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: Lessons Learned in Loss
January 31, 2020
By Karissa Niehoff
NFHS Executive Director
Sometimes in life things simply do not happen as planned. The unexpected is always right around the corner. When these situations occur, we must adapt to change and determine the best steps in moving forward.
Such was the case in selecting the subject for this week’s “Voice.” We were set on addressing the ugly spotlight on professional baseball with the recent sign-stealing incidents and that high school sports is not and must not be about “winning at any cost.”
This is certainly a worthy subject. High school sports is about competing fairly and doing things the right way. The wrong in the baseball scandal was not getting caught; it was players and managers believing that cheating was an acceptable means to winning. These are not the kind of heroes we want to follow.
And then came the events of Sunday morning in California. It was hard to fathom. Kobe Bryant and his 13-year-old daughter, Gianna, were no longer with us. Along with seven others on the helicopter that crashed that morning, Kobe and “Gigi” were on their way to what else – a basketball game.
As people from all over the world – both those who knew Kobe on a personal basis as well as casual fans – expressed their shock and sadness about this tragedy, there were consistent messages about the value of sports and family that were ever present.
While Kobe Bryant was one of the best basketball players ever to play the game, it was apparent that more so than all the all-star appearances and scoring titles and NBA championships, his impact came from the relationships formed through participating in sports – from Lower Merion High School in the Philadelphia suburb of Ardmore, Pennsylvania, to his 20 years with the Los Angeles Lakers.
And then it was about family as he supported his daughters, Natalia, who plays volleyball, and Gigi, a basketball player who was determined someday to play at the University of Connecticut, in their participation in sports. In an interview with PEOPLE Magazine in 2018, Bryant shared how he used his opportunity to coach his daughters in basketball as an opportunity to teach them valuable life lessons.
“A valuable life lesson that I can teach them is what it means to pursue excellence and the commitment level that comes with that,” Bryant said in the PEOPLE interview.
There are many lessons to be learned from this tragedy and the nine lives that were cut short. Our original plan of re-emphasizing that high school sports must not be about “winning at any cost” is certainly among those lessons. Success at the high school level has more to do with preparing students for their lives after high school than winning games or state championships.
Doing things the right way, playing the game the way it is supposed to be played, developing relationships and having fun along the way – that’s the message of high school sports.
As we listened to hundreds of people share their remembrances of Kobe Bryant the past few days, a few things were evident. Like all of us, he was not perfect; however, he showed us the power and influence of sports in our country. He played the game the right way, giving 100-percent effort every night. He regularly praised and supported others, always smiling. And he was passing on his love of sports to his daughters.
And the last lesson – be sure you tell those closest to you every day that you love them.
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.