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.
Pandemic Planning: Creating a Schedule
December 15, 2020
By Stacy Leatherwood Cannon, M.D.
Henry Ford Health System
With coronavirus continuing to grab headlines and physical distancing orders still in place, every day tends to feel the same.
More parents than ever are working from home, have reduced hours or may even be out of work due to the pandemic. Those who are working at full capacity may feel the strain of trying to balance work and childcare. Many schools and extracurricular programs have been moved online or canceled.
With both parents and kids feeling the stress of new daily routines, it's more important than ever to create a schedule that all family members can follow.
Staying On Schedule
When schedules are off (particularly sleep schedules), children and teens may be at greater risk for depression and anxiety. Younger children may act out because they have increased energy with no outlet. The good news: Creating a schedule — and sticking with it — can help everyone feel more grounded.
Children thrive with an understanding of the daily routine. Knowing what to expect and what they need to do reduces anxiety and helps kids feel more in control.
A few ways to achieve an effective schedule:
• Make it a family affair: Instead of drawing up a schedule and expecting everyone to stick to it, involve your children in the process. Call a family meeting where you come up with sleep and waking times, mealtimes and breaks. Kids are more likely to embrace a new schedule if they played a hand in creating it.
• Enforce bedtime: Children doing remote learning may not have to rise as early to make it to school on time. Even so, it's important to set a regular bedtime so they can remain on task during daylight hours. Your best bet: Establish a bedtime routine that includes calming activities (like a bath and reading) and ensure your children go to bed at an appropriate hour. School-aged kids should get about 9 to 10 hours of sleep each night.
• Stick to mealtimes: Keeping mealtime consistent allows for a structured break where kids and parents can reconnect and troubleshoot when necessary. This is especially important with older adolescents who may work independently during the school day. Unfortunately, what works for one family member may not work for another. Ideally, families should work together to establish mealtimes, then adjust based on each individual's needs and assignments.
• Encourage breaks: Kids and adults alike become zombie-like after sitting in front of a screen for extended periods. For children who are distance learning, frequent breaks are especially important. The younger the child is, the more breaks they need to stay engaged. That said, even older kids should take breaks every 30 minutes or so to walk around, get a snack and do some simple stretches. Better yet, take your breaks together and do some jumping jacks or share a snack as a family.
Successful Scheduling
Coming up with an effective schedule that the whole family can follow is not something you do at the last minute. Plan for the week ahead over the weekend. Sit down as a family and discuss what worked — and what didn't — the previous week. Then tweak as necessary.
Most important, be patient. These are unprecedented times for all of us. And while we have months of experience dealing with this pandemic, transitioning back to school has brought new challenges.
Try to shift your focus toward the perks of this experience. This is a rare moment in history when families can come together and spend a lot of quality time together. It could be a time of growth and transformation for your whole family.
Concerned about how your children are managing the pandemic? Help is available. To find a doctor or pediatrician at Henry Ford, visit henryford.com or call 1-800-HENRYFORD (436-7936).
Stacy Leatherwood Cannon, M.D., is a board-certified pediatrician and the physician champion for childhood wellness for Henry Ford LiveWell. She sees patients at Henry Ford Medical Centers in midtown Detroit and Sterling Heights. Learn more about Dr. Leatherwood Cannon
PHOTO: Novi's Abigail Pheiffer, a senior on the MHSAA Student Advisory Council, gets in some wall sits during a break in her day.