Note: I watch a lot of college football, and I have seen this scenario play out many times in the last few years. I have watched games with friends who literally screamed at the TV screen after one of their team’s players was ejected for a targeting penalty. I am generally a huge advocate for any steps that make sports safer for the athletes. A new study questioned whether the targeting rule was actually preventing concussions or if it produced unintended consequences. I thought it would make an interesting debate for my latest newspaper column.Football game

One team is moving the ball down the field in a tight game. The quarterback throws a pass over the middle of the field to a wide receiver who stretches out to catch it. The safety launches his body at the receiver, knocking him to the ground. A referee throws a flag in the air and calls a targeting penalty. Fans of the penalized team boo loudly. The television commentators spend minutes arguing whether it should be a penalty after watching replays in slow motion from multiple camera angles.

Replays of targeting penalties

In February, the NCAA took steps to address concerns about targeting penalties. After a four-day meeting in Orlando, the NCAA Football Rules Committee decided to allow the instant replay official to review every aspect of a targeting penalty. The replay official could also stop the game if he witnesses an obvious violation missed by officials on the field.

Bob Nielson, the chair of the committee and head coach at the University of South Dakota, believes the rule is working. “The targeting rule is serving the game well, and has enhanced player safety,” Nielson observed in a statement on the NCAA’s website.

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Is the NCAA targeting rule making college football safer?

Fans might criticize these penalties and ask whether they are making the game less appealing to watch. Coaches can debate what actually constitutes a targeting penalty. It’s worth asking a more fundamental question.

Does the targeting rule actually do what it’s supposed to do – protect the health of the players?

What is the targeting rule in college football?

The targeting rule bans an athlete from hitting a defenseless player above the shoulders or delivering the hit with the crown of his helmet. TheEmpty football field in lights NCAA adopted the rule in 2008 to try to decrease head injuries in the sport. Initially a targeting call only produced a 15-yard penalty. In 2013, the NCAA toughened its stance by ejecting the guilty player from the game.

Are football players tackling differently to avoid targeting?

In the season prior to the automatic disqualification of players called for targeting, officials called 99 penalties, or roughly one in every eight games, according to the New York Times. In the first part of the 2013 season, referees called one penalty for every 10 games.

It seems likely that players actually changed their behaviors to avoid the penalty. Instead of aiming for an opponent’s head, the defender might aim lower on the body. Unfortunately, it seems that the change in tackling technique might be creating other problems.

Data on concussions and other injuries with the targeting rule

Robert Westermann, M.D. recently studied injuries before and after the NCAA rules went into effect. He and his colleagues at the University of Iowa analyzed the incidence of both concussions and lower extremity injuries (thigh, leg, ankle and foot) that occurred in 48 NCAA football teams between 2009 and 2014. They presented their findings at the American Orthopaedic Society for Sports Medicine’s Specialty Day.

They found that the rate of lower extremity injuries increased from 9.45 per 1000 athlete-exposures (one practice or one game) in the 2009-2010 season to 12.63 injuries for 1000 athlete-exposures in the 2013-2014 season. A majority of those were knee or ankle injuries, and 59% were caused by player contact.

Worse yet, the rate of concussions did not decrease. In fact, concussions increased slightly over that time. 1.64 concussions occurred for every 1000 athlete-exposures in 2009-2010, but 2.87 concussions per 1000 athlete-exposures occurred in 2013-2014.Football helmet

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Knee and other injuries can lead to long-term disability

“Nearly a third of all concussions in collegiate athletics occur during football,” Dr. Westermann explained in a press release. “With the relatively recent rule changes, concussion rates have not decreased. Our analysis of the NCAA Injury Surveillance Database though noted increased rates of ankle and knee injuries, which may result in osteoarthritis and disability issues later in life for these athletes. Athletes may be making contact lower on the body, to avoid the head-to-head contact and thus stiffer game penalties.”

Westermann is correct that many of these injuries cause long term disability. ACL tears, sprained ankles and broken legs can lead to arthritis and lingering pain as the athletes get older. Time and much more research will tell us if we are truly protecting athletes or just trading one injury with long-term consequences for other ones.

Do you think the targeting rule in football has made the sport safer for its athletes? How can we decrease impacts to the head while preserving the nature of football? Please share your thoughts below!

 Note: A modified version of this article appears as my sports medicine column in the April 14, 2016 issue of The Post and Courier. 


Robert W. Westermann, MD, Peter Wehr, MD, Annunziato Amendola, MD. Unintended Consequences of Concussion Prevention in NCAA Football. 2016 AOSSM Specialty Day Abstracts. Orthopaedic Journal of Sports Medicine. March 2016.

Rise in Lower Extremity Injuries Possible Result of New Concussion Prevention Rules in NCAA Football. American Orthopaedic Society for Sports Medicine. March 5, 2016.

Football Rules Committee approves proposals to enhance player safety. Feb 11, 2016.

Despite Good Intentions, New Targeting Rule Creates Problems. By Greg Bishop. The New York Times. October 7, 2013.

College football’s targeting rule under fire. By Tim Tucker. The Atlanta Journal-Constitution. Oct. 22, 2013.