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: Nationally, Lost Spring Ends
May 8, 2020
By Karissa Niehoff
NFHS Executive Director
On Monday, the New Jersey State Interscholastic Athletic Association became the 51st and final NFHS member state high school association to cancel its spring sports championships due to the Coronavirus pandemic.
The cancellation announcements began in late March and stretched to early May as states made every attempt possible to conduct spring sports and other activity programs.
Driven by a desire to offer perhaps a few weeks of competition – particularly for graduating seniors – many states waited as long as possible to move from postponed to cancelled, ultimately forced to make decisions when schools were closed to in-person learning for the remainder of the academic year.
While the leaders of our state associations knew that spring activities could not occur if schools did not re-open, and that the health and safety of the millions of participants ultimately drove these decisions, having to make these announcements was perhaps the most difficult task they had experienced as state leaders.
“We are disappointed for the thousands of New Jersey student-athletes who will be unable to compete this spring,” said Larry White, executive director of the New Jersey State Interscholastic Athletic Association. “While we remained hopeful to the end, and left open every possibility, competition simply is not feasible given the circumstances. It has been a harrowing time for everyone, and we know our student-athletes are extremely disappointed. That said, these unfortunate circumstances may have put an intriguing challenge in the path of our young people. As New Jersey’s own Vince Lombardi once said, ‘It's not whether you get knocked down, it's whether you get up.’ We’re confident all our kids will get back up and stand tall.”
Rhonda Blanford-Green, commissioner of the Colorado High School Activities Association, showed her emotions in making the difficult decision in her state:
“This decision, unlike the many decisions our office makes over the course of a year, has been extremely difficult because we are personally connected as former participants and officials, current parents and grandparents of graduating seniors, as well as educators and members of our high school communities. Our hats are off to the many seniors who have shown maturity and resolve as their culminating year of high school has been impacted beyond activities and athletics due to the worldwide COVID-19 pandemic. The Class of 2020 will not be forgotten.”
Craig Anderson, executive director of the Illinois High School Association, said, “Our thoughts are with all the impacted students, coaches and communities, especially the seniors. It will be difficult for them to find a silver lining in all of this, but we stress that even if they don’t get the chance to compete again at the high school level, they are better for having been a part of their respective high school teams. They were exposed to life lessons in teamwork, leadership and overcoming adversity that are difficult to replicate elsewhere.”
What was at stake and who was affected by these cancellation announcements? More than 500 girls and boys spring sports championships in about 18 sports and involving about three million student-athletes. Along with multiple classes for both boys and girls in track & field, other sports affected this spring were baseball, softball, lacrosse, golf, tennis, soccer, flag football, boys volleyball, water polo, weightlifting, gymnastics, riflery, judo, Unified track & field and ultimate Frisbee. Also grounded were perhaps another million participants in band, choir, orchestra, speech, debate, robotics and other activity programs.
And last, but far from least, we remember the thousands of volunteers who make these events happen every year – ticket-takers, concession stand workers, booster club parents, meet officials and the leaders in communities throughout the country where these events were planned. We thank these individuals for their faithful service year after year, and we look forward to the day we are all back together again.
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.