What 10 Years of Emergency Room Data Say About Injuries in Girls Flag Football
A published study of 2014 to 2023 emergency room data estimated 22,666 female flag football injuries. Sprains and fractures led; concussions were third.
By Flag50 TeamPublished Updated
Carlsbad, Calif.: A study of US emergency room data from 2014 to 2023 estimated 22,666 injuries to female flag football players. Sprains and fractures led, concussions were third at 8.0% of cases, and injury counts held steady.
A peer-reviewed study of US emergency room visits is the most complete look yet at injuries in girls and women's flag football. Using National Electronic Injury Surveillance System (NEISS) data from 2014 to 2023, the authors estimated 22,666 injuries nationwide. The study, by Balachandran and colleagues, was published in the Orthopaedic Journal of Sports Medicine in August 2025 and is free to read in PubMed Central. It is back in the news as Georgia's headgear rule starts its first season.
What the study found
The sample held 605 emergency room cases. The figures below are shares of those cases, as reported in the paper's full text:
| Finding | Share of cases |
|---|---|
| Strain or sprain, most common diagnosis | 30.2% |
| Fracture, second most common | 20.8% |
| Concussion, third most common | 8.0% |
| Finger, most injured body part | 22.6% |
| Head, face or neck combined | 24.1% |
| Players ages 11 to 20 | 71.1% |
Falls were the most common stated cause, at 19.1%, though more than half of the cases recorded no cause at all. Yearly counts did not change in a statistically significant way across the decade. The low was 2020, during the COVID-19 shutdowns, and the high was 2023.
What it does not say
The data come only from emergency rooms, so they miss injuries treated on the sideline, at urgent care or by a family doctor. The study counts injuries, not injury rates, because it has no count of how many girls played each year. And it cannot say whether headgear would have changed any outcome.
In the discussion, the authors call for protective equipment for younger players. Co-author Rachel Frank, MD, discussed the findings in a January 2026 Q&A from CU Anschutz. Atlanta News First cited the study in its July 30, 2026 report on Georgia's new headgear rule.
What it means for families and leagues
Most injuries in this data were to fingers, ankles and knees, not heads. Still, concussion was the third most common diagnosis, and players in the age band that feeds high school programs carried most of the injuries. For parents, our guide to flag football safety and headgear covers what to ask your league. For league operators, the youth flag football concussion protocol lays out removal and return to play. For any injury, follow your doctor's advice.
Frequently asked questions
How many flag football injuries do female players have each year?
The study estimated 22,666 emergency room visits for female flag football injuries from 2014 to 2023, about 2,270 a year on average. The yearly count held steady, with a low in 2020 and a high of about 3,500 in 2023. Injuries treated outside an emergency room are not included.
What is the most common injury in girls flag football?
Strains and sprains, at 30.2% of the emergency room cases in the study, followed by fractures at 20.8%. The finger was the most injured body part, at 22.6% of cases. Concussions were third among diagnoses, at 8.0%.
Does the flag football injury study recommend headgear?
The authors call for protective equipment for younger players in their discussion. The study itself did not test headgear, so it cannot say how much headgear would reduce injuries. For rated models, see the Virginia Tech flag football headgear ratings.