Helmetless tackling training reduces head impacts in high school football - Children's National

Football is a beloved sport for many young athletes, but repeated head impacts remain a serious safety concern. A study published in the Journal of Athletic Training and recognized with the 2025 Journal of Athletic Training Outstanding Research Manuscript Award highlights a practical prevention strategy: a structured rugby-informed helmetless tackling and blocking training program that significantly reduces head impacts among high school football players.

In the study, athletes who consistently followed the 12-week Helmetless Tackling Training (HuTT) program experienced 34% to 37% fewer head impacts over the course of a season. Gerard Gioia, PhD, director of the Safe Concussion Outcome, Recovery and Education (SCORE) Program at Children's National, was among the researchers.

Why it matters

"There has been little empirical focus on teaching methods for contact skills in football to reduce head impacts," Dr. Gioia said. "By focusing on how players learn to tackle and block, the research suggests coaches can play a direct role in reducing repetitive head impacts associated with concussion risk and long-term brain health concerns."

Moving the field forward

The three-year study followed 496 varsity and junior varsity football players from high schools across Oahu, Hawaii. Players wore helmets equipped with head-impact sensors that measured both the number and force of impacts throughout the season.

During years two and three, teams implemented HuTT as a season-long progression of 10 helmetless tackling and blocking drills designed to teach proper body positioning and safer contact techniques.

Players who completed at least 60% of the training experienced 34% to 37% fewer head impacts per athletic exposure than teammates who were less consistent. They also accumulated a significantly lower overall head-impact burden, particularly from impacts to the top and sides of the head.

The findings show that consistent coaching and player adherence are essential to achieving meaningful reductions in head-impact exposure.

The patient benefit

The results offer encouraging news for families weighing the benefits of youth sports against concerns about player safety. Evidence-based coaching may provide a practical way to make football safer while preserving its physical, social and developmental benefits.

"With everything we've learned about the cumulative effects of repetitive head impacts in football, the decision for many parents has felt binary - either allow your child to play football and accept the inherent risks or decide not to let them play at all," one parent said. "What I find so exciting about Drs. Gioia and Swartz's research is that it offers a third alternative - continuing to allow kids to enjoy all of the benefits of football while using evidence-based approaches to meaningfully reduce head-impact exposure and prioritize long-term player health. I think that represents an important shift in how we think about youth football."

Dr. Gioia oversees the concussion management program for the Howard County Public School System and plans to implement HuTT across all 13 high schools there, while continuing to evaluate its effectiveness in real-world settings.

Children's National leads the way

Led by Dr. Gioia, the SCORE program has long advanced pediatric concussion care through assessment tools, treatment strategies and return-to-school protocols tailored to children's developmental needs.

This latest work extends that leadership from concussion diagnosis and recovery to prevention. The team's developmental approach recognizes that children learn skills differently at different ages, an important consideration as researchers prepare to study HuTT in younger football players ages 8 to 13.

Future research will examine which physical, behavioral and cognitive characteristics help young athletes learn safer tackling techniques most effectively, with the goal of further reducing head impacts across youth football.

Read the full study, Influence of Adherence to a Helmetless-Tackling and -Blocking Training Intervention on Head-Impact Exposure Rates in Hawaiian High School Football, in the Journal of Athletic Training.