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.

NFHS Voice: Participants Show Resilience

September 28, 2020

By Karissa Niehoff
NFHS Executive Director

The resiliency of players, coaches and leaders in high school activity programs the past seven months has been amazing. As attempts continue to offer all sports and performing arts this year, these individuals are making the most of tough times and demonstrating great resolve to change. 

No doubt, high school juniors and seniors involved in high school sports and performing arts would have preferred a less turbulent end to their high school days, but many have been willing to go to great lengths to have an opportunity to participate. 

In Michigan, when football was initially moved to the spring, student-athletes had two choices: be upset that their sport was postponed or seize the moment and look for new opportunities. Royce Daugherty of Watervliet High School chose the latter. 

A 6-foot-3, 300-pound two-way starter last year as a freshman on the Watervliet football team, Daugherty opted to join the cross country team! He said he decided to run cross country because it would help him get tougher mentally and physically. 

Daugherty’s decision was perhaps predictable given that he played four sports – football, wrestling, basketball and baseball – as a freshman. Although the switch was short-lived with Michigan reinstating football a couple of weeks ago, Daugherty’s resilience is remarkable and a good predictor of future success. 

In Colorado, with football on hold this fall, members of the Limon High School two-time defending Class 1A state football championship team petitioned the school administration to resurrect the golf program. 

“Sports are our lifeline,” said Andy Love, the school’s baseball coach who agreed to coach the golf team, in an article posted on CHSAANow. “Our community follows our sports so strongly. It gives our kids this great atmosphere and environment whether it’s the football field, the basketball court or whatever. Our community rallies around our kids.” 

Turning a problem into an opportunity, the Limon High School football players and staff demonstrated the never-give-up spirit of high school activities. 

In Kansas, with the heading of “the show must go on,” the Goodland High School athletic director and superintendent stepped in to coach the football team a few weeks ago because the head coach and assistant coach were quarantined during the week. The result? Goodland, a Class 3A school, defeated Liberal High School, a Class 5A school! 

Coaches have demonstrated resiliency as well by finding new ways to conduct competition and keep students engaged. In Minnesota, at a swimming meet between Chaska High School and Bloomington Kennedy High School, Chaska swimmers occupied lanes 1 to 4, while Kennedy swimmers were in lanes 5 to 8 for social distancing purposes. 

In the same state, the South Suburban Conference decided to conduct virtual swim meets this fall. Each team competes in 11 races in their own pool, and the coaches compare times to determine scoring. Two methods in the same state, both done to keep students engaged but to minimize risks of the virus. 

On the performing arts side, teachers and leaders have benefited from an aerosol study conducted by the NFHS and more than 125 other organizations to determine best practices. In some cases, band and other music programs were moved to the spring, but leaders continued to engage with students in many innovative ways.

Larry Friend, assistant principal of Caesar Rodney High School in Camden, Delaware, in a Dover Post article, told his students, “This is not the time to put the instruments aside. This is not the time to stop singing. This is not the time to run away from your passion. This is an opportunity to run toward your passion and to find what it is that motivates you to reconnect.”  

Band directors in Michigan – like those in many other states – are finding new ways to keep music going during the pandemic – from outdoor band camps to all-virtual rehearsals. 

“We have some really incredible band directors doing some really neat things locally,” said Josh Bartz, director of bands at Portage Northern High School in an interview with WWMT-TV in Kalamazoo. 

In the same interview, Chris Ludwa, assistant professor of music at Kalamazoo College, said, “I think you will always find ways to make art. Oftentimes, when in society there is deep need, deep pain, struggle, oppression – that’s the time when art flourishes.”  

These are but a few of the great stories that have occurred across the country as players, coaches, administrators, officials, parents and fans are making the most of tough times. While these student participants may not become stellar athletes at the next level or excel at higher levels in the arts, their resiliency through these tough times will play a major role in their future success. 

High school activity programs – building resilient people for the future of our nation. 

Dr. Karissa L. Niehoff is starting her third 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.