Neck Training for American Football

Why every football player should train their neck

Neck strength is one of the only concussion risk factors a football player can change. Sex, sport, position, age, prior concussion history, and the behaviour of whoever is hitting you are all fixed. Neck strength is not — it responds to training reliably, quickly, and measurably.

In the largest study to look at this, 6,704 high school athletes across 51 schools had their neck strength measured before the season and their concussions counted during it:

After adjusting for gender and sport, overall neck strength remained a significant predictor of concussion (p = 0.004). For every one pound increase in neck strength, odds of concussion decreased by 5 % (OR = 0.95, 95 % CI 0.92-0.98).

Collins CL, Fletcher EN, Fields SK, Kluchurosky L, Rohrkemper MK, Comstock RD, Cantu RC. Neck strength: a protective factor reducing risk for concussion in high school sports. Journal of Primary Prevention, 2014 Oct;35(5):309–19. PMID 24930131.

Five percent per pound compounds. Ten pounds added across an off-season — an unremarkable result from three sessions a week — is associated with roughly 40% lower odds. The paper’s own title calls neck strength “a protective factor reducing risk,” and its authors recommended targeting weaker-necked athletes for prevention programmes.

A 2019 Rutgers review in the Journal of Orthopaedic and Sports Physical Therapy reached the same practical conclusion from the wider literature: neck strength, neck size, and neutral neck posture each appear protective, and the authors recommended cervical assessment at pre-season physicals and neck-strengthening work in pre-season training. They also flagged that female athletes, who typically have less neck strength, face higher concussion risk and longer recovery — which makes the case for training stronger in girls’ sports, not weaker.

Brown A, Esopenko C, et al. Cervical Spine Characteristics and Concussion Risk. Journal of Orthopaedic and Sports Physical Therapy, 2019.

Add to that the finding nobody argues about: resistance training increases neck strength, pooled effect SMD 0.85, rated high quality by systematic review. The intervention works. The target is worth hitting. Full treatment on neck strength and concussion risk.

Where to be precise

Two things are true at once, and coaches get asked about both.

No product prevents concussion, and this site will not say one does. A player with a strong neck can still be concussed. Equipment sold on a promise of prevention is being sold dishonestly.

What has not been run is the specific trial that trains one group of footballers, leaves another untrained, and counts concussions in each. Nobody has done it. Until somebody does, the strongest available evidence is the observational relationship above plus the established fact that training moves the variable.

The intermediate measure — head acceleration — has been tested and did not reach significance:

Ivanic B, Cronström A, et al. Efficacy of exercise interventions on prevention of sport-related concussion and related outcomes: a systematic review and meta-analysis. British Journal of Sports Medicine, 2024;58(23):e108260. DOI 10.1136/bjsports-2024-108260.

Those acceleration numbers come from small, low-quality studies with wide confidence intervals — the reviewers rated the evidence “very low” and “low” themselves — and instrumented-mouthguard work of that kind is notoriously noisy. They are a reason to keep the claim narrow, not a reason to stop training. The full treatment is on neck strength and concussion risk.

So the honest sales pitch, which is also the true one: train the neck because it is a modifiable risk factor with a real association behind it, because it reliably works, because untrained necks get weaker across a season, and because it costs almost nothing. Do not train it believing it makes a player immune to anything.

Watch how it is done

More setup and technique demonstrations: neck training videos.

What the sport actually demands

Impact, not sustained load. Contact lasts milliseconds. The qualities that matter are stiffness and rate of force development rather than how much force can be produced given a full second to build it.

Unpredictable direction. Unlike wrestling, where an opponent’s force is applied progressively and can be felt developing, football contact frequently arrives from a direction the player has not seen.

This is the crux, and it is not a strength problem. The neck resists impact largely by co-contraction — stiffening before the force arrives. That requires anticipation. A braced player and an unbraced player are mechanically different objects, and a substantial share of injurious impacts are the ones that were not seen coming.

Strength measured in a lab is a proxy for a capacity that has to be deployed with correct timing. The strength is trainable. The timing is largely a function of awareness and technique.

Repeated exposure across a season, which makes cumulative load and recovery a real consideration rather than a theoretical one.

The best-evidenced intervention in this sport’s history

It is not equipment and it is not strength. It is a rule change, and the numbers are worth knowing precisely, because they are the benchmark everything else in football safety gets measured against.

1976: quadriplegic events in American football peaked at 34 in a single year. The mechanism was axial compression of the cervical spine from spear tackling — contact initiated with the top of the helmet, head down.

That year the rule banning spearing was introduced.

The 1976 ban on spear tackling substantially reduced quadriplegia injuries, which dropped to 6 per year on average (1989 to 2002).

Boden BP, Anderson SA, Sheehan FT. Catastrophic Sports Injuries: Causation and Prevention. Journal of Bone and Joint Surgery, 2024;106(1):62–73.

Thirty-four a year down to six. Catastrophic events nonetheless persisted, which is why the NCAA strengthened the spear-tackling rule again in 2005 and the NFHS in 2007.

Running alongside it, the equipment standard:

NOCSAE, History, nocsae.org. NOCSAE itself credits rule changes against dangerous tackling, improved coaching fundamentals and better medical care alongside the helmet standard, rather than claiming the result for the standard alone.

The part that matters for anyone selling neck training

A strong neck does not protect against the injury those rules prevented. Axial loading with the head down is a different mechanism entirely. The standard account in the cervical spine injury literature is that flexing the neck to roughly 30° straightens out the normal cervical lordosis, and the spine stops behaving like a curved structure that can deflect and absorb load and starts behaving like a segmented column loaded end-on. A column fails by buckling, and it fails fast. Muscle strength does very little about that, because at that point the musculature is largely out of the load path.

Head up, and the mechanism does not occur. That is why technique and rule enforcement — not equipment, not conditioning — produced the largest injury-prevention result this sport has ever recorded, and any company implying otherwise is misrepresenting a body of work that took thirty years and a lot of paralysed teenagers to establish.

Where neck training does have a case is a different question entirely: repeated impacts, head acceleration, and concussion odds, where the neck is in the load path and where the evidence above applies. Two mechanisms, two literatures, two claims. Keeping them apart is the whole job.

So: technique and rules first, always. Neck training is the best-evidenced thing an individual player can add on top of them. A player cannot change how the game is officiated. He can change how strong his neck is by December.

Programming for football

From the general programming guidance, with these shifts:

Use a loadable harness. Every published protocol that produced measurable neck strength gains used equipment with a known load — the aviation trials used a head harness with bands or plates, the rugby protocol used weighted isometrics. A harness fits in a locker, works in any weight room or at home, loads flexion, extension and lateral flexion, and progresses in whatever increment the facility owns. See what to buy and why.

Bias toward rate of force development, not maximal holds. Shorter, sharper contractions. Where a wrestler benefits from forty-second holds, a football player benefits more from the ability to produce force quickly. The Danish air force trial measured rate of torque development as a separate outcome from maximal strength and found it responded to training — cervical extension RTD rose about 15% in the trained group while the reference group fell. That trial used a Neck Flex head harness, named in its methods section.

Train all four directions, and rotation especially. Contact comes from everywhere. Rotation gets the least equipment coverage; a rotation-capable harness attachment or hand resistance covers it.

Use the in-season window honestly. In-season neck work has to fit around contact exposure. Two short sessions a week maintained is worth more than four sessions abandoned in week three — the adherence finding from the military literature applies with force here, and it is the strongest practical argument for equipment a player can keep in his own bag rather than equipment that lives in a facility he can only reach twice a week.

Machines are worth using if you have one. Football facilities are where four-way neck machines actually exist, and machines are the only modality shown by EMG to reproduce high-intensity muscle activation. They cannot train rotation, they are not portable, and most players lose access to them the moment the season ends — which is precisely when the off-season strength has to be built. Pair or replace with a harness. See machines.

Youth athletes need more conservatism, not less. The cervical injury tolerance data scales sharply with size: the Nij tension intercept for a Hybrid III 6-year-old is 2,800 N against 4,500 N for a mid-size male, and 5,440 N for a large male. Smaller necks tolerate less, and the margin is not proportional to enthusiasm.

What to tell a parent

Say this, because all of it is true and none of it is a promise:

“Stronger necks are associated with fewer concussions.” Six thousand seven hundred athletes, five percent lower odds per pound, adjusted for sex and sport. It is one of the very few risk factors in this sport your kid can actually do something about.

“Neck training reliably makes necks stronger.” High-quality evidence, large effect. This part is not in dispute.

“Nobody has run the trial that connects those two directly, so nothing here is a guarantee.” A strong neck does not make anyone concussion-proof, and any company telling you their product prevents concussion is selling you something the evidence does not support.

“Not training it isn’t neutral.” Untrained control groups in the published studies measurably lost cervical strength across a season. The choice is not between training and staying the same.

That is a stronger case than most things offered to parents in this sport, and it survives being read carefully — which is the only kind of case worth making about a child’s brain.

Equipment: what to buy and why. Programme: start here.