Author(s): HAN, K., DIAZ, K., Institution: CALIFORNIA STATE UNIVERSITY, NORTHRIDGE, Country: UNITED STATES, Abstract-ID: 123

INTRODUCTION:
Concussions are a significant health risk in high school American football, given their potential to cause both immediate and long-term neurological impairments. As awareness of concussion risks increases, there is a pressing need to develop and implement effective prevention strategies to safeguard young athletes. The neck plays a crucial role in stabilizing the head during impacts, and emerging research suggests that strengthening neck muscles may reduce the risk of concussion by limiting excessive head movement during collisions [1,2,3]. This study investigates the effect of neck strengthening exercises on concussion incidence among high school American football athletes over the 2022-2024 seasons. The primary objective is to determine whether incorporating neck exercises can reduce concussion rates, thereby supporting their integration into high school football training programs.
METHODS:
Certified Athletic Trainers (ATCs) affiliated with a California State University campus were recruited. Inclusion criteria required ATCs to be 25-65 years old, have 3 years of concussion data (covering the 2022-2024 seasons), and work with a high school American football team. Data were collected via a Qualtrics XM survey reporting physician-confirmed concussions, athlete numbers, athletic exposures (scrimmages, practices, games), and use of neck strengthening exercises during the 2022-2024 seasons; athletes with recent or ongoing concussion symptoms were excluded. One school served as a control without neck exercises, while 3 schools implemented neck training using weighted cervical movements, resistance-based exercises, or Iron Neck equipment with school-specific protocols.
RESULTS:
Schools implementing neck strengthening programs reported consistently lower concussion rates compared with the school without neck exercises across the 2022-2024 seasons. In 2022, concussion rates ranged from 2.9-4.0% at schools with neck exercises versus 14.2% at the control school. Similar trends were observed in 2023 (1.9-5.8% vs. 15.0%) and 2024 (2.6-8.3% vs. 14.2%). Concussion incidences included scrimmages, games, and practices, consistently lower at schools with neck exercise programs.
CONCLUSION:
Preliminary findings suggest that neck strengthening exercises may contribute to reduced concussion rates in high school American football athletes. However, variability across schools and potential confounding factors such as protective gear, exercise type, athlete conditioning, and coaching style, warrant cautions interpretation. Larger, controlled studies incorporating standardized neck interventions and objective neck strength assessments are needed to clarify the role of neck strengthening in concussion prevention.

References
1) Eckner et al, AM J Phys Med Rehabil, 2018.
2) Felix et al, J Sci Med Sport, 2024.
3) Whittaker et al, J Orthop Sports Phys Ther, 2023.