![](/sites/default/files/imported/Photos/Daily/2019_NFHSVoice.jpg)
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.
![](/sites/default/files/imported/Photos/191231_benchmarks_2H.jpg)
Speakers Bureau Helps Generate Conversation
December 30, 2019
By Rob Kaminski
MHSAA benchmarks editor
As student mental health climbs the list of health and safety concerns, the MHSAA and state associations across the country are taking measures to provide resources and guidance aimed to keep school sports an enjoyable and valuable experience.
In sports, coaches and athletes learn to expect the unexpected. It’s the nature of competition; constructing gameplans tailored to utilize team strengths and expose opponents’ weaknesses. Often times this entails doing things that opponents won’t expect. Participants then learn and prepare for the next time; it’s one of the ways athletics prepares participants for life, as educational leaders often preach.
Today’s ever-changing culture recently threw such a curveball at the young people who populate our hallways and playing surfaces, calling for statewide associations and organizations to shift focuses and prepare for a new opponent while attempting to keep school sports one of the best means to a healthy adolescent lifestyle.
“I was at the NCAA summer meeting in 2017, discussing health and safety issues and the topic of concussions came up, as it often does. I assumed that concussions was the No. 1 health and safety issue,” said MHSAA Executive Director Mark Uyl. “I was quickly corrected that it’s student mental health; that knocked me back.”
It would not be an uncommon reaction, given the amount of information, media coverage and programs designed to recognize and reduce concussion incidents in recent years.
All the while, anxiety, depression and stress had been creeping into the picture beneath the surface. Such disorders are much more difficult to detect, as there are few visible symptoms when compared to sprains, fatigue, head injuries and other physical ailments.
“I became interested and began to research the topic. The more I read, the more concerned I became,” Uyl said. “The MHSAA, with a great deal of help and cooperation from our school leaders, has done a tremendous job educating and providing resources for health-related issues such as heat management, concussion reporting and practice policies, and now we have a new challenge.”
Fortunately, as has often been the case, there are knowledgeable and qualified people throughout Michigan’s roster of educational leaders who are willing to assist.
As word spread regarding the student mental health initiative, the MHSAA was able to establish a Mental Health Speakers Bureau composed of several experienced individuals willing to assist (see below).
“Our speakers bureau really grew by word of mouth,” Uyl said. “A school would bring in a speaker, or a league would invite a speaker, and once we were connected with them, then those people would share names and it grew from there.”
The resources range from former professional athletes, to behavioral specialists, to current MHSAA coaches.
Dave Ingles, basketball coach at Kent City, is one such individual. His credibility comes from first-hand experience.
“I privately struggled with deep depression for six years,” Ingles said. “Be alert. Talk to your athletes and students and actually listen to what they are saying. I always used the phrase, ‘I’m fine;’ that is not an acceptable answer to me anymore when I hear it.”
The National Institute of Mental Health reveals that most mental health conditions begin around the time children are transitioning from middle school to high school. The more people trained to identify symptoms and behavior, the better the chance to reduce or reverse some of the following numbers:
• 50% of all lifetime cases of mental illness begin by age 14
• 37% of students with a mental health condition age 14 or older drop out of school
• 20% of students ages 13-18 live with a mental health condition
• 11% of youth have a mood disorder and 8% have an anxiety disorder
• Suicide is the third leading cause of death for ages 10-24
Non-visible ailments always have been most difficult to detect, and today’s proliferation of technology – from streaming to social media – can serve to further mask symptoms.
“The more kids spend time with their devices, staring at their screens, isolation can be quick to take hold,” Uyl said. “Everything is instant. It used to be if our friends didn’t invite us somewhere, we didn’t worry about it; we probably wouldn’t find out for a couple days and had already moved on. Today, in about 10 minutes, there’s a picture on Instagram or Snapchat and kids instantly know, ‘I’m not included.’ Isolation leads to depression and anxiety, and in the worst cases can even lead to suicide.”
That message might sound familiar. Segments of the 2019-20 MHSAA online rules meetings include Uyl emphasizing student mental health and a video clip produced by benice.org promoting a mental health action plan endorsed by four of the state’s most recognized collegiate coaches.
It’s all part of the plan to promote awareness and generate conversation surrounding this serious health and safety issue during 2019-20 and beyond.
“We’re not going to try to do this all by ourselves,” Uyl said. “There are plenty of experts in the field, and we’re going to utilize their knowledge. We’ll build relationships and align ourselves with these people to provide a foundation. We need to become a resource center for our membership.”
In addition to the rules meetings messages, the MHSAA also partnered with the Michigan Association of Secondary School Principals Student Mental Health Summit on Oct. 8 in Lansing. This event – sold out within weeks of posting – invited principals, counselors, student leadership advisers and student leaders to come together to discuss and seek solutions for student mental health concerns impacting schools. The MHSAA lined up Eric Hipple, one of its speaker bureau members, who delivered a keynote, “Depression and Suicidal Awareness.”
Student mental health was among topics during the MHSAA Update and AD In-Service tour around the state this fall as well. The meeting at Comstock Park on Sept. 30 included a presentation from the Mental Health Foundation of West Michigan to introduce the be nice® action plan and encourage schools to take advantage of that and other resources the group has to offer.
The rise of mental health as one of the more prominent medical concerns nationally has occurred, as Ingles sees it, “because more people are talking about it now.”
Leaders like Ingles and those in numerous organizations have begun to assist the MHSAA in identifying and treating cases in our schools.
MHSAA Mental Health Speakers Bureau
Below is a list of individuals and organizations partnering with the MHSAA to assist in promoting mental well-being for students around the state. The MHSAA encourages school personnel to reach out to any of these experienced leaders in the field for programming in your buildings and districts.
• Christy Buck, Executive Director – Mental Health Foundation of West Michigan - be nice.® [email protected]
• Brooke Buys, Mental & Behavioral Health Specialist – BLND Health [email protected]
• Eric Hipple, former Detroit Lions quarterback [email protected]
• Dave Ingles, Basketball Coach & Speaker – Kent City High School [email protected]
• Cat Lanting, Program Coordinator – Mental Health Foundation of West Michigan - be nice.® [email protected]
• Halle Wangler, former University of Michigan basketball player [email protected]
PHOTO: Brooke Buys, a mental and behavioral health specialist and founder of BLND Health, speaks with students. (Photo courtesy of BLND Health.)