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.
Century of School Sports: Why Does the MHSAA Have These Rules?
By
Geoff Kimmerly
MHSAA.com senior editor
September 18, 2024
MHSAA administrators are two trips into their annual seven-stop fall tour that has become a tradition during nearly half of the Association’s “Century of School Sports” – and this year, a focus has been on answering a key question at the heart of educational athletics since long before the MHSAA was formed during the 1924-25 school year.
The MHSAA’s Update meeting series is in its 47th year and includes half-day conferences in seven locations – generally in the Kalamazoo, Metro Detroit, Grand Rapids, Saginaw, northern Lower Peninsula and mid-Michigan areas, and at Northern Michigan University in Marquette. The six Lower Peninsula sessions begin with an athletic director in-service during which MHSAA assistant directors explain recent rules changes and discuss challenges our administrators face on a daily basis (with Upper Peninsula athletic directors participating in a similar in-service during the spring).
Those in-services are followed by a session with executive director Mark Uyl, who speaks to athletic directors, superintendents, principals and school board members on a variety of topics including the MHSAA’s current objectives and ideas for the future, while also reinforcing the longstanding values that remain the bedrock of our daily work.
And that leads to the question he’s presenting across the state this fall:
Why does the MHSAA have these rules?
Frankly, the answer goes back to the beginning of school sports in Michigan – all the way back to 1895, when the first MHSAA predecessor organization was formed.
The first MHSAA Representative Council president Lewis L. Forsythe explained in his book “Athletics in Michigan High Schools – The First Hundred Years” how regulations always have been necessary:
“Eligibility rules are a necessity in interscholastic competition. It was common acknowledgement of this fact that led to the first State inter-school organization in 1895. The rules at first were few, simple and liberal. But with the passing of the years they came to be more numerous, more complex, and more restrictive, again through common acknowledgment of desirability if not of necessity.”
That necessity – and the reasoning behind it – has not changed.
Two main points explain why rules are absolutely imperative for educational athletics to thrive.
► 1. Participation – through providing as many opportunities as possible for students to play – has been the mission of school sports since their start. Rules contribute to the value of participation.
If there are requirements for children to participate in athletics – for example, an academic standard or rules that dissuade students from switching schools every year – then school sports programs mean more to all involved.
If we raise the bar, raise the standards of eligibility and conduct, we raise the value of our school sports programs. If we lower the bar, we lower the value of being part of school sports – because without rules, contest results are meaningless, and the value of participating is diminished.
► 2. We have rules where the stakes are higher, and agreement is lower – because where the stakes are highest, there is the greatest tendency for some people to try to gain an unfair advantage, and the greatest need for rules to curb possible dishonest activity.
This statement goes to the heart of the history, rationale and application of MHSAA rules. Obviously and simply put, school sports mean a lot to those who take part, and that significance is high enough to stoke disagreement – and we need rules to govern those disagreements. We have the most rules for high school sports, where championships are at stake and the possibility of disagreement is greatest.
***
Finally – and perhaps providing the strongest reinforcement of the two points above – is this:
Schools choose to make MHSAA rules their own.
Quite literally, school districts vote annually to be part of the MHSAA – and confirming this voluntary membership comes with the requirement to follow all MHSAA rules.
When schools challenge our rules, they literally are seeking to break the rules they already have committed to uphold.
These rules, and this commitment, are the strength of our organization across 752 member high schools and several hundred more middle schools and junior high schools. They have been constructed on a century of precedents and after considerations by representatives of those same member schools – representatives those schools have voted to elect every school year during the MHSAA’s history.
Previous "Century of School Sports" Spotlights
Sept. 10: Special Medals, Patches to Commemorate Special Year - Read
Sept. 4: Fall to Finish with 50th Football Championships - Read
Aug. 28: Let the Celebration Begin - Read