NFHS, states continue efforts to reduce concussion risks


As the end of the 2015 high school football season nears completion, this provides the National Federation of State High School Associations (NFHS) and its 51 member state associations an opportunity to reflect on the work that has been accomplished in the area of player safety. With more than one million student-athletes involved in the sport at the high school level, the NFHS and its member state associations have made risk minimization in football – and all sports – a top priority for many years.

The NFHS has a sound rules-writing process focused in significant part on risk minimization. Also, through the use of online education courses for players, coaches, officials and parents; and the adoption of state laws and protocols for concussion management, the sport of football at the high school level is as safe as it has been since the first rules were written in 1932.

With more than one million students playing the full-contact, collision sport of high school football, there undoubtedly is a degree of risk involved. But from the prohibition of spearing in the mid 1970s to the continued focus on eliminating helmet-to-helmet contact, tremendous strides have been made to reduce that inherent risk of injury.

Within the past 10 years, the following are some of the important steps taken by the NFHS and its member state associations to manage the risk of concussions in high school sports:
• 2005-present – Through the National High School Sports-Related Injury Surveillance System and Dr. Dawn Comstock, the NFHS and its member associations have used comprehensive injury data as a resource in the rules-writing process to reduce risk of future injuries.
• 2008 – The NFHS Sports Medicine Advisory Committee advocated that a concussed athlete must be removed from play and not allowed to play on the same day.
• 2009-present – All NFHS rules publications have contained guidelines for management of a student exhibiting signs, symptoms or behaviors consistent with a concussion. Such player shall be immediately removed from the contest and shall not return to play until cleared by an appropriate health-care professional.
• 2010 – The NFHS developed its “Concussion in Sport” online course at More than two million courses have been taken since that time. In addition, a recent study indicated individuals who took the free course demonstrated a 40-percent higher level of understanding of concussions as compared to their pre- course knowledge base.
• 2010-present – The “Suggested Guidelines for Management of Concussion” have been published in all NFHS rules books.
• 2011 – A six-page section on Concussions was added to the fourth edition of the NFHS Sports Medicine Handbook, which was distributed free to all high schools in the country.
• 2011-2012 – The NFHS Football Rules Committee adopted “Concussions Related to Proper Use of the Helmet” as a Point of Emphasis.
• 2014 – The NFHS Concussion Summit Task Force met in Indianapolis and adopted recommendations for reducing the amount of full contact in practices. State associations crafted their own policies based on these recommendations for implementation in the 2015 football season.
• 2014 – By January 2014, all states had adopted state concussion laws which established mandatory protocols.
• 2014 – The NFHS Football Rules Committee adopted a definition and penalty for targeting aimed at preventing players from hitting an opponent – primarily with the helmet – above the shoulders.
• 2015 – The NFHS distributed the “Anyone Can Save a Life” emergency action plan and training program originally developed by the Minnesota State High School League and Medtronic Foundation to member state associations and their schools.
• 2015 – Some states begin the use of pilot telemedicine programs to assist schools without certified athletic trainers in managing concussions during games.

Football is the most popular sport at all levels in the United States – both in terms of participants and fans – and we believe it will remain the top participatory sport at the high school level for many years to come. With state laws and rules administration in place to govern removing individuals from games who have concussion-like symptoms, to the reduction of contact in practices, to the continued education efforts, the focus on risk minimization has never been higher.
Throughout its history, the NFHS Football Rules Committee has made risk minimization its No. 1 priority and will do so again in January 2016 when it meets to examine the state of the game and address the needs of the students who play the sport.

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