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: Find Answers at Youth Level
November 13, 2019
By Karissa Niehoff
NFHS Executive Director
Are there long-term solutions to increasing the number of participants in high school sports and improving parental behavior at high school contests? The answer to both questions might start at the youth sports level.
The NFHS hosted a first-ever meeting of about 25 leaders of National Governing Bodies and the U.S. Olympic & Paralympic Committee last week to discuss common concerns and opportunities to align and work together.
Within the youth areas of these organizations, the issues are familiar ones to high school leaders – decline in participation, parent behavior, coaches education and minimizing the injury risk. Clearly, however, reaching parents with appropriate educational messages on sportsmanship, injury risk and the values of participation is a top priority for leaders at all levels – youth, middle school and high school sports.
Recently, the NFHS formed a Middle School Committee in an effort to build interest in education-based sports at that level and to share the proper messages with parents before their kids reach high school. However, as we learned last week, middle school may even be too late!
Those educational messages will be enhanced if the process starts in out-of-school youth sports. If messages about the values of multi-sport participation, playing for the love of the game, and limiting contact in sports like football are consistently shared and demonstrated at the youth level, the education-based concept should be firmly in place by the time students reach high school.
Coaches education is another common concern. While the NFHS has created an outstanding online education program for interscholastic coaches through the NFHS Learning Center (www.NFHSLearn.com), there is no standard requirement to coach at the youth level. There should be some type of required certification for anyone to walk onto a field or court to coach. And while knowledge about teaching the proper tackling form in football or the proper defensive positioning in basketball is important, those are not the most important prerequisites for coaching.
Similar to the NFHS’ online Fundamentals of Coaching course, youth coaches should be required to take courses that help them learn how to coach the kids more so than the sport. And since many of the coaches at this level are parents of players on the team, these individuals – and all youth parents – should be presented materials similar to what is presented at preseason meetings at the high school level. This would include, among other things, the non-negotiable requirement to positively support their child while letting the coaches coach, and the officials officiate.
Lofty goals, for sure, without a collective governing organization over youth sports. However, these concepts can be endorsed and promoted within the youth areas of sport-specific NGBs. These fundamentals of education-based athletics are essential for the 2-3 percent who play sports beyond high school as well as the majority who apply the values learned in high school sports in their chosen careers.
The skills will eventually fade – even for those individuals who play sports beyond high school – but the values learned from playing sports, beginning at the youth sports level, will last a lifetime.
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.