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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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Choose the Right Sports Medicine Expert
July 7, 2020
By Christina Eyers, Ed.D., AT, ATC
Henry Ford Health System
If you're an athlete, chances are you'll require specialized care from a health professional during your career.
Confused about the differences between athletic trainers, sports medicine physicians and exercise physiologists, among other experts? You're not alone!
Each of these professionals has different levels of training, expertise and certifications, but the care they provide often overlaps. That's one reason why they often work together.
Sports Professionals Defined
Caring for athletes isn't always clear-cut. In fact, most athletes require a full team of professionals working in concert to stay at the top of their game. Yet confusion remains about which professionals you need to see for training, injury prevention, and recovery and treatment after an injury.
Each type of professional has its own set of experience, training and certifications. Here’s how they measure up:
· Sports medicine doctor: Sports medicine physicians are typically trained in orthopedic surgery, primary care or emergency medicine. These professionals have medical degrees as well as specialized training in sports medicine, including the prevention and treatment of injury. In addition to caring for conditions ranging from concussion to head colds, sports medicine physicians also focus on helping people return to sports safely and effectively after illness or injury.
· Athletic trainer: Athletic trainers take care of athletes from prevention through rehabilitation. In collaboration with a physician, these professionals offer insights that help minimize risk and prevent injuries. They evaluate athletes and provide immediate care and treatment, sometimes even on the sidelines. They also provide rehabilitation and reconditioning after an injury or illness.
· Exercise physiologist: Exercise physiologists study the effect of exercise on the muscular, cardiovascular, and sympathetic and parasympathetic nervous systems. They examine functional capacity and strength due to endurance training or strength training. These professionals may also test athletes for VO2max (your oxygen volume while training) and body composition (the ratio of fatty mass to lean mass).
· Physical medicine and rehab physician: These professionals treat a variety of medical conditions that affect the brain, spinal cord, nerves, bones, joints, ligaments, muscles and tendons. They take the whole body into account to pinpoint problems and enhance performance without surgery.
· Physical therapist: Physical therapists diagnose and treat individuals of all ages with conditions that limit their ability to move and perform daily activities.
Other Specialized Professionals Who Care for Athletes
In addition to the health care professionals described above, athletes may meet with a host of experts, including:
· Nurses and medical assistants
· Occupational therapists
· Cardiologists
· Neurologists
· Behavioral health specialists
· Dietitians
· Complementary medical practitioners, such as acupuncturists and chiropractors
None of these individuals are "fitness professionals," a term nearly anyone can use to describe a range of professional activities. Rather, these sports medicine experts are part of a comprehensive team that includes at least one physician. They are each licensed by the state to provide specialized care to athletes.
Personal trainers, on the other hand, focus on helping people find their way around the gym, hold them accountable to achieve their goals and help new exercisers and seasoned fitness enthusiasts stick to a workout regimen.
If you're an athlete, you need a team of health professionals who can provide comprehensive care to reach your highest potential.
Christina Eyers, Ed.D., AT, ATC, is the Director of Athletic Training & Community Outreach with Henry Ford Sports Medicine.
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.