Abstract

Participation in sport offers numerous physiological, psychological, and social benefits, yet injury remains an inherent risk,
particularly in collision-based sports. Increasing scrutiny surrounds these sports, especially for youth, with inconsistency in
the age for introducing deliberate contact (e.g., body checking, tackle) and debate regarding proposals for banning high-risk
actions to reduce injuries. This article explores the policies and controversies regarding how, and when, physical contact is
introduced in sports. Current policies vary significantly across sports, sexes, and national jurisdictions, leading to inconsistent
implementation and outcomes. We outline arguments for both delaying and lowering the contact introduction age, including
implications for participation rates, skill acquisition, and injury risk. Raising the age may reduce injury history and cumulative head impacts, while earlier, progressive contact training may enhance technical competence. Growth, maturation and
size discrepancies further complicate such policy decisions. Evidence supports multimodal approaches, including training
guidelines (e.g., reduced contact in practices), neuromuscular training, and rule modifications, to enhance safety without
compromising play. Weight-based categorisation and bio-banding (grouping players by attributes associated with growth
and/or maturation instead of chronological age) strategies show potential for injury-risk reduction but lack comprehensive
evaluation. Despite polarised opinions, developing sport-specific recommendations on best practices for contact introduction
remains critical to ensuring athlete welfare and sustainable participation in collision sports.
Original languageEnglish
JournalSports Medicine
Early online date4 Dec 2025
DOIs
Publication statusE-pub ahead of print - 4 Dec 2025

Bibliographical note

Publisher Copyright:
© The Author(s) 2025.

Data Availability Statement

Not applicable

Funding

SWW currently receives funding from World Rugby, unrelated to the current article. SH consults for World Rugby and the South African Rugby Union. BJ is employed in a consultancy capacity by Premiership Rugby as their Sports Science & Medicine Research Lead; employed in a consultancy capacity by Rugby Football League as their Head of Performance Science and Research; and employed in a consultancy capacity by Premiership Rugby and the Rugby Football League, although neither organization had input into this article. BP is a named investigator on grants received from the Australian Football League; Associate Editor at the British Journal of Sports Medicine. ATK is an external Advisor (no financial support) for Hockey Canada related to Concussion Prevention. SB: University of Michigan; National Institutes of Health; Centers for Disease Control and Prevention; Department of Defense – USA Medical Research Acquisition Activity, National Collegiate Athletic Association; Speaker honorarium, research consulting (Medical College of Wisconsin, University of Georgia); Conference travel expenses; C3Logix; ‘Brain Metabolism Monitoring Through CCO Measurements Using All-Fiber-Integrated Super-Continuum Source’ (US 11, 529, 091 B2) and ‘Organ Or Tissue Hemodynamic And Metabolic Function Measured Using Super-Continuum Light Sources’ (US 12, 089, 945 B2); ‘Biomechanics of Injury (3rd edition)’ SB has past research funding from the National Athletic Trainers’ Association Foundation; National Football League/Under Armour/GE; Simbex; and ElmindA. He has consulted for US Soccer (paid), US Cycling (unpaid), University of Calgary SHRed Concussions external advisory board (unpaid), is President of the Concussion in Sport Group (unpaid), medico-legal litigation, and received speaker honorarium and travel reimbursements for talks given. He is on and is/was on the editorial boards (all unpaid) for Journal of Athletic Training (2015 to present), Concussion (2014 to present), Athletic Training & Sports Health Care (2008 to present), British Journal of Sports Medicine (2008 to 2019). CAE has been PI on grants from Canadian Institutes for Health Research, Canadian Foundation for Innovation, Canada Research Chairs Program, National Football League Play Smart Play Safe Program, World Rugby, International Olympic Committee; Deputy Editor British Journal of Sports Medicine. CDMCK is employed as the Director of Research at Podium Analytics (listed as an affiliation); named investigator on grants received at the University of Bath from The Rugby Football Union (UK) related to injury in rugby; Associate Editor at the Journal of Science and Medicine in Sport. The other authors declare that they have no conflicts of interest relevant to the content of this article.

FundersFunder number
Centers for Disease Control and Prevention
National Institutes of Health
Canada Research Chairs
Canadian Institutes of Health Research
University of Michigan
Department of Defense089, 091 B2, 945 B2

    ASJC Scopus subject areas

    • Orthopedics and Sports Medicine
    • Physical Therapy, Sports Therapy and Rehabilitation

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