The national leadership organization for high school sports since 1920, the NFHS is dedicated to providing a fulfilling education-based athletic experience to the more than 7.8 million students that participate in high school sports every year.
As has been the case throughout the organization’s history, the safety of those student-athletes remains the No. 1 priority. In recent years, the NFHS and its 51 member state associations have devoted their efforts to risk minimization strategies regarding head injuries and concussions.
In 2008, the NFHS Sports Medicine Advisory Committee (SMAC) began advocating for more strict return-to-play guidelines for concussed athletes. For the past six years, all NFHS rules publications have included guidelines for the management of concussions suffered by student-athletes. And in 2010, the NFHS launched the online course, “Concussion in Sports,” which has now been taken by more than two million individuals through the NFHS Learning Center at www.nfhslearn.com.
In July 2014, the first NFHS Concussion Summit Task Force convened to continue this vital initiative, specifically for the sport of football. The task force composed of medical and scientific professionals, high school football coaches, state association personnel and representatives of various stakeholder organizations developed a list of recommendations and guidelines intended to minimize the risk of head trauma and concussions.
Perhaps the most significant of the nine total recommendations were those that called for limiting the overall amount and frequency of full-contact during practices, both during the traditional fall season and offseason activities. The task force followed the USA Football definitions of Levels of Contact in its position paper, meaning that both full-contact levels, “Thud” and “Live Action,” would be restricted in practice. The “Air,” “Bags” and “Control” levels are considered no- or light-contact and, therefore, are not limited in their use.
First, the task force strongly recommended that full-contact practice be limited to two to three practices per week, and only 60-90 minutes in that week. Additionally, the task force urged states to consider restricting full-contact on consecutive days and to only one session of two-a-day practices.
“The primary concern of the NFHS Concussion Summit Task Force was to limit head impact exposures and try to minimize the long-term, cumulative negative effects related to non-concussive blows to the head and body,” stated Dr. William Heinz, chair of the NFHS SMAC. “We also were very cognizant of trying to avoid any unintended consequences of increased injury rates related to not having the players adequately prepared for game situations. We feel the recommendations achieve a good balance between the two goals.”
Some states had already adopted similar limitations in previous years. In 2013, Texas began limiting its players to 90 minutes of full-contact practice per week during the regular season and postseason. Preliminary High School RIO injury surveillance data suggest that the new policy resulted in a statistically significant decrease in concussion rates during practices, and similar results were seen in Arizona, Maryland and Alabama after comparable changes were made to practice rules in those states.
The task force designed its recommendations to be flexible for state associations as they adopted their own requirements. In the months leading up to this fall season, some state associations adopted the recommendations exactly, while others altered them to more closely fit the needs of their member schools.
For example, the state associations in Iowa, Kansas, Georgia and Tennessee opted to limit full-contact practice to 90 minutes a week. Other states, such as Ohio, chose to limit full-contact to 60 minutes a week instead. That flexibility was an important part of the recommendations according to many state association administrators across the country.
“Our committee was able to adjust some things so the recommendations would be a better fit for our schedule,” said Mark Lentz, assistant executive director and administrator for football at the Kansas State High School Activities Association (KSHSAA).
The KSHSAA has been one of many state associations to make changes to its football rules that went beyond the recommendations of the task force. For example, players in Kansas will no longer be able to participate in “Live Action” the day after a game. And, effective with the 2016 season, they will not be allowed to participate in games on consecutive days. That change was made to address the issue of student-athletes playing a varsity game followed by a junior varsity game the next day, Lentz said.
Many states have also enacted rules changes establishing a progression up to full-contact in preseason practices, similar to the heat acclimatization schedules integrated into preseason workouts in recent years. In Illinois for example, the Illinois High School Association (IHSA) limits equipment to helmets only during the first two days of practice, helmets and shoulder pads the next three days, with full pads being allowed on the sixth day of the acclimatization period. Similar progressions have also been adopted in Alabama, Minnesota and Kansas, among others.
Another key recommendation from the task force was that each member state association review its policies concerning offseason football. In states such as Ohio and Illinois, there were already rules in place to limit contact during the offseason, with teams prevented from participating in full gear or in full-contact practices. Other states that previously had no restrictions in place for offseason football have begun to adhere to the task force’s guidelines as well.
“The information from the NFHS Concussion Summit was very beneficial as we developed these new policies,” said Kevin Merkle, associate director of the Minnesota State High School League (MSHSL). The MSHSL now limits its coaches to 11 contact days during the summer, with full-contact – “Thud” and “Live Action” – being limited to four of those days.
Although the new rules being enacted this year vary among the states, there has been one constant: the overwhelmingly positive response from coaches. Because of the increased focus on student-athlete safety in recent years, there has been little pushback, said Beau Rugg, assistant commissioner and administrator for football at the Ohio High School Athletic Association (OHSAA).
“Our coaches like the new regulations because they understand they help make football safer for our students,” Rugg said. “Some coaches have even responded saying that the new limitations are keeping their teams fresher for the upcoming season.”
Rugg’s feedback in Ohio has been mirrored in Kansas, according to Lentz.
“Our coaches were part of the process to implement these recommendations, so they completely understand why it was time to make some changes,” Lentz said.
As for future changes, there are still a few important topics to be discussed for upcoming seasons. Continuing to emphasize proper techniques and adjusting to the new rules for targeting and unnecessary contact are chief among them, Merkle says.
“We are making the rules changes a major focus for our game officials, as it is imperative that they call those penalties to keep the game as safe as possible.”
Other recommendations from the NFHS task force involved implementing coach education programs, as well as having a written Concussion Management Protocol and Emergency Action Plan in each school.
“We continue to emphasize the concussion issue with our schools, not just in football but in all sports,” Merkle said. “It is vital that we do our best to provide them with the most recent information.”
“Looking at the big picture going forward, it is all about continuing to change the football culture across the country and minimizing risk for all who participate in the sport,” said Bob Colgate, NFHS director of sports and sports medicine.