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: Football Powerful in Healing
December 27, 2019
By Karissa Niehoff
NFHS Executive Director
Dates of some tragedies are etched in our memories forever. On September 11, we pause to remember the thousands who perished in 2001 as a result of the attacks on the World Trade Center, the Pentagon and the hijacked United Airlines Flight 93 that crashed near Shanksville, Pennsylvania.
Many individuals remember where they were when President John F. Kennedy was assassinated on November 22, 1963 and/or when Dr. Martin Luther King Jr. was gunned down on April 4, 1968.
Unfortunately, in the past 20 years, there are several dates stamped in our memories because of shootings in our nation’s schools, such as the ones at Columbine High School in Littleton, Colorado, on April 20, 1999, and Marjory Stoneman Douglas High School in Parkland, Florida, on February 14, 2018.
And on December 14, 2012, the nation wept when 26 people, including 20 children, were killed during the mass shooting at Sandy Hook Elementary School in Newtown, Connecticut. While this tragedy tore the hearts of people nationwide, it was profoundly personal to me.
I was executive director of the Connecticut Association of Schools-Connecticut Interscholastic Athletic Conference and, on that day, was attending a meeting with the Commissioner of Education and the Board of Directors for the Connecticut Association of Public School Superintendents. The commissioner was interrupted to take a private call, left immediately, and shortly thereafter the news of a “school shooting” reached the nation.
Suddenly, what previously was important became insignificant as we were all shocked at yet another senseless act of violence. As details of the shooting rampage were released, the incident became more and more horrific. The principal of Sandy Hook Elementary at the time, Dawn Hochsprung, was one of the six adults who perished that day. She was a personal friend of mine.
So, like millions of Americans earlier this month, I was overcome with emotion when Newtown High School won the CIAC Class LL State Football Championship – seven years to the exact day of the Sandy Hook tragedy. Newtown won the state title on the last play of the game as Jack Street – a fourth-grader at Sandy Hook in 2012 – threw a touchdown pass just as the fog lifted enough to be able to see downfield.
Once again, high school sports, and football in particular, was a unifying activity for a community. Amid the sorrow of the day, this incredible storybook finish by the Newtown High School football team gave everyone in the community – at least for a moment – the strength to continue the healing process.
We have seen time after time when high school sports provided students, parents and those in our communities a means to come together, to band together and to rise above struggles arm in arm. This was but the latest example.
The grieving process will continue for those people who lost loved ones in the Sandy Hook tragedy, but this amazing effort by these high school football players brought smiles and tears of joy to a community that has not had many of those emotions for the past seven years.
Bobby Pattison, the Newtown High School football coach, had the following to say after the state title:
“The great thing about football and sports in general, moments like this bring people together,” Pattison said. “These guys had an outstanding year. To win a state championship, to win on the last play, it’s been a tremendous accomplishment. And these boys deserve it. They’re a great bunch.”
The value of high school football for communities across America? We would suggest what happened in Newtown, Connecticut, this season says it all.
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.