
position eliminates the cervical fracture/ dislocationhasthe potential spearing penalties (1). During ttu;
spine's normal force handling for quadriplegia. The rule change seasonvia game films I observed239
abilities and transfers the impact has also reduced this number since incidents of spearing.I believe this r'
directly to the cervical vertebrae. 1976,although not as successfully the norm for enforcement of the
Through the study of game films as quadriplegia. It has reduced spearing rule rather than the
of actual iniuries Torg found spearing Fracture,/dislocationsfrom a high of excePuon.
to be the causeof theseaxial loading 86 i^ 7976 to a low of 22 in 1987, The spearing rule is the single
injuries. Spearing is defined as a which representsa 707oreduction (7). most important rule in football in
player lowering his head and making It should be noted the number of terms of consequences (paralysis)and
contact using the top or crown fracture/ dislocations are not yet is probably the least enforced.
portion of his helmet. In this necessarily an indicator of the One explanation may be officials d..
situation upon impact, the athlete's incidents of quadriplegia. For not understand the importance of the
head stops while his body continues example, in 1987 there were 22 rule and spearing'srelationship tr
to move forward crushing the fracture/ dislocations and seven catastrophicspine injuries.
cervical spine between the two. This casesof quadriplegia, while in 1984 Another explanation is the
will only occur if the athletes neck there were 36 fracture/ dislocations spearing rule is the only rulc :n
position transfersthe impact directly and only four casesof quadriplegia. football that penalizesa player for hi;
to the cervical vertebraewith enough The data Torg has collected own protection. The vast majoritv oi
force to causethe vertebraeto fail. It indicates the spearing rule has been football infractionsprotect one plaver
is important to note in none of Torg's very successful. The data does not from the actionsof another (clip, face
analysis has hyperflexion or indicate why the spearing rule has mask, etc.). Football adoptcd the
hyperextension been a cause of a been effective. The most logical spearingrule to deter and protect th.--
cataskophic neck injury resulting in explanation is the spearing rule player who spears. Its prima^'
paralysis. Spearinghas beenthe only decreased the number of fracture/ function is not to protect the player
identified cause. dislocations by reducing the getting speared. It is the onl)'
Basedon this information in 1926 incidence of spearing. A decreasein penalty in football that protects a
collegeand high schoolfootball made the incidence of the iniury player from himself.
spearinga rule infraction resulting in mechanism would explain the I believeofficials have focusedon
a 15yard penalty or ejection. College decrease in cervical fracture/ protecting the player who receivesa
football chose to exclude initiating dislocations that spear,which is a misinterpretation of
The Sideline\ Vol 9, No.2, Spring 93
the rule. The spearthat is a late hit
or the sp€ar of a player who is
already down represents this
situation. In my experience officials
havenot enforcedthe rule during the
tackling processwhen most cervical
spine iniuries have occurred.
Officials havenot usedtheir flag asa
deterrent to head first contact
What hascausedthe reductionin
cervical spine injuries? I believe it
has beenthe efforts of coaching
staffs and athletic trainersto educate
and teach athletes (1,31,10).
Educating them that spearing is a
mechanism of paralysis, Teadring
them proper contacttechniques. number. Being tackled was also progr€ssion should be from elow
It is safe to state these efforts the activity associatedwith seven walk through skills to full- speed
have stopped most athletes from casesof quadriplegia between 192 contact. The coachesshould focus
purposefullymakint contactwith the and 1!)87(4). each drill or session solely on
top of theil heknets. I believe this The point is eachtime any athlete keeping the head up and initiating
removal of intent has been the spears he increases the risk of contact with the shoulder, The
major factor in the successof the quadriplegia (1). If the above techniquehas to be drilled tn game
spearingrule. This is not to imply spearing rate is representative of like situations. They also should
spearinghas beenremoved from the other high sdrools then there is a include types of collisions Torg Q)
8ame. significant amount of spearing that identified with quadriplegia. Two
can be eliminated. These numbers athletes colliding while moving in
FI,JRTHERREDUCING THE RISK indicate football needs to recognize oppositedirections and athletes
dl types of spearing (ball carriers, meetingat an obliqueangle. Coaches
Can the risk of catastrophicspine blockers,and tacklers). and atNetic trainerr
injuries be rcduced further? Is it Inittating contact with the should design drtlls for ball carriers,
possible to lower the 30% of shoulder while keeping the neck in blockers,and tacklers.
fracture/ extension is the safegt contact Officials also can aid in lowering
dislocations 207o quadriplegias
and of position (1,2). By the incidenceof spearing. They can
that have remained each year? Or observinggamefilms I found tacklers begin by enforcingthe spearingrule
are these iniury levels part of the and ball carriers often were in the during games. They also should
inherent risk of a collision sport. I correct position but dropped their acknowledgespearingduring
believe severalthings can be done headsjust before contact. Thb may the tackling procEsswhen it most
that will further reduce the risk of not
dernonstrate purposeful but often occurs, The flag should be
catastrophicneck injuries. unintentional spearing by ball thrown on the player who spearsto
Spea.ring an inherent risk of carriers and tacklers. I believe this protect the player who spears.These
quadriplegia(12).Sincetacklershave showsa need for more practicetime players should include ball carriers,
accountedfor the maprity of to perfect proper technique during and
blockers, tacklers. Cewicalspine
catastrophic neck injuries (5,6,10) the crucial instant of contact. Each fractures/ dislocations do not
they have been the focus of has
pLayer to overcome instinct of
the discriminateby position.
preventive techniques(1). This has protecting his eyes and face by Officials enforcing the spearing
allowed the techniques of other lowering his head at contact. rule will deter playersfrom spearing
positionalplayersto go urmoticed. I Coaches should spend added and serveas an incentivefor coaches
found ball carriersspeared one of
on time on clrrect contact technique. to spendmore time pr€ventingit. A
every five plays or 20Eo the plays
of They should follow a regimented 15 yard penalty is a real, immediate
p€r game(1I For such a dangerous schedulethat spreads sessionsover result of a spearthat a coachcan see.
techniquethis is a surprisingly high the entire season (1), The Continuat on ?agc 75
Th. Sirt lij',.'., Vol 9, No2, Sltittg 9i
It becomes more than .56 6. Torg JS. The Epidemiologic, lnjuries Resulting lrom Tackle
quadriplegias per 100,000 atNetes. Biomechanical, Cinemalographic
and Football. Am Coll HealthAssoc.
It now affects the outcome of each Induced
of Cervical 1977i25i224-266.
and every game. Spine Trauma. Athletic Trainino.
To further reduce the risk of JNATA. 25:
1990; 147-159. 10. Torg JS, Sennett VegsoJJ.
catastrophic spine iniuries officials SpinalInjury the Thirdand Fourth
must enforce the spearing rule on a 7. T o rg J S . E p id e mio lo g y , Vertebrae
level with the clip, face mask, or Pathomechanics, Prevention
and ol Axial Loading Mechanism: An
hold. Coachesmust spend adequate FootbalFinducedCervicalSDineCord Analysis and Classificalion. Clin
time drilling correctcontacttechnique Trauma.ExercSpgll Sci Rev.1992; SportsMed.1987; 159-185.
in game like situations throughout 20:321-338.
the season. Officials, coaches and 11. TorgJS,Vegso Sennet The
athletic trainers must realize spearing Paralysis:
8. TorgJS. Prevenl Don't National Football Head and Neck
is potentially dangerous to ball Hit with Your Head (video).Penn lnjuryRegistry: yea( Reporlon
carriers. blockers, and tacklers. Sports Medicine-NFSHSA-Riddell; CervicalQuadriplegia.Clin Sports
When these things are accomplished 1992. Med.1987; 61-72.
the spearing rule will take a huge
step toward maximum effectiveness. 9. Torg JS, Ouedenfeld Moyer
TC, 12. WatkinsRG. Neck Injuriesin
RA,TruexR, Spealman Nichols
AD, Foolball Clln Sports Med.
CE. Severe CatastroDhic 5:
1. Heck JF. The Incidence ol
ol Athletic Traininq. 1992;27: DAVID And CHARLES LEVINSON
120-124. MEDICAL SPECIALTIES INC.
2. HodgsonVR, ThomasLM. Play
Natl Fed News. Speeialists in
2: . P hy sical Ther apy Equipm,ent
3. MuellerFO, BlythCS. Fatalities
and SpineInjuries * Ultrasound. *
Occurring in Tackle Football: 40 * Muscle Stimulators x
x Whirlpools x
* Hydrocollators *
4. MuellerFO, BlythCS, CantuRC. * Cold. Po,chs*
Catastrophic Spine Injuries in
Football.Phvs SEIWSL Oclober
1989;17:51-53. RD #1, Box 189
5 . To r g JS. E pidemiology,
to Spine. 1-800-542-0064
Med Sci Soorts Exerc. 1985;17:
The Sidelind, VoI 9, No.2, Spring 93