Hawaiian High School Football Player Positional Differences in Helmet Impact Characteristics.

Context: The importance of analyzing head impact exposure among football players is well established, yet few studies have explored the differences across position groups in high school athletes. Better understanding of these differences may provide optimized intervention strategies for coaches and healthcare providers.

Objective: To quantify the difference of head impacts per exposure (Imp/E) and impact burden high school football player position groups.

Design: Prospective observational.

Setting: High school athletic fields during Fall sports seasons.

Patients and participants: 200 football players from three high school varsity teams including 69 offensive/defensive linemen, 51 linebackers/running backs/tight ends and 80 cornerbacks/safeties/wide receivers (16.1±0.9yrs, 177.9±7.8cm, 86.4±22.7) categorized as linemen, backers, and skills players respectively.

Main outcome measures: Imp/E across positions, teams, session type, and seasons. Cumulative head impact burden per location (front, top, right, left, back) across position groups.

Results: Significant differences in Imp/E were found between position groups (P<0.001), where the backers group, (3.77[95% CI: 3.146, 4.395]) experienced higher total Imp/E compared to linemen (1.47[ 95% CI: 0.983, 1.96]) and skill players (1.56[95% CI: 1.11, 2.01]). Total accumulated burden of head impacts was significant (F(2,194) = 4.938, P<0.008), with backers (4622.85g's [95% CI: 3077.43, 6168.27]) significantly (P=0.011) higher than linemen (2657.70g's [95% CI: 2045.61, 3269.19 ]) and skill players (2875.7g's [95% CI: 2216.38, 3535.01]) (P=0.022). Front location impact burden (F(2, 194) = 7.784, P<0.001) revealed backers (1606.24g's [95% CI: 977.89, 2234.58]) also significantly (P=0.008) higher than both linemen (768.24g's [95% CI: 433.84, 1102.64]) and skill players (567.75g's [95% CI: 360.71, 774.78]) (P<0.001).

Conclusion: Linebackers, tight ends, and running backs experienced more Imp/E and higher cumulative burden than other positions, which highlights the potential influence of specific positional requirements during football participation. Coaches and healthcare providers should be aware that a position's role during play may directly relate to changes in head impact risk.