NFHS Voice: Madness to Maddening
March 23, 2020
By Karissa Niehoff
NFHS Executive Director
March Madness took on another meaning for everyone in the sports world during the week of March 9 – a week like none other in the history of organized sports with the acceleration of the coronavirus (COVID-19) in the United States.
The Madness was not the bouncing of basketballs in arenas around the country. Instead it was organization after organization trying to determine the viability of continuing to operate – particularly after the suspension of the NBA season and the cancellation of the NCAA Division I Men’s and Women’s Basketball Championships.
And NFHS-member state high school associations were among those organizations faced with making decisions because the heightened state of the coronavirus pandemic occurred in the middle of state high school basketball tournaments across the country. While 13 states had completed their tournaments, the remainder were faced with tough decisions throughout the week.
By the end of that week, another four states were able to complete their girls and boys basketball tournaments – although all of these states had to impose extreme limits on the number of fans in attendance.
About two-thirds of our member state associations had to shut down their tournaments. At this point, 19 state associations have cancelled their state basketball tournaments, while 15 others have postponed or suspended their events, although the hope of completing them seems to fade with each passing day.
In addition to basketball, some states were in the midst of conducting ice hockey, gymnastics and swimming championships. While most of those sports championships, along with wrestling, were completed, some states were forced to suspend or cancel these as well.
Because of varying information from state health leaders, the Centers for Disease Control and Prevention (CDC) and state governors, some states were able to continue playing longer than others. Each state’s high school basketball tournament is one of the anticipated events of the year – particularly for residents in towns with schools playing for a state title.
From start to finish of state basketball tournaments in the 50 states plus the District of Columbia, more than one million fans trek to gymnasiums to watch these events. This year, however, many of these fans, along with about half of the 950,000 boys and girls who play high school basketball, were not able to experience March Madness.
And if this wasn’t enough, spring sports seasons and championships are at risk – mainly because schools are closed in many states, which means the discontinuation of school activity programs. The NCAA has cancelled all spring sports championships; and while state associations haven’t cancelled spring championships yet, athletics and activities programs are on hold for a set period of time – or indefinitely in some states.
While the loss of college and professional sports has an enormous impact on everyday life, considering that events surrounding the coronavirus affect some 19,500 high schools and 12 million participants in high school sports and performing arts activities, the impact on high school sports is perhaps even larger.
We support our 51 member state association leaders as they continue to work through these challenges. The loss of state basketball championships in many states is a sizeable financial challenge ahead as they work to continue to make state-level athletics and activities programs available.
On many occasions, we have written about the value of high school sports and activities. This month, we have witnessed the disappointment of thousands and thousands of players and fans who were not able to experience a state championship – many of whom were “going to state” for the first time.
High school sports is different from every other level of sport as these programs are a vital part of communities across our nation. Two weeks ago, when the doors were closed in many gymnasiums, it was confirmation of the desire and need for education-based high school sports and activities in the United States.
During this time of imposed social distancing, it is a time to step back and be thankful for these programs in our nation’s schools.
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.