When college football preseason practices begin this month, players, coaches and officials will receive instruction on clarifications to NCAA rules on "spearing."

Earlier this year, due to concerns about head and neck injuries related to "head-down" contact and spearing in football, the National Athletic Trainers' Association (NATA) and the American Football Coaches Association (AFCA) co-sponsored a task force to develop recommendations. The task force, composed of certified athletic trainers, physicians, researchers and coaches, met with the NCAA Football Rules Committee in February and collaborated on the changes that become effective this season.

Last year, two high-profile injuries raised awareness. One occurred when Drew Hixson, a wide-receiver from Tennessee Tech University, received a violent helmet-to-helmet blow from a defensive back that resulted in a severe injury. Hixson was in a coma for a significant time and continues to undergo rehabilitation today.

University of Georgia wide receiver Reggie Brown later received a violent helmet-to-helmet hit during a nationally televised game. Both events demonstrated the potential consequences of head-down contact and spearing.

Over the years, the development of improved helmet technology has led to increased use of the head at contact. Catastrophic cervical spine injuries are among the most devastating injuries in all of sports. The primary mechanism for catastrophic cervical spine injury is axial loading, which occurs as a result of head-down contact (spearing), whether intentional or not.

The normal cervical spine has a curve, allowing it to absorb shock. When the neck is flexed slightly forward, the cervical spine becomes straight. When a force is applied to the top of the head in that position, the energy is transmitted along the axis of the cervical spine -- axial loading. With a collision, the head is stopped and the trunk keeps moving, crushing the spine between the two. When maximal compression is reached, the spine fails.

In the laboratory, fracture or dislocation of the neck occurs with less than 150-foot pounds of kinetic energy. A running football player can possess 10 times this energy.

Before the original rule regarding spearing was adopted in 1976, more than 30 football players a year sustained catastrophic cervical spine injuries resulting in permanent quadriplegia. A noted decrease in catastrophic cervical spine injuries followed the change; however, the number of cervical spine injuries and close-head injuries has risen in recent years.

The NATA/AFCA task force focused on two primary problems:

• Head-down contact still occurs frequently in intercollegiate football, and
• Helmet-contact penalties are not adequately enforced.

The task force reviewed guidelines and position statements regarding spearing and head-down contact. The group also reviewed football penalty data, obtained feedback from coaches and surveyed officials regarding their interpretation of the existing rules.

The NCAA Sports Medicine Handbook contains a guideline regarding the use of the head as a weapon in football and other contact sports. Additionally, the NATA has published a detailed position statement about head-down contact and spearing. Both support the notion that football should be concerned with the prevention of catastrophic head injuries. Rules against butting, ramming and spearing with a helmet are for the protection of the players. A player who does not comply with those rules is a candidate for a catastrophic injury. Each time a player initiates contact with his head-down, he risks quadriplegia. Each time a player initiates head-first, he increases the risks of concussion.

Yet a review of football penalty data shows that head-contact fouls seldom are penalized. The task force cited statistics from a recent Division I season in which of the 20,837 penalties called, only 25 (one of every 833) were for head-contact violations. In fact, in 12 of the 20 major Division I conferences, no spearing penalties were called for the entire season.

Additionally, the survey of football officials from the ACC, Big East, Big Ten, Big 12, Pacific-10, and SEC found that 80 percent of the 205 respondents did not flag a helmet-contact violation all season. Surprisingly, the survey also showed that officials felt that the primary purpose of the helmet-contact penalty was to protect the athlete who received the hit. However, it is important to note that catastrophic cervical spine injuries occur most often to defensive players, at a rate four times higher than for offensive players. Further, many officials felt the helmet contact rules were not easily interpreted and not easily enforceable.

A look at the 2004 spearing rule shows the violation being defined as "the intentional use of the helmet (including the facemask) in an attempt to punish an opponent." Many officials surveyed said they felt the use of the word "intentional" made it difficult to call the penalty. Consequently, many found it difficult to call the penalty.

During the winter meeting between the Football Rules Committee and NATA/AFCA task force representatives, members agreed to delete the word "intentional" for the 2005 season.

The task force is now focusing on educating student athletes, coaches, officials and administrators regarding prevention of head and neck injuries. Also, the NCAA will distribute a poster that is intended to be placed in the football locker room as a daily visual reminder of unsafe hitting techniques.

Other educational initiatives include a PowerPoint presentation that the task force has asked certified athletic trainers to show student-athletes in the fall and the spring, idea lly before beginning contact drills. It is designed to educate student-athletes regarding who is at risk, the mechanism of injury, the concept of axial loading and prevention of injury through safe techniques. Development of an educational video also has begun, as well as a public relations campaign.

In some instances, illegal helmet contact plays have been glamorized by the media and become "highlight hits." As many young athletes follow college football and emulate the actions of their heroes, it is important to demonstrate proper legal tackling procedures for all to see.

We hope that the new rule clarification will play a significant role in reducing head and neck injuries in college football.

Ron Courson, director of sports medicine at the University of Georgia, chaired the NATA/AFCA task force.