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.

School Sports Reflection: Play to Learn

December 7, 2018

By Christopher Mundy
Special for benchmarks 

Christopher Mundy is a graduate of Manton High School and Michigan State University and the principal of Mundy Advisors Group in Chicago. This commentary previously was published this summer in the Traverse City Record-Eagle.

What are sports really about today? And are today's parents missing the point? Time, money, effort and energy. All for what? Trophies, medals, first place, a college scholarship or that top-five draft pick and that multi-million dollar contract that come with it. Fortune and fame? 

Why does American society have such an obsession with sports, and are the true values of the games being lost in the “new” modern era of sports?

What if the games kids played were for the pure values of competition, hard work, camaraderie, trust, respect, discipline, communication and relationship building? Even just expressing these words and phrases seems healthier than the win-at-all-cost, everyone-gets-a-trophy, playing for the “end game” society we currently live in.

What messages are we instilling/infusing in our future leaders? It has become a strong and consistent message across all fronts – the arms race to be the best and win at all costs.

Families sacrificing their most precious resources, time and money, for what? For the golden child, the chosen child ... that special one. A glimmer of hope that becomes a burning obsession (for the parent). Are parents attempting to right their wrongs of their playing days or relive their youth through their child? It is an easy and complex trap. 

I don’t have children, but I have played sports for nearly 40 years. I have coached, officiated, watched and listened closely at all levels. A spectator with an intense passion for the lessons to learn and a strong curiosity of why and how. I guess at 45 I am old ... or maybe just old-school.

Being raised on an isolated farm in Northern Michigan with a dirt driveway and a makeshift basketball hoop created the love affair with sports. Games of pig, horse or around-the-world with my father are some of my fondest memories. He has since passed. He would always shoot with his off-hand or easy bunny shots to finish me off. And Dad always told me, if you want to play in the fourth quarter, be a 90-percent free-throw shooter and the coach has to put you in.

Baseball would entail games of rain on the roof by myself and a homemade batting tee to hit home runs into the pasture. Football was either offense-defense (three-person football, with my father as quarterback) against my older sister or breakaway running plays against my aggressive dogs; a stiff-arm was my best defense. No video games or cable television on our farm, maybe this fueled my fire or forced my hand. It sure did not make friends want to come over for sleepovers. 

Small town America was a great place to be raised. I am biased in that regard. I do think it takes a village to raise a child. Sports was and is the fiber of these communities; it was reality TV before reality TV, and what Friday Night Lights was based on. Kids playing a game for a common goal. It could not be more simple or pure. They are called “games” for a reason. When did we start taking it so seriously? Where did we go wrong? 

In high school, we were pretty good. You put kids together since kindergarten and they kind of know and trust each other, they know each other’s strengths and weaknesses. They know more than this. They know each other’s families. And extended families. They pretty much know everything about each other. Which family is broken and which one may have a little more love at their dinner table. Good or bad, this is the reality of being raised in a small town.

Our basketball team was so good we received a top-five ranking, and legendary Detroit Free Press writer Mick McCabe compared us to Hickory, Indiana, in the movie “Hoosiers.” No Hollywood ending for Manton in 1991 though.

This is where the lessons of sports become real; the harsh reality of your childhood fantasies begin to fade, and fade quickly. The hours spent in that driveway will lead to no state championships. The early morning trips to the gym to play against your adult coaches would lead to no college scholarships. And the thousands of hours in the weight room lifting, jumping rope and wearing ankle weights would lead to no multi-million dollar contract. Devastating. Crushing. The end?

No. This is just the beginning. 

This is the beginning of life’s toughest lessons being learned. This is where the sweat of your youth meets the tears of maturity, leading to a wisdom that is worth more than any trophy. Maturity is processing these challenging life lessons, learning from them and moving on. If you do not let go of these failures, the burdens can lead you to a life of regret or maybe becoming that aggressive parent trying correct his or her shortcomings through a son or daughter. You know these parents from your kid's games, and I hope you are not one of them.

It has often been stated more is learned from losing than winning. The lessons from failure burn deep, etched into our soul, this pain more powerful than the glory of victory. These lessons and scenarios easily translate to our personal relationships and work life. Memorable. Powerful anecdotes that become part of us. Part of or history. Part of our story. Erase these chapters from our lives, and what are we left with? A shell of a person. A half-written book. A journey half-walked. Perspective with no depth.

These kinds of lessons can’t be learned in a textbook, cannot be explained by a parent or modeled by a teacher in a classroom. The field, the court, the rink is where these lessons are learned. Where family values are refined. Manners are taught. And respect is earned.

Or is it?

This is the crossroads we are at as a society.  I cannot think of any other vehicle that offers so much potential and opportunity for the building of character. It starts with the family. And where does it go from there? School, church, a job. The military. A fraternity. Volunteering? An internship or apprenticeship? A civic organization?

Nope. Sports.

Sports is the most dynamic and able tool to build character. The kind of character we need right now as a country and society. Polished. Refined. Character with a sharp edge. An edge called courage. But the reality is sports has become about money, power and control. Are these qualities desirable? Have they corrupted the innocence of sports? Do we worship false idols? Is this generation entitled? Have we given them too much? Made it to easy?

Are the kids having fun? What do the kids want? Do kids have and show a genuine passion for a sport? Have we dared to ask them? Have we prepped them with the appropriate answer? Or do we answer for them? Do we hear them OR do we listen to them? To clarify, listening is an active process of hearing and then processing. Coach Tom Izzo starts each basketball camp with, “Learn to listen ... and listen to learn.” It is that simple.

I do think communication is vital to this process. Communication between all parties: athletic directors, coaches, parents and players. Governing bodies. All stakeholders. A real and raw dialogue on what we collectively want out of sports. Because somehow we have gotten lost, and the many headlines and feature stories confirm the crossroads where we’ve arrived.

Do we as leaders, adults, parents care enough to look into the mirror and ask the tough questions? Or is it just easier to proceed as is?  If you believe sports has a larger impact than trophies, medals and ribbons, a larger value than money, then I encourage you to start the conversation with those around you. Our communities’ futures depend on these conversations.

We may soon reach a point of no return, and this would be a catastrophic failure for our generation. When playing for the “love of the game” is just a marketing tagline and not a real opportunity for our kids. For our children’s sake, I hope this is not the case. I know I am a better athlete, better professional and better human from all the losses in my life.

Play hard. Play to compete. Play with passion. Play to learn.