NATA Position Statement Review Part 3: Reducing Intentional Head-First Contact Behavior in American Football Players

For athletic trainers and athletic training students preparing for the BOC exam, being well-versed in the National Athletic Trainers’ Association (NATA) Position Statements is not optional—it’s essential. These documents serve as authoritative, evidence-based guidelines that shape clinical practice, inform injury prevention strategies, and guide ethical decision-making across all levels of sport. For the BOC exam, understanding these statements not only demonstrates clinical competence but also signals that a practitioner is prepared to deliver the highest standard of care. The information found in the Position Statements are very common BOC exam questions! In part 3 of our Position Statement series, we’re covering the NATA Position Statement: Reducing Intentional Head-First Contact Behavior in American Football Players.

This particular position statement addresses a persistent and dangerous issue in football—using the head to initiate contact during play. Despite decades of rules against “spearing” and other unsafe techniques, head-first contact remains prevalent and is directly linked to catastrophic cervical spine injuries, concussions, and long-term neurocognitive disorders such as CTE (chronic traumatic encephalopathy).

Key Recommendations of the NATA Statement

The position statement outlines 14 targeted recommendations grouped into four main areas:

1. Education and Administration

• Educate players, coaches, officials, and parents on the risks of head-first contact.
  
• Mandate documented training for coaches and regular communication with all stakeholders, especially when working with minors.
  
• Encourage multidisciplinary collaboration to implement and evaluate head safety strategies.
  

2. Skill Development and Behavior Modification

• Introduce progressive, evidence-based techniques for tackling and blocking that discourage head-first behavior.
  
• Emphasize teaching until mastery and continuously reinforce correct form, particularly in young and first-time players.
  

3. Rules and Regulations

• Limit full-contact practices and modify or eliminate drills that promote unsafe contact.
  
• Consistently enforce rules and penalties related to targeting, spearing, and unsafe blocking techniques.
  

4. Technology and Scientific Research

• Warn against over-reliance on helmet technologies or untested aftermarket products.
  
• Encourage the use of validated head-impact monitoring systems and video analysis for behavior tracking—not as diagnostic tools.
  
• Promote ongoing research and stakeholder engagement to validate and improve safety practices.
  

Why This Matters for the BOC Exam

Understanding position statements like this one helps BOC candidates:

• Integrate best practices into clinical reasoning.
  
• Support injury prevention strategies with current evidence.
  
• Demonstrate awareness of public health implications in sport safety.
  
• Apply multi-level interventions (education, rule enforcement, technology, and communication) when evaluating and managing risk.
  

Ultimately, these statements are not just test content—they are foundational to being a competent, responsible, and forward-thinking athletic trainer.