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.
Timeout to Appreciate Officials
September 23, 2013
By Kevin Wolma
Hudsonville athletic director
Wolma is in his third school year as athletic director at Hudsonville and previously coached basketball and golf. Below is a recent “30-second timeout” he wrote for the Hudsonville district newsletter.
We were five seconds away from one of the greatest upsets in the history of Caledonia basketball.
During the regular season, South Christian had beaten us by more than 30 points on two different occasions. The District Finals became the site for the third contest between the two schools on a warm March day.
We were able to slow them down just enough to stay within striking distance until late in the fourth quarter, when we finally took the lead for the first time. South Christian had one last chance with seven seconds left on the clock. After a timeout, they in-bounded the ball from the sideline and their player forced up a shot. I could see it was going to be short from my viewpoint, and my heart began to race with adrenaline as I could sense the impossible was going to become possible.
What happened next has stuck with me for the rest of my life, as one of the South Christian players pushed one of our players in the back, grabbed the rebound, and put the ball in the basket with one second left.
Game over. South Christian wins the District championship.
For the next eight years as a varsity basketball coach, I held a grudge against officials for that one call. Twelve years later, after I was done coaching, I went back and watched the game over again for the first time. I almost turned the video off when they in-bounded the ball in those last seven seconds because I did not want to relive that moment and the ensuing emotions that took place.
While watching I discovered something.
The South Christian player did not shove my player as much as I thought, and our players did not box out like I had thought, which made it easier for them to get the rebound and score. Looking back, did I even tell my players to box out during that last timeout before the ball was in-bounded?
At that moment it became very clear to me that what we see during a game may be clouded because we want our team to gain every advantage and every call in order for them to be successful. Perception is not reality. Officials are human. They will make mistakes just like the coaches and players do during a game.
There still has never been a game that has been decided by an official. Some people will say that the Class B Semifinal boys basketball game (in 2010) was decided on an official’s call when they ruled one of Forest Hills Northern’s player's foot was on the line on his last-second shot when in reality his foot clearly was behind the line. That call cost them a chance to play in the (MHSAA) Finals.
Coach Steve Harvey was quoted in the paper as saying, "We had opportunities to take care of the game before it even came down to that shot.” In the moment it seemed like that one play cost Forest Hills Northern the game, but there were over 50 possessions on offense and defense that preceded the play and potential outcome.
Having the opportunity to spend time with officials inside the locker room has made it very evident they are serious about their jobs and calling the best game they can. I have had requests from officials to have a monitor available to break down film an hour and a half before their contest begins to see strengths and weaknesses in their placement and mechanics from prior contests. I have had officials upset at halftime or after a game because they realized they made a mistake. I have had officials contact me personally after a game to apologize for a call made during the contest.
In the business world and also in education we use the word collaboration a lot. Officials collaborate before, during, and after every contest to garner more knowledge so they can continue to improve.
This is not even their full time job. Officials do what they do because they love the game and want to give back to the sport that made an impact on them.
The next time we are at a game and we think the officials missed a call, let’s take a 30-second timeout to gather our emotions so we do not say anything we will regret later. Instead let’s spend our energy cheering on our teams to be the best they can be.