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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.
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NFHS Voice: Multi-Sport Paves QB's Way
February 10, 2020
By Karissa Niehoff
NFHS Executive Director
On football’s grandest stage earlier this month, its latest star attraction not only delivered another virtuoso performance but demonstrated the best career path to success.
In leading the Kansas City Chiefs to victory in Super Bowl LIV, quarterback Patrick Mahomes brought to an end another tremendous year of football at all levels and became the latest – and perhaps best – example of the benefits of playing multiple sports during high school.
In the week prior to the Super Bowl, Mahomes talked about his ascension to the top of the football world. Despite the opportunity to focus solely on baseball as his father had done, Mahomes rejected sport specialization. Instead, he spoke about how playing multiple sports in high school paved the way for his success.
The top performer on the grandest stage of the sport, Mahomes made it to the top of the football mountain by NOT playing football year-round. Had he chosen to specialize in one sport during his high school days in east Texas, Mahomes might never had made it to NFL since, as he noted in the week prior to the Super Bowl, he was “a baseball player that was playing football.”
Mahomes believes the skills he learned as a shortstop in baseball and as a point guard in basketball helped him more as a quarterback on the football field than if he had chosen to devote his entire energies to football.
His uncanny ability to throw passes from various angles unlike any of today’s perfect-form pocket quarterbacks? He gained those skills on the baseball field. His ability to throw lasers to his intended receivers without looking? He learned those skills on the basketball court at Whitehouse High School in Texas.
His trek to the top of the football world supports our belief that playing multiple sports within the education-based structure – as opposed to a single-sport focus in a non-school program – is the best route to future success.
Mahomes experienced the benefits of playing multiple sports – better leadership and teamwork skills from cross-training, reduced risk of burnout in one sport, a variety of experiences from involvement with different sports and teams, reduced risk of overuse injuries in one sport and exposure to a variety of coaching styles.
Many parents believe that in order for their son or daughter to earn a college scholarship and eventually play at the professional level, they have to specialize in one sport year-round. This pattern has led to the proliferation of non-school programs and coaches, many of which stray from the education-based focus of high school sports.
While there are a few who achieve elite status in a sport, the majority of people who participate do not. We believe the multiple-sport path demonstrated by Mahomes is the best route to attaining athletic success and lifelong enjoyment of sports.
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.