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.
Workout Basics: Warm-Ups & Cool-Downs
February 3, 2021
By Nick Parkinson, M.Ed., AT, ATC, TSAC-F
Henry Ford Health Systems
You may know a good warm-up — and cool-down — are essential to getting a good workout. You may also know that warming up your muscles and stretching them out after exercise can help prevent injury and keep you at the top of your game.
They’re the two bookends that help maximize a workout. Unfortunately, a lot of exercise enthusiasts don’t know how to warm up and cool down correctly.
Warm-Up Basics
A warm-up is exactly what it sounds like: The goal is to warm up your muscles and prepare your body for whatever you’re asking it to do. Warming up increases your body temperature and helps blood flow to the muscles that you’re using.
So if you’re going to play soccer, your warm-up should touch all of the muscles in your legs and core. Shooting hoops? You’ll need to add shoulders and arms to your routine. Circuit training at the gym? Choose a warm-up that flexes all of the muscles you’re about to use.
The thing that all warm-ups have in common is that they require dynamic (or constantly moving) motion, not static stretching (holding poses for a certain amount of time). In fact, static stretching prior to a workout can inhibit power and strength, especially if you’re doing something like weightlifting.
The anatomy of a solid warm-up:
• Before any activity, do about 10 minutes of light cardiovascular activity, whether walking, biking or jogging.
• Dynamic stretches. After you get your muscles moving, do a series of lunges, jumping jacks or toe touches to stretch a bit.
• Dive in. When you start your workout, begin slowly and gradually increase power and speed.
Cool-Down Basics
After you’ve put your body through a challenge, a good cool-down is essential. It helps slow down your heart rate gradually, relax your muscles and stretch them out.
Cool-down routines should always include some type of motion before you get to static stretching, especially if you’ve just finished a high-intensity workout. Static stretching improves flexibility and performance and it can also help stave off future injury.
As with warm-ups, the right cool-down exercises depend on the activity you engaged in. If you biked for 20 miles, you might coast on your cycle for a while before coming to a stop. If you ran, you might jog or walk before you begin stretching. As with your warm-up, the key is addressing every muscle group you worked during your workout.
The anatomy of a solid cool-down:
• At the end of your workout, slow the pace and intensity of whatever activity you’re doing. So, if you’re running, slow to a jog and then a walk for 5 to 10 minutes before stopping.
• Stretch out the muscles you work, but don’t push past the point where you feel tight. Then, hold the position for at least 30 seconds. That’s how long it takes for the body to overcome its stretch reflex.
• Breathe through your stretches and make sure to finish your cool-down with deep, belly breaths.
Running short on time? Target muscle groups you may have injured in the past or that tend to get sore after activity. Cooling down will preserve your athleticism — and your ability to participate in daily activities — over the long term.
Be Good to Your Body
While there’s some controversy about whether warming up and cooling down can help prevent injury, there’s little dispute that they can help you ease in and out of activity.
The key is to find something that works for you. Your warm-up could be as simple as walking to the gym and doing a set of jumping jacks when you arrive. Your cool-down might just involve ending your workout 10 minutes early so you can slow down.
It doesn’t have to be complicated. It just has to give your heart and blood vessels a chance to breathe before and after activity.
Nick Parkinson, M.Ed., AT, ATC, TSAC-F, is the Supervisor of Athletic Training with Henry Ford Sports Medicine and also leads Sports Performance training at the William Clay Ford Center for Athletic Medicine. Learn more about Nick.
Want to learn more? Henry Ford Health System sports medicine experts are treating the whole athlete, in a whole new way. From nutrition to neurology, and from injury prevention to treatment of sports-related conditions, they can give your athlete a unique game plan.
Visit henryford.com/sports or call (313) 972-4216.