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: Committed to HS Football
February 12, 2020
By Karissa Niehoff
NFHS Executive Director
The enduring popularity of football in the United States was celebrated in the past year at all levels of the sport.
The NFHS celebrated its 100th year of service in all areas of high school sports, including the writing of football playing rules, although the first-known games date to the 1870s.
This past year, the NCAA recognized the 150th anniversary of college football which started in 1869 when Princeton and Rutgers met for the first time. And the National Football League just closed its 100th season, which started with a 1919 game between Dayton and Columbus.
From those beginnings to today, the impact of football on life in America is incalculable. From the youth leagues, through high school and college, and on to the NFL, football is the runaway leader as this country’s most popular sport – both from a participant standpoint with about three million players annually at all levels, to the millions of fans who attend or watch games.
Every fall, millions of families spend a portion of their weekends supporting their grade-school kids in youth football programs. Through these programs, kids are exposed to the basics of the sport and, more importantly, they begin to learn teamwork, sportsmanship and how to win and lose in a proper manner.
On Friday nights, beyond the one million high school students – boys and girls – actually playing football, there are more than 150 million fans who attend games each year. Parents are involved in booster club activities, and homecoming activities occur during one football game every year. In many communities – particularly smaller cities and towns – Friday night football is often the most anticipated event of the week.
Another 50,000-plus players are involved in college football on Saturdays. As is the case at the high school level, homecoming events are tied to one football game every fall. Postseason bowl games have been a part of American culture for decades, and the new College Football Playoff has brought even more excitement to the end of the season.
NFL games on Sunday complete the three-day weekend focus on the country’s favorite sport. Thanks, in part, to the singular weekly focus as opposed to multiple games each week in the other three major professional sports, football dwarfs its competitors.
The interest level in playing football – and following the sport at all levels – has never been higher. With that continued interest in the sport comes the expectation that everything possible is being done – at all levels – to ensure that the safety of each and every participant is of the upmost concern.
With that backdrop, last week we met with leaders from USA Football, several state high school association executive directors and high school coaches and athletic directors representing the National High School Football Coaches Alliance and the National Interscholastic Athletic Administrators Association, respectively.
Collectively, these groups are committed to consistent messaging and support to ensure the ongoing popularity of the sport for the next 100 years. We believe the Football Development Model (FDM) enacted by USA Football will re-invigorate interest in the sport at the youth levels. The FDM reduces contact in youth football and advances the game through comprehensive education, game progressions and safety standards.
There was also agreement about the importance of high school football coaches. By connecting with coaches of youth football programs in their communities, high school football coaches can spur excitement on the part of youth players and their parents and improve chances of kids continuing to play the sport. Without a doubt, high school football coaches can be the focal point to success of programs in communities across the nation.
Working together, we can count on a continuation of the sport’s popularity at the high school level.
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.