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: Salute Seniors with Spring on Hold
March 27, 2020
By Karissa Niehoff
NFHS Executive Director
A visitor to the local high school in late March would normally find boys and girls engaged in track and field, baseball, softball and lacrosse practices. Inside the building, some students would be involved with speech or debate activities. Unfortunately, this is not a normal year – far from it.
Spring sports playing fields are empty. High school sports and activities, with more than 12 million participants, are on pause, and high school athletes, coaches, athletic directors, parents and other fans are trying to determine when these programs will return.
The ever-changing news we are receiving almost on an hourly basis is more than one can comprehend as we all deal with this global health crisis. Each day, with the spread of the coronavirus, we try to determine what has changed since the day before. Can we go to work? Can we leave our house to go to the store?
Like every other activity in our nation, high school sports and activity programs are on hold. With all schools closed for varying amounts of time – some to the end of the academic year – millions of participants in spring sports and activities are on the sidelines awaiting the green light for competition to resume.
In past years, our member state associations and the 19,500 high schools across the country have had to postpone or cancel events for short periods of time due to weather or other factors, but this is unprecedented. The reality is that spring sports may never occur in some states – particularly those where schools are closed for the academic year. And this would be doubly disappointing in those states that were not able to conduct or complete state basketball championships.
The possibility of losing spring sports is particularly disappointing for graduating seniors. While everyone is affected by this health crisis and has their own issues to confront, it is important for everyone involved in high school activity programs to salute those seniors – boys and girls in sports and activities programs who have sacrificed for 3½ years but may not be able to reach the finish line.
While they may miss some of the final games and events, the benefits of being involved in these programs will carry them for a lifetime. The early-morning practices, offseason workouts and late-night studying after a day of activities will undoubtedly make them stronger and more dedicated in their future professions.
We thank all high school athletes and performing arts participants for the great memories – especially those who may not be able to complete their races or sing in the music ensemble this year. While some will have more competitive opportunities in sports and activities, for others that continued involvement may be in the form of coaching or officiating, but the impact of involvement in these programs will last a lifetime.
There have been times in the past when high school sports and performing arts helped individuals in communities through difficult times – events like weather-related disasters or school shootings as examples. We believe that these programs will play an even larger role once the coronavirus pandemic subsides and we are able to return to normalcy.
Why? Because after our days, weeks and perhaps months of social distancing, teamwork will help us all come back together, and there is no better demonstration of teamwork than education-based high school sports and activity programs.
We all anxiously await the day when the whistles blow and the curtains rise 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.