NFHS Voice: Emphasis on Education

January 20, 2020

By Karissa Niehoff
NFHS Executive Director

Sometimes, numbers or statistics in sports can be misleading or perhaps even meaningless. Often, they simply do not tell the whole story. 

Such was not the case, however, with the massive number of 10,000,000 announced last week by the NFHS. As in 10 million online education courses that have been taken by high school coaches, administrators, officials, students, parents, performing arts educators and others since the inception of the NFHS Learning Center in 2007. 

When we talk about the difference between education-based sports within our nation’s high schools versus out-of-school club sports, this says it all. And the quest for more continues to rise each year.

After starting with 15,000 courses in 2007, more and more people have utilized the Learning Center (www.NFHSLearn.com) on computers, tablets and smartphones. The number of courses jumped to 200,000 by 2010 and 1,071,000 by 2015 and almost two million (1,975,000) last year. 

While there are now more than 70 courses available through the NFHS Learning Center, including more than 35 that are offered at no cost, the runaway success story has been the free Concussion in Sports course that was launched in 2010 and updated in 2018.

With more than five million Concussion in Sports courses delivered in almost 10 years, the NFHS has been the leader in concussion recognition and management. This course teaches how to recognize a suspected concussion. It provides protocols to manage a suspected concussion. It provides steps to help players return to play safely after a concussion.

As a result of educational initiatives such as the Concussion in Sports course, and NFHS playing rules in all high school sports that contain guidelines for management of an athlete who exhibits signs and symptoms of a concussion, to the creation of concussion laws in every state, there are positive trends in concussion rates. 

And that leads to some more meaningful numbers.

Data from the National High School Sports-Related Injury Surveillance Study released late last year indicated that concussion rates during football practices dropped from 5.47 to 4.44 concussions per 10,000 athletic exposures between the 2013-14 and 2017-18 seasons. Repeat concussion rates across all sports declined from 0.47 to 0.28 per 10,000 exposures during the same time period.

The annual increase in the number of individuals taking education courses on the Learning Center, which also includes the popular free courses Heat Illness Prevention and Sudden Cardiac Arrest, indicates – at least in part – the insatiable desire on the part of parents to determine the actual risk of playing contact sports.

And more and more when it comes to football – this country’s most popular contact sport – we believe the inherent risk has never been lower.

From the youth level where USA Football has created the Football Development Model to reduce contact and teach fundamentals in a progressive manner, to the educational initiatives of the NFHS to reduce injury risk in high school sports, the focus on player safety has never been higher.

And one more important number. We believe this continual rise in the number of people taking online education courses will have an additional benefit – a growing number of high school students competing in education-based sports and activity programs.

Dr. Karissa L. Niehoff is in her second year as executive director of the National Federation of State High School Associations (NFHS) in Indianapolis, Indiana. She is the first female to head the national leadership organization for high school athletics and performing arts activities and the sixth full-time executive director of the NFHS, which celebrated its 100th year of service during the 2018-19 school year. She previously was executive director of the Connecticut Association of Schools-Connecticut Interscholastic Athletic Conference for seven years.

NFHS Voice: No HS Football Link to CTE

October 21, 2019

By Karissa Niehoff
NFHS Executive Director

When it comes to the long-term effects of concussions in sports, there is a wide range of information published – almost on a daily basis. Unfortunately, much of the media coverage as it relates to high school sports – and particularly the sport of football – is misleading.

Last week, the Concussion Legacy Foundation introduced its new public-service announcement that compared youth football dangers to smoking. As the pre-teen football players puff on cigarettes, the voiceover says, “Tackle football is like smoking, the younger I start, the longer I’m exposed to danger.”

The “Tackle Can Wait” campaign by the foundation is an attempt to steer children under the age of 14 into flag football. Although establishing a finite age may be difficult, reducing contact at youth levels is certainly a positive. USA Football is doing just that nationally through its Football Development Model. Likewise, the 51 member state associations of the National Federation of State High School Associations (NFHS) have enacted limitations on contact during preseason and practice sessions.

Our concern is the term “exposed to danger.” These types of messages continue to spread unwarranted fear to parents of high school student-athletes. The “danger” refers to reports that players who incur repeated concussions can develop chronic traumatic encephalopathy (CTE).

A 2017 study from the Journal of American Medical Association (JAMA) linked CTE in the brains of deceased National Football League players. Even if this report is accurate, these are individuals who endured repeated blows to the head for 20 to 25 years BEFORE any concussion protocols were in place.

Less publicized is a study by Dr. Munro Cullum and his colleagues at the Peter O’Donnell Jr. Brain Institute, which is a part of the University of Texas Southwestern Medical Center in Dallas. Cullum’s group studied 35 former NFL players age 50 and older who had sustained multiple concussions throughout their careers. The findings showed no significant association between the length of the individuals’ careers, the number of concussions and their cognitive function later in life.

Two studies, two different conclusions. Regardless of the outcome, however, they are not applicable to kids playing football before and during high school. There is absolutely no linkage to CTE at these levels, and the word “danger” should not be a part of the discussion.

A more applicable and significant study was also published in JAMA in 2017. In a study of about 4,000 men who graduated from Wisconsin high schools in 1957, there was no difference in cognitive function or decline between those who played football and those who did not as they reached 65 years of age. We would assume the majority of these individuals discontinued football after high school.

With more than one million boys – and girls – playing the contact sport of football each year, severe injuries do occur from time to time, but parents should know that efforts to lessen the risk of a catastrophic injury, including head injuries, have never been stronger than they are today.  

In fact, new data from the National High School Sports-Related Injury Surveillance Study indicates some positive trends in concussion rates. The study, which was released in the American Academy of Pediatrics online issue of Pediatrics last week, indicated that concussion rates during football practices dropped from 5.47 to 4.44 concussions per 10,000 athletic exposures between the 2013-14 and 2017-18 seasons.

In addition, repeat concussion rates across all sports declined from 0.47 to 0.28 per 10,000 exposures during the same time period.

Concussion laws are in place in every state. All NFHS sports rules books have concussion management protocols. Helmet-to-helmet hits are not allowed in football. Limits on contact in preseason and practice in football are in place in every state.

After considering all the available research, we encourage parents to let their kids play their sport of choice in high school, but we would discourage moving away from football – or any contact sport – solely based on the fear of developing CTE later in life.

Dr. Karissa L. Niehoff is in her second year as executive director of the National Federation of State High School Associations (NFHS) in Indianapolis, Indiana. She is the first female to head the national leadership organization for high school athletics and performing arts activities and the sixth full-time executive director of the NFHS, which celebrated its 100th year of service during the 2018-19 school year. She previously was executive director of the Connecticut Association of Schools-Connecticut Interscholastic Athletic Conference for seven years.