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: Your Best Sports Option
September 18, 2019
By Karissa Niehoff
NFHS Executive Director
Recent articles have documented the rising costs of club sports, with one noting that about 62 percent of “travel ball” parents will go into debt to involve their kids in year-round sports.
A USA Today article in 2017 suggested that travel baseball or volleyball could cost a family upwards of $8,000 a year, with soccer running about $5,000 on the high end. A study by TD Ameritrade suggested some parents were spending about $100 to $500 a month to fund their kids’ participation on a club team, with about 20 percent spending $1,000 a month.
Why? In some cases – unquestionably the minority – students are in the elite category from a skills standpoint and could benefit from a higher level of competition in preparation for college. In most cases, however, it is a case of parents spending beyond their means with the hope that playing club sports will be the difference-maker in their children receiving an athletic scholarship to an NCAA Division I school.
It is, in fact, true that an overwhelming majority of NCAA Division I athletes played club sports. According to an NCAA survey, 92 percent of women and 89 percent of men played club basketball, and 91 percent of women’s volleyball players competed on a non-school team in high school. At the other end, however, only 24 percent of football players competed on a club team.
Herein lies the difference. There are more than 540,000 boys who played high school basketball last year and fewer than 6,000 who played basketball at the NCAA Division I level where most of the scholarships are available. Stated another way, about one percent of high school boys basketball players will play at the NCAA Division I level. About 2.8 percent of the one million-plus boys in high school 11-player football will play at the Division I level.
The answer? Parents should encourage their kids to play multiple sports for their high school teams and save the money they would spend on club sports for college tuition if scholarship money does not materialize. Even in those situations where students are charged a modest fee to participate, school-based sports remain an incredible bargain when compared to club sports.
In many cases, Division I football and basketball coaches are looking to recruit multiple-sport athletes. While there are a few sports where non-school competition is crucial, college coaches will find those athletes who excel in school-based sports.
High school-based sports have more interest, more media coverage and more fans than club sports, and the kids have more fun because they are representing their team and their community.
Playing one sport in the fall, another during the winter and yet another in the spring is the best route to future success – whether that success is on the playing field or court, or in a boardroom.
Dr. Karissa L. Niehoff is beginning 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.