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: March Madness Begins Again
March 4, 2020
By Karissa Niehoff
NFHS Executive Director
The calendar has turned to March, which in the world of high school sports can only mean one thing – Basketball. It is time for state tournaments, March Madness and, yes, the annual rhetoric about the merits of the shot clock.
For the almost one million boys and girls who participate in high school basketball, there is nothing quite like the state tournament. Although there are great memories from the one-class days, led by Carr Creek’s almost upset of powerhouse Ashland in Kentucky in 1928 and Milan’s Cinderella victory in Indiana in 1954, today, basketball provides more opportunities for girls and boys teams to be crowned state champion than any other sport.
This month, about 450 girls and boys teams will earn state basketball titles in championships conducted by NFHS member state associations. Multiple team champions are crowned for both boys and girls in all states but two, with the majority of states sponsoring tournaments in 4-6 classifications for each, and four states conducting state championships in seven classes.
That is truly March Madness, which is appropriate since the term was first used in connection with high school basketball. Although the tag line became familiar to millions on a national scale in relation to the NCAA Division I Men’s Basketball Championship, the NCAA shares a dual-use trademark with the Illinois High School Association (IHSA), thanks to H. V. Porter, the first full-time executive director of the NFHS.
In his final year as IHSA executive director in 1939, Porter published his “March Madness” essay in reference to the mania surrounding the IHSA’s annual state basketball tournament. Eight years later, in a 1947 Associated Press article, Porter said, “Naturally, we think basketball has done a lot for high school kids, but it’s done something for the older people, too. It has made community life in general a lot more fun each winter.”
While many things have changed in the past 73 years, the value of high school sports – and especially state basketball tournaments – remains as strong as ever today. In some states, seemingly the entire community will travel to the site of the state tournament in support of the high school team.
As a footnote to the use of March Madness, Scott Johnson – recently retired assistant executive director of the IHSA in his book “Association Work” – discovered through research that the first recorded mention of March Madness in relation to basketball occurred in 1931 by Bob Stranahan, sports editor of the New Castle Courier-Times in Indiana.
While the sport remains strong and March Madness is set to begin in earnest across the nation, there is a belief by some that the addition of a shot clock would make the game even better.
Although there are some arguments for implementing the shot clock, the
NFHS Basketball Rules Committee, similar to the other 14 NFHS rules committees, must make decisions based on what is best for the masses – the small schools with less than 100 students as well as large urban schools with 3,000-plus students. Rules changes will always be made with considerations for minimizing risks, containing costs and developing rules that are best for high school athletes.
Nine of our member state associations have elected to use a shot clock in their states, which certainly adds to the clamor for its implementation nationally. And, we at the NFHS have read the headlines, seen the social media posts and received the phone calls advocating for the shot clock’s adoption. However, the Basketball Rules Committee will continue to assess the shot clock based on the aforementioned considerations, as well its members representing all areas of the country.
We encourage everyone to support their local high school teams by attending this year’s exciting state basketball tournaments.
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.