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: Campaign Touts Benefits of High School Football
By
Karissa Niehoff
NFHS Executive Director
May 21, 2021
A full return to high school sports and performing arts programs – that’s the hope for this fall in schools across the country.
After a year of unprecedented challenges in keeping these programs going due to the pandemic, which included 11 states that conducted their primary football season this spring, there is great optimism as we look to a new school year.
Even in those states that were able to conduct activities last fall, attendance restrictions kept many fans out of stadiums and watching games online. However, with vaccine eligibility now at 12 years of age and older and with vaccinations continuing during the next three months, the likelihood of routines and traditions returning this fall grows stronger each day.
And there is no tradition more anticipated than the full-scale return of high school football. While there were 34 states there were fortunate enough to conduct football at some level last fall, the routines were anything but normal.
This fall, however, we anticipate a return to the energy and excitement of the 2019 season when 1,003,524 boys participated in 11-player football. That total marked a decline of only 2,489 from the previous year and was a good sign of a renewed confidence on the part of parents and student-athletes that concerns about the risk of injury were being addressed.
While boys participation in 11-player football has exceeded one million participants every year since 1999 and is overwhelmingly the most popular boys sport, there have been concerns about declines in past years.
Last fall, the NFHS and the National Football League announced a partnership to promote the growth, understanding and support for football at the high school level. The NFHS and NFL have been studying participation trends, developing educational tools and striving to restore confidence in students and parents that the sport is, in fact, more focused on risk minimization than ever before.
As a result, the springboard to the return of high school football next fall begins this week with the launch of the #ThisIsHSFootball campaign. Through this effort over the next few months, the NFHS will be reaching out to coaches, students, parents, officials, athletic directors and others with research information, participation trends and data on various risk mitigation efforts that, we believe, continues to make high school football safer than it has ever been.
As a part of this effort, the NFHS produced a video entitled “This is High School Football” designed to detail the benefits of participation in high school football.
As the video states, more so than at any other level of play, parents should feel good about their kids playing high school football.
>Here are some of the many educational and medical safeguards put in place the past 12 years to offer parents a comfort level about the safety standards that are a part of high school football.
► Concussion research and education. All NFHS high school playing rules require a student who is exhibiting signs of a concussion to be removed from the game and not allowed to return until the student has been cleared by a medical professional. Thanks to education and training on the part of students, coaches, trainers, parents and others, research data has shown positive trends in concussion rates. In a recent five-year period, concussion rates during practices dropped from 5.47 to 4.44 concussions per 10,000 athletic exposures.
► Concussion in Sport Course. This free online education course has been available through the NFHS Learning Center since 2010, and millions of individuals have taken the course for a deeper understanding about concussions.
► Concussion Laws. By 2014, every state had adopted state concussion laws that established mandatory protocols, and every state high school association has adopted policies that limit contact during preseason drills and in practices during the season.
► Football equipment. Manufacturers continue to produce higher quality equipment every year, and high school coaches are doing a much better job at teaching and coaching the rules of the game and making attempts to minimize risk of injury for players.
► Emergency Action Plans. Thanks to the NFHS Foundation, a copy of the “Anyone Can Save a Life” emergency action plan originally developed by the Minnesota State High School League was sent to all state high school associations and their high schools, and all schools have access to an AED to help save lives.
► Playing Rules. Risk minimization is a major focus of every NFHS sports rules committee. In football, helmet-to-helmet hits are not allowed.
High school football has been a significant part of schools, towns and communities across America for almost 100 years. The NFHS is committed to making the sport as safe as possible for the millions of kids who will play the sport in the years to come.
Dr. Karissa L. Niehoff is in her third 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.