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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.
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Enhancing Your Running Performance
August 4, 2020
Henry Ford Health System
With summer now in full swing and many people still avoiding gyms, lots of us are hitting the track, the streets and the trails to get and stay fit.
Whether you run marathons or prefer a quick lap around the block, there are many ways to adjust your running routine to get the most out of your workout.
"It's not uncommon for runners to get into a regular running routine," says Jamie Schwab, an athletic trainer at Henry Ford Health System. "They'll find a comfortable pace and stick with it, often even doing the same route." Unfortunately, doing the same run day after day not only leads to boredom, but it can also prevent you from reaching your full potential.
5 Tips to Run Smarter
It’s no secret that running is tough on the body. In fact, runners frequently develop muscle imbalances that make the body work harder. But you can take steps that can help you improve your run, maximize efficiency and get the most out of your running workout. Here's how:
1. Listen to your body: Whether you're a seasoned runner or just starting out, pay close attention to what your body is telling you. If your hips and knees are sore, back off. Feeling strong? Run another mile. The key to improving your run is to gradually increase distance and intensity over time. At first, you may only be able to handle a 10- or 15-minute jog. But if you keep at it, you'll be running for 30 minutes straight in no time.
2. Get the right footwear: If you're not a competitive runner, you might think any pair of running shoes will do. In reality, properly fitted running shoes not only enhance your performance but also reduce your risk of injury. Find a running store that can analyze your form and recommend shoes based on your unique gait and foot strike.
3. Pay attention to your target heart rate: Your target heart rate is 220 minus your age. Once you hit that rate during your run, you're working at maximum capacity. Don't want to invest in a heart rate monitor or be bothered with another tracking device? You're probably hitting the zone if you can still carry on a conversation during your run.
4. Focus on strength: If you're an avid runner but you aren’t strength training, you're setting yourself up for injury. "You're asking your body to do a lot during a run," Schwab says. "Weak glutes or hips add stress to your knees and ankles." Want to stabilize your run? Pay special attention to your core muscles. Solid strength training exercises include lunges, planks, squats and pushups.
5. Keep it interesting: Doing the same running routine day after day can be exhausting. Break out of your comfort zone by trying a different route, playing with your pacing, or running stairs or hills. You might even incorporate plyometric activities into your run. These explosive motions — hopping, skipping and jumping — help build power, strength and performance.
Running Safe
Eating well and getting regular exercise are key to enhancing overall health. Plus, a fit body is better equipped to avoid and battle infection. Running can also protect your sanity.
"Running is a great escape for many exercise enthusiasts," Schwab says. "Many people find they not only feel physically healthier, but their mental and emotional health also gets a boost."
The caveat: When you're running, you're placing double or triple your body weight on one side of your body at a time. So it's critical to pay attention to what shape your body is in before you take to the track. A few questions to ask yourself:
• Am I in good cardiovascular shape?
• Am I recovering from shin splints, knee injuries or hip problems?
• Am I at risk of falls?
• Am I suffering from osteoporosis?
It’s always important to check with your doctor before making changes in your exercise regimen. If running isn't appropriate for you, plenty of other activities, such as swimming, hiking and biking, can get your heart pumping.
Jamie Schwab, AT, ATC, SCAT, CSCS, is an athletic trainer with Henry Ford Sports Medicine and works with student athletes at Edsel Ford High School. She is a National Strength and Conditioning Association certified strength and conditioning specialist.
Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan.
Visit henryford.com/sports or call (313) 972-4216 for an appointment within 24 business hours.