The incidence of catastrophic head injuries in football has remained low since the advent of the modern day football helmet in the early 1970s. The incidence of catastrophic head injuries in football is dramatically higher at the high school level than at the college level. Although the reason for this discrepancy is unclear, an unacceptably high percentage of high school players were playing with residual symptoms from a prior head injury. Coaches, athletes, athletic trainers, and medical personnel need to adhere to the guideline that an athlete with any neurologic symptoms from a head injury should be strongly discouraged from returning to play.
Suggestions for reducing catastrophic injuries in baseball include teaching proper techniques to avoid fielding and baserunning collisions, protecting the pitcher via a combination of screens and/or helmets with faceguards, continued surveillance and modifications of the bat and ball, eliminating headfirst slides, and continued analysis of chest protectors and automatic external defibrillators for commotio cordis.
The total number of quadriplegic events for high school and college football players is approximately 6 per year, with a higher incidence at the college level. Cervical cord neurapraxia can be caused by hyperflexion, hyperextension, and axial compression forces. Upper level cervical injuries involving the atlas and axis can occur in football players and may be associated with noncontiguous subaxial injuries.
Suggestions for reducing catastrophic injuries in cheerleaders include enhancing the number and training of spotters, mandating floor mats for complex stunts, restricting complex stunts when surfaces are wet, and encouraging safety certification of coaches. Pyramids and basket tosses should be limited to experienced cheerleaders who have mastered all other skills and should be performed with spotters and landing mats.
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