Research supports the sanctioning of flag football for girls in Colorado schools

AURORA, Colo., July 30, 2025 /PRNewswire/ -- Researchers at Children's Hospital Colorado (Children's Colorado) partnered with the Denver Broncos Foundation to investigate the benefits of flag football for female high school athletes in 2023-2024. The research and the resulting data focused on the sport's physical and mental impacts on these athletes and was used to inform the Colorado High School Activities Association decision to support the sanctioning of girl's flag football in Colorado for the 2024-25 school year.

Flag football is a no-contact version of American football where a player is "tackled" when the flag at their waistband is taken by the opponent. The sport has rapidly grown in popularity among adolescent female athletes and will be included in the 2028 Olympics. Despite this surge in interest, there remained a notable lack of research specifically focused on the experiences and outcomes of girls playing flag football. Girls in high school are more likely to drop out of sports earlier than teenage boys, and many inequalities remain for high school girls, including fewer opportunities for team sports, underrepresentation and lack of research around mental and physical health and their associated benefits with organized sport participation. The partnership between Children's Colorado and the Denver Broncos Foundation is designed to help level the playing field.

"While launching and executing this study required an immense amount of effort and coordination, the true value lies in what that work helped achieve," said David Howell, PhD, ATC, research director at the Sports Medicine Center at Children's Colorado. "From early planning through data collection and analysis, we knew this project had the potential to inform a meaningful decision impacting hundreds of high school athletes across the state. Being able to contribute data that supports the growth of girls' flag football highlights how clinical research can drive progress not just in medicine, but in our communities."

Howell, along with the research team at the Sports Medicine Center, conducted a four-month pilot study of female adolescents participating in a season of high school flag football, gathering data around a variety of health-related outcomes from a pre-season assessment and weekly in-season questionnaires among female flag football players. Howell led the study efforts to evaluate the sport's physical impacts, such as injuries, as well as trends of the tracked in-season mental health factors of sleep, stress and energy levels. While physical injuries were difficult to predict based on any single factor, athletes' fingers were found to be impacted most often. Additionally, female flag football players reported significantly more physical activity than non-athletes during the season, emphasizing the impact this new sport can have on helping adolescent females meet physical activity recommendations. Howell and team also found that flag football athletes had higher self-reported energy levels during the week than non-athletes, even when accounting for differences in physical activity. This led them to propose that flag football provided benefits to mental health, in addition to the physical and mental health benefits of athletic activity alone.

Sports participation offers a key opportunity for a multitude of health benefits, such as promoting female adolescents' confidence, self-esteem, resilience, academic performance and increased social interactions. However, certain aspects of female athlete health, such as menstrual function, may get overlooked despite it being a potential indicator of overall health.

Rachel Meyers, PT, DPT, physical therapist at Children's Colorado, worked with the research team to conduct pre-season assessments followed by evaluating sleep, mood, stress and physical activity levels each week during the season. The second study monitored 60 adolescent female flag football athletes over the course of a season. At the beginning of the season, 25% of female athletes reported menstrual dysfunction, which is defined as irregular periods (having nine or less in 12 months), having the first period at age 15 or older, or going three or more consecutive months without a period. While this didn't affect energy or mood, those with menstrual dysfunction experienced higher stress levels and worse sleep quality ratings during the season. 

"Many healthcare providers do not feel comfortable asking about menstrual health," Meyers said. "And yet it is essential that all healthcare providers who treat female athletes have this conversation with their patients. Menstrual health can affect all aspects of life: physical, psychological and emotional domains. Thus, it is imperative to identify screening practices for menstrual dysfunction pre-season to help improve quality of life and overall health for all female athletes and to reduce the prevalence of menstrual dysfunction in this population."

For more information about this study, visit our website.

ABOUT CHILDREN'S HOSPITAL COLORADO
Children's Hospital Colorado is one of the nation's leading and most expansive nonprofit pediatric healthcare systems, with a mission to improve the health of children through patient care, education, research and advocacy. Founded in 1908 and ranked among the best children's hospitals in the nation, as recognized by U.S. News & World Report, Children's Colorado has established itself as a pioneer in the discovery of innovative and groundbreaking treatments that are shaping the future of pediatric healthcare worldwide. Children's Colorado offers a full spectrum of family-centered care at its urgent, emergency and specialty care locations throughout Colorado, including an academic medical center on the Anschutz Medical Campus in Aurora, hospitals in Colorado Springs, Highlands Ranch and Broomfield, and outreach clinics across the region. For more information, visit childrenscolorado.org or connect with us on Facebook, Instagram and YouTube.  

ABOUT DENVER BRONCOS FOUNDATION
The Denver Broncos Foundation is committed to making a positive impact on future generations by creating a "game plan" for life through youth health and wellness initiatives, dynamic in and out of school programming, and access to career pathways. For more information on the Denver Broncos' community partnerships and programs, please visit https://www.denverbroncos.com/community/foundation/ or follow @BroncosOffField on X and Instagram.

Media Contact:
Blayke Roznowski
Media Relations, Children's Hospital Colorado                        
media@childrenscolorado.org

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SOURCE Children's Hospital Colorado