NFHS Voice: Reading the Crystal Ball

May 15, 2020

By Karissa Niehoff
NFHS Executive Director

Re-opening is the key word in sports at all levels right now. Every day, there are new projections for when the National Basketball Association and Major League Baseball will resume – and if the National Football League will start on time this fall.

Along with leaders of youth-level sports and the NCAA, the NFHS and its member state associations are exploring all options for conducting sports this fall. And while we all want answers, the truth is that there are more questions than answers at this point.

Dr. Anthony Fauci, the leading national medical authority throughout the COVID-19 pandemic, told ESPN earlier this week that “the virus will make the decision for us” on whether sports will return this fall. His comments underscore the need for leaders of all levels of sport in the United States to exercise great caution as we re-engage in activities.  

Without a doubt, education will play a larger role in the decision-making process for high school programs than for non-scholastic programs. Despite the significant loss of revenue that could occur at some levels if programs remained closed, health and safety concerns must take priority when it comes to re-opening the sport or activity.

At the high school level, sports and other activity programs will most likely not return until schools re-open. High school sports and performing arts are education-based programs and complete the learning process on a day-to-day basis. As such, academics during the school day and sports and other activities after school are inseparable. 

Could any of those sports and activities return without fans? That option is certainly not one schools favor, but it is a very real possibility. While a few state associations opted for that arrangement to complete state basketball tournaments, that is not a desired ongoing plan for school sports. Besides, this troubling question would have to be addressed: If it is unsafe for fans in the stands, is it safe for the students to be participating?

Students, parents and other fans in the stands cheering for and supporting student-athletes, and applauding from the theatre audience, are among the most wonderful aspects of education-based activities. Before accepting that arrangement, efforts will continue to make attending events a safe experience for everyone.

While we remain uncertain as to the timetable for the return of high school sports and other activities, we believe that when these programs return – and they will return – that everyone will bring renewed zeal to provide the 12 million participants in these programs the best experience possible.

One of the challenges to solving the crystal ball of high school sports and activities this fall is the uncertainty of the spread of the virus as states begin to re-open this month. The NFHS will continue to work with its Sports Medicine Advisory Committee on an ongoing basis to provide the most updated information.

With the non-negotiable tenet of safety for student activity participants, expect every avenue to be pursued so that students can be involved in football, soccer, volleyball, field hockey, speech, debate, music and many other school activities this fall.   

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.

Concussion Care: Signs & Symptoms to Watch

October 27, 2020

Henry Ford Health System

When you experience a blow to the head, knowing whether you've suffered a concussion isn't always clear cut.

Head injuries have a range of physical, psychological and intellectual effects — and only a small number of people lose consciousness.

"It's critical for parents, coaches, players and trainers to recognize the potential signs and symptoms of a concussion," says Jeffrey Kutcher, M.D., a sports neurologist who treats athletes at the Henry Ford Kutcher Clinic for Concussion and Sports Neurology. "The basic rule is that a concussion can affect any aspect of brain function."

Signs of Concussion

The Latin root of the word "concussion" means "to shake violently" — which makes sense. Concussions happen when there's a combination of movement and impact. So, any injury that involves a hit to the head — a fall, collision or hard hit by a heavy object — could cause one. So could a hit to the body that causes the head to move quickly.

"But every brain injury is different," Dr. Kutcher says. "Some symptoms show up right away while others develop gradually over days."

Here are common concussion symptoms to watch for — both immediately following a head injury and in the hours and days after:

Physical Concussion Symptoms

  • Changes in sleep patterns
  • Difficulty with balance
  • Dizziness or lightheadedness
  • Fatigue
  • Headache
  • Light sensitivity
  • Nausea
  • Numbness or tingling
  • Sensitivity to sound
  • Visual problems
  • Vomiting

Emotional Concussion Symptoms

  • Anxiety
  • Depression
  • Irritability
  • Mood swings

Cognitive Concussion Symptoms

  • Confusion
  • Difficulty concentrating
  • Feeling "slow" or "foggy"
  • Memory problems

Diagnosing Concussion: Getting It Right

One reason concussions are frequently misdiagnosed is because they're assessed on the field or courtside during game play or practice. Coaches, trainers and parents often make lightning fast decisions about whether symptoms, such as headache, nausea and light sensitivity, are signs of concussion.

"Unfortunately, it’s more complicated than completing a concussion checklist. Everyone — and every concussion — is different. So, observers shouldn’t be diagnosing a head injury on the spot, but rather making a triage decision for safety. They should leave the diagnosis to the medical professionals," Dr. Kutcher says. In fact, those in-the-moment assessments are wrong about half of the time.

People should focus instead on getting immediate, emergency care for anyone who displays the following signs and symptoms right after a hit:

  • Difficulty walking
  • Weakness on one or both sides
  • Not waking up
  • Repeated vomiting
  • Persistent confusion
  • Seizures
  • Unconsciousness

No matter how hard (or lightly) you think you've been hit, it's important to take head injury symptoms seriously. Even a seemingly minor blow could have a major impact. A complete evaluation by a medical professional will not only determine whether you have a concussion, it can also identify more serious, or even life-threatening, concerns.

"In every case, medical professionals are better equipped to assess the extent of the damage if you have a comprehensive baseline evaluation on file," Dr. Kutcher says. This thorough evaluation with a sports neurologist, including a complete family and neurological history, can act as a critical point of reference when trainers and medical professionals are trying to diagnose or manage a concussion.

Dr. Jeffrey Kutcher is a sports neurologist and the medical director of the Henry Ford Kutcher Clinic for Concussion and Sports Neurology.

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 for an appointment within 24 business hours.