Lifting the lid on American football equipment: understanding current knowledge and safe practise of equipment use in British American Football

Purpose
Primary aims of the study were to (i) assess the current equipment usage amongst American football (AF) players in the UK, (ii) evaluate the knowledge, adherence and practise to correct helmet fit guidelines, and (iii) explore AF player attitudes towards the use of protective safety equipment for injury prevention.

Methods
Cross-sectional study design. One hundred and sixty-eight British AF athletes participated in the online survey. Data were collected on current equipment usage, including practise related to reconditioning of equipment. Questions to assess knowledge, behaviour and perception of importance were designed using the 13-criteria checklist used for helmet fit assessment. Questions related to safety of helmet use and attitude towards equipment were asked on a 5-point scale.

Results
Knowledge of safe helmet fit was generally good. The most common knowledge question correctly identified by all participants was ‘The helmet should fit the head snugly on all sides’; however, attitude to use of equipment and long-term health was not reflective of this knowledge. Nineteen percent of athletes reported that wearing equipment allowed them to play, whilst injured and 31% of players felt fearless when wearing full AF equipment.

Conclusion
Despite good knowledge related to helmet safety, attitude to equipment and long-term health was poor. Research shows that the wearing of and choice of equipment is of upmost importance; however, our findings suggest that players attitude to its use could impact its effectiveness. The authors recommend that the national governing body seeks to educate players on equipment use and conditioning to ensure safe play.