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.
Teaching ABC's of Pressure Situations
October 30, 2013
By Eric Martin
MSU Institute for the Study of Youth Sports
Coaches have seen the signs: Athletes having too much or not enough energy prior to a game, quickening breathing, sweating more than usual, being unable to focus on important details, and having their minds wander from the present to “what if” scenarios and past mistakes.
Athletes deal with pressure in many ways. Although some handle it well, many do not have the tools to perform to their full abilities in these situations. Most athletes place a high importance on succeeding in sport, and when athletes reach regional, district, or state championships, the pressure they feel may become overwhelming.
How athletes handle this increased pressure can often mean the difference between winning and losing. Therefore, helping athletes deal with it is something coaches should consider prior to athletes encountering these high-stakes situations.
Unfortunately, there is no magic elixir for helping your athletes work under pressure. But if these ABC’s of pressure situations are followed, your athletes will be much better equipped to cope, and the chances of their performance levels dropping significantly will be reduced.
1. Act the Part
How you as coaches act influences your athletes. For better or worse, athletes notice your emotions in response to these situations and take cues from how you handle pressure.
You are a demand on your players’ attention – you can add or reduce your players’ perceived stress by how you act. Understanding the demand you place on players requires self-awareness. How do you respond when a key call goes against you? Do you have nervous habits that athletes may notice? What messages are you providing to your athletes – both verbally and non-verbally? Athletes pick up on these non-verbal cues, so you must be aware of how you respond to these situations.
It is important to remember emotions are not always negative – rather acting differently than normal can be a signal to your athletes that you are stressed. Strive to be consistent in your actions – whether you are coaching during a preseason match or championship contest. These situations are stressful for you too, but you need to be the constant your athletes look to for stability.
2. Breathing – Remember to do it
It seems like a simple thing, but when athletes’ emotions are running high, they forget how to breathe – or, at least, forget how to breathe properly. Worse, they often think they are breathing normally but don’t notice breaths are becoming shorter and shallower. Teaching athletes to breathe properly when not in pressure situations will help them have the tools to rely on when they encounter more intense scenarios.
For proper breathing, athletes need to do so from the belly and not the chest. The pace of this breathing should be 6-2-7; that is, have athletes take a deep breath from the abdomen for six seconds, hold for two seconds, and then finally slowly exhale completely for seven seconds. This breathing strategy is ideal for pregame situations to quiet nerves and help athletes get ready to play, but a condensed version (3-2-3) can also be used for quick breaks in the action like a timeout or court change.
3. Control the controllables
During times of high pressure, athletes sometimes feel they do not have control over their own performances. It is important to help athletes focus on things they can control and not worry about those that cannot be changed or are outside their influence.
Instead of athletes dwelling on aspects that are out of their control like unusual game times for championship finals or a referee’s bad call, help them focus on completing their warm-up preparations and how they can respond to poor calls. Helping focus athletes’ attention on things they can control will help them better handle pressure situations and leave them feeling less helpless
Athletes’ emotions are typically out of their control, but how they view them and respond to these emotions are under their control. Author and preacher Charles R. Swindoll said, “Life is 10 percent what happens to you and 90 percent how you react to it!” Be sure your athletes know how to respond when difficult situations arise.
Conclusion: Fearlessness is an assembly
Not all athletes react to pressure situations in the same manner, but all athletes can benefit from these simple suggestions. Remember to ACT THE PART of how you want your athletes to act, teach your athletes proper BREATHING techniques, and help athletes focus on CONTROLLING THE CONTROLLABLES.
Good preparation is the key to performance. Increase self-monitoring and give athletes the tools to succeed in pressure situations; they, in turn, can be in a better position to succeed. However, like any skills, they must be practiced accordingly, and one session will not solve all issues. Devote the time to train athletes in these skills, and when the need arises they will have them ready to use.
Good luck this season!
Martin is a third-year doctoral student in the Institute for the Study of Youth Sports at Michigan State University. His research interests include athlete motivation and development of passion in youth, sport specialization, and coaches’ perspectives on working with the millennial athlete. He has led many sessions of the MHSAA Captains Leadership Clinic and consulted with junior high, high school, and collegiate athletes. If you have questions or comments, contact him at [email protected].