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.
Adjust Your Workout When Gym Isn't Option
April 6, 2020
Henry Ford Health System
Feeling at a loss about not being able to stick to your normal workout routine? You’re not alone.
Social distancing during the COVID-19 outbreak has resulted in people all over the world having to adjust their schedules to accommodate working from home, schooling and caring for kids, and finding ways to maintain as much of a “normal” schedule as possible.
As a result, many people are struggling to figure out how to get a good workout in without the help of gym equipment or a personal trainer.
“Anxiety over the current situation can add to a lack of motivation to work out,” says Brianna Gauna, an athletic trainer for Henry Ford Health System. “But just remember how beneficial it is to move your body, even if it is just around the house.”
How a Routine Change Affects Your Body
If you are used to working out every day or going hard at the gym on a regular basis, a short rest period from your routine might have its advantages.
“Taking time to rest can actually be a really good thing because it allows your body to recover,” says Gauna. “You might even start to see more muscle tone set in as you give your body a break.”
On the other hand, if you usually work out a few times throughout the week and suddenly stop, the results may cause negative effects. You may experience:
- Increased resting heart rate
- Less energy
- Change in mood or emotions
- Loss of sleep
How to Work Out at Home
Being stuck at home is not an excuse to skip a daily workout. Everyone works out a little differently, and there are plenty of options for you to stay active and try out new forms of exercise.
“Whether you are used to strength training or cardio, think about what your fitness goals are and choose activities based on what you’d like to achieve,” says Gauna.
Here are some ideas to keep you and your family active:
1. Yoga. Practicing yoga requires a great deal of muscle strength and balance. It is best for a full body workout. Look to YouTube or free apps on your phone for beginner workout videos that you can follow along.
2. HIIT workouts. These workouts are best for getting your heart pumping and increasing your stamina. Try choosing four exercises from the following list. (Search YouTube or Google for examples if you are not sure what each of these entails.) Do one exercise at a time for 30 seconds and then give yourself 20 seconds of rest before moving on to the next exercise. After you get through one rotation of those exercises, repeat three more times.
- Squats
- Push-ups
- Lunges
- Burpees
- Mountain climbers
- Glute bridges
3. Running or walking. Many apps allow you to track your run on a map, so you can plan out your route in your own neighborhood. This allows you to adjust how far you run or how much time you have for a run. A brisk walk through the neighborhood also works.
4. Biking. Biking is a great low-impact workout that works to engage and tone leg muscles. (Remember to wear a helmet!)
5. Team sports. If you are looking for something to engage you and your family, team sports are the way to go. Kick a soccer ball around, try to race through an obstacle course while dribbling a basketball or take turns throwing a football. If you don’t have the equipment, try playing keep-away with a stuffed animal or set up a relay race.
Exercise by Age and Fitness Level
The younger you are, chances are you have a faster metabolism. If you can’t get to a gym, think about how active you usually are and gauge the length of your workout from there.
If you are using this time to get started on your fitness journey, use these recommendations as a starting point:
Ages 7-17: 1-2 hours. Athletes that are used to going to weekly practices may find that two-hour workouts are more suitable.
Ages 18-30: About an hour. Look for times throughout the day that you can squeeze in workouts. Maybe you do yoga in the morning, a HIIT workout in the afternoon and a walk after dinner.
Ages 31-49: About a half hour. If you have children or a pet, you may find that you are already spending more time being active than this!
Ages 50 and up: At least 10-15 minutes. Gauge this based on your own abilities. You may live a more active lifestyle that allows you to be very active throughout the day. If you find yourself struggling to meet this mark, consider a walk during the day or stretches in the morning.
Once you get a regular fitness routine in place, work your way up to longer or more intense workouts to keep yourself challenged.
Making Your Own Equipment
If you have a treadmill, stationary bike or elliptical machine at home, now is the time to clear off the laundry it may have been collecting. If you don’t have access to weights or other gym equipment, though, that doesn’t mean you have to miss out on a quality workout. Look for things around your house that you can use in their place – get creative!
- Bags of beans, rice or pet food as added weight for squats or lunges
- Old books/textbooks as dumbbells
- A chair for triceps dips, calf raises or for stability during yoga
- Stairs to run sprints or to help you stretch out leg muscles
When your day-to-day routine is shaken up, do what you can to create normalcy in your life. If you find you have more free time throughout the day, take that time to get moving – even if it’s running up and down the stairs or going for a walk around the block.
“Don’t worry about feeling silly for switching up your routine,” adds Gauna. “Whether that’s using a random object for added weight during a workout or trying to remember how to ride a bike again on your street, think about yourself and your fitness goals first. Don’t let thoughts of what other people think of you get in the way of you reaching your goals!”
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.
PHOTOS: (Clockwise from left) MHSAA Student Advisory Council members Abigail Pheiffer of Novi, Lydia Davenport of Ithaca and Trevin Phillips of Caro will be working to stay in shape while staying home these next many weeks.