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: Regardless of Future Direction, Multiple Sports/Activities is Best Choice
By
Karissa Niehoff
NFHS Executive Director
May 7, 2021
The values of participating in high school activities – sports, speech and debate, music, theatre and other programs – are well-documented.
A majority of the 12 million-plus participants in education-based activities have higher grade-point averages, are more disciplined and self-confident. In addition, research indicates that participation in high school activities is often a predictor of later success – in college, a career and becoming a contributing member of society.
This past year, the importance of these activities was demonstrated further through the consequences that occurred when these programs suddenly were unavailable.
The social, emotional and mental health of students was affected. When sports and activities no longer were available, many students self-reported symptoms of depression and anxiety. With less physical activity and no involvement in these programs, there were state-reported higher incidences of youth suicide. The research is sobering, and the link between participation in activities and overall health has arguably never been so clear.
So, there is a hope that the expected return to full programming this fall will begin the healing process.
And, if the opportunity to play one sport or activity is a positive step, the chance for involvement in multiple sports or activities throughout the entire school year has untold benefits – for the majority of students who are involved in high school activities to compete with their friends for fun, as well as those who are hoping to play sports at higher levels.
For many students, the experience of playing on a high school team may be the most positive aspect of their lives, and the high school coach or director of a speech or music group may be the most positive role model they have.
So, the return of these activities in schools nationwide is crucial. These programs provide a welcoming place and a means for support, guidance and direction. And when one sport or activity season ends, students should be encouraged to become involved in another activity the next season. Students can also enjoy multiple activities concurrently, such as participating on a sports team while also belonging to a performing arts group.
In a recent article in High School Today magazine, counselors at a school in Delaware reported that the most successful students applying to college and for scholarships are those involved in multiple sports, band, debate and other activities.
In some cases, the opportunity to participate in activities is the chief motivator to attend classes, graduate from high school, obtain a job and begin a career. Playing multiple sports and/or being a part of multiple arts and activities keeps students engaged throughout the school year.
Playing multiple sports is also the best direction for the 3 to 5 percent of high school athletes who will play at the college level. Many parents believe for their son or daughter to earn a college scholarship, they have to specialize in one sport year-round. This is simply not true.
As opposed to playing one sport year-round, playing multiple sports often affords student-athletes a better chance of landing a college athletic scholarship or, for the most elite athletes, having their name called in the NFL or NBA draft.
Consider this year’s NFL draft. Of the 32 first-round draft picks, 27 played one additional sport other than football in high school, and 10 of the 32 played two other sports. Amazingly, one individual – Jaelan Phillips – played five sports (football, basketball, baseball, volleyball and track & field) at Redlands (California) High School.
The list of high-profile professional athletes who played multiple sports in high school rather than focusing on one sport year-round includes the likes of Patrick Mahomes, Tom Brady, Aaron Rodgers, Joe Mauer, Bo Jackson, Alex Rodriguez and John Elway among numerous others.
The advantages of playing multiple sports rather than specializing in one sport are numerous. Students who play multiple sports have a reduced risk of overuse injuries, are able to learn from multiple coaches, participate in cross-training which leads to better athleticism, have better mental development and teamwork skills, and have a reduced chance of burnout in sports.
A number of successful business men and women were highly involved in high school and college sports or performing arts as well. Meg Whitman, CEO of Hewlett-Packard, was the captain of her swimming team and also played lacrosse, tennis and basketball. Former Whole Foods CEO Walter Robb was the captain of the Stanford soccer team. Bank of America CEO Brian Moynihan played rugby at Brown University.
Whether the goal is to participate in high school sports and activities to have fun with their peers, or to achieve a college athletic scholarship, or to be a lifelong participant, the best route to achieving a successful, healthy balance in life is to participate in multiple sports and other activities.
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.