NFHS responds to the IOM/NRC Concussion Report
After reading the IOM Concussion Report yesterday which put the NCAA and the NFHS in a leadership role, I called the NFHS to see what they thought about the report and how they viewed their role in the future.
I left a message for Bob Colgate, Director of Sports and Sports Medicine, National Federation of State High School Associations (NFHS) and Bob called me back today. I appreciate Bob taking the time to speak to me on a number of aspects about concussion including the online NFHS Concussion Training Course and NATIONAL HIGH SCHOOL SPORTS-RELATED INJURY SURVEILLANCE STUDY. We both agreed on the importance of concussion education for coaches, parents, school staff, and students - all students - not just student-athletes.
Bob then emailed me with the following press release: NFHS Responds to Concussion Report. Please see my follow-up questions/comments following the press release.
INDIANAPOLIS, IN (November 1, 2013) — On October 29, the Institute of Medicine (IOM) and the National Research Council (NRC) released a detailed report on “Sports-Related Concussions in Youth – Improving the Science, Changing the Culture.”
The National Federation of State High School Associations (NFHS), which has been a leader among national sports organizations in the area of concussion awareness and management the past five years, fully cooperated with the preparation of the report and is in support of many of the report’s recommendations.
“We support the report’s conclusion that a culture change is a national priority,” said Bob Gardner, NFHS executive director. “Concussions are not ‘dings’ – they are serious medical conditions that need to be addressed. I am pleased to report that the NFHS places its highest priority on risk minimization for the 7.7 million participants in high school sports.”
In 2008, the NFHS Sports Medicine Advisory Committee advocated that a concussed athlete shall be immediately removed from play and not return until cleared by an appropriate health-care professional. For the past four years, all NFHS rules publications have contained guidelines for the management of an athlete exhibiting signs, symptoms or behaviors consistent with a concussion.
In addition, with help from the Centers for Disease Control (CDC), the NFHS developed a free, 20-minute online course “Concussion in Sports – What You Need to Know.” More than 1.2
million administrators, coaches, officials, athletes, parents and health-care professionals have taken the course since 2010. (See www.nfhslearn.com)
The NFHS also agrees that injury surveillance is important to help prevent future injuries. Since 2005, the National High School Sports-Related Injury Surveillance Study (High School RIO), commissioned by the NFHS and compiled by Dr. Dawn Comstock, principal investigator from the Pediatric Injury Prevention, Education and Research (PIPER) program at the Colorado School of Public Health and Colorado Children’s Hospital in Aurora, Colorado, has been collecting injury surveillance data for the NFHS. (visit http://www.ucdenver.edu/academics/colleges/PublicHealth/research/ResearchProjects/piper/projects/ RIO/Pages/Study-Reports.aspx for the full reports.)
The NFHS also works with the National Center for Catastrophic Sports Injury Research (NCCSIR) at the University of North Carolina-Chapel Hill, which has been collecting catastrophic injury data on all sports for more than 35 years.
“The NFHS strives to minimize risk for all high school athletes in all sports,” Gardner said. “The athletic community – administrators, coaches, officials, athletes, parents and health- care professionals – should know that this support system of rules, education and research exists to provide a safer environment for all athletes in all sports. We hope the report will encourage all these leaders in the high school athletic community to recognize and respond more effectively to concussions.”
### About the National Federation of State High School Associations (NFHS)
The NFHS, based in Indianapolis, Indiana, is the national leadership organization for high school sports and performing arts activities. Since 1920, the NFHS has led the development of education-based interscholastic sports and performing arts activities that help students succeed in their lives. The NFHS sets direction for the future by building awareness and support, improving the participation experience, establishing consistent standards and rules for competition, and helping those who oversee high school sports and activities. The NFHS writes playing rules for 17 sports for boys and girls at the high school level. Through its 50 member state associations and the District of Columbia, the NFHS reaches more than 19,000 high schools and 11 million participants in high school activity programs, including more than 7.7 million in high school sports. As the recognized national authority on interscholastic activity programs, the NFHS conducts national meetings; sanctions interstate events; offers online publications and services for high school coaches and officials; sponsors professional organizations for high school coaches, officials, speech and debate coaches, and music adjudicators; serves as the national source for interscholastic coach training; and serves as a national information resource of interscholastic athletics and activities. For more information, visit the NFHS Web site at www.nfhs.org.
MEDIA CONTACTS:
Bruce Howard, 317-972-6900 Director of Publications and Communications National Federation of State High School Associations bhoward@nfhs.org
Chris Boone, 317-972-6900 Assistant Director of Publications and Communications National Federation of State High School Associations cboone@nfhs.org
Questions I have after reading the release and have emailed Bob Colgate for clarification:
1. From this statement, "The National Federation of State High School Associations (NFHS)... fully cooperated with the preparation of the report and is in support of many of the report’s recommendations," can I take that the NFHS doesn't completely agree with "all" the recommendations?
What parts of the IOM report are not supported by the NFHS and which are supported by the NFHS?
2. I read the IOM committee's recommendation that the "NCAA and NFHS (in conjunction with others..) develop, implement, and evaluate" as if the current efforts of concussions education/training/research efforts are not enough, and in the future, the NCAA and NFHS would lead the way with new "large-scale efforts."
The statement from NFHS press release states all that the NFHS has done (which is very commendable) but it "appears" by saying "We hope the report will encourage all these leaders in the high school athletic community to recognize and respond more effectively to concussions,” seems that the buck is passed to the high schools themselves.
Is the NFHS going to initiate any new programs or initiatives based on what was learned in the IOM report?
Is there anyway for the NFHS to hold high schools accountable or reward the schools to make the changes needed?
...
We have been waiting for a year the IOM report and the APP report which is a clear blueprint for schools to follow. So now with these reports in hand along with the various concussion online trainings, and variety of education flyers, who is going to lead the way and how?
The IOM recommends the NCAA and NFHS as for the job of leading schools and sports organizations. The NFHS press release states what they have already been doing.
What can the NFHS really do beyond supplying its members with info (which they have already done) and funding the data collection of injury rates (which they are doing)?
I realized it is a balancing act for organizations which rely on voluntary members to require/demand their membership meet certain standards. I have talked with Steve Stenersen, President of US Lacrosse, over the years on the issues of carrot or stick with concussion education/training and youth lacrosse organizations. There are really no sticks to use with members who can leave your organization, and carrots cost money.
Note: From my read, the IOM Report does not suggest any source of funding for any organization to use to pay for any of the recommendations the report suggests. It is hard to be passed the command without the funds to pay the troops.
- Could there be an answer in the NFHS accrediting a high school with a NFHS "concussion-prepared," or "concussion-savy" stamp of approval when a school hires full time ATs and trains coaches, staff, parents and students?
- Could a seal of approval from the NFHS be something for the schools to strive for to be the "highest level" of prepared a school can be (in the concussion field which is still developing)?
- Would parents value this standard and pressure schools who did not meet the standard?
Concussion education isn't hard to understand, and the resources exist to teach coaches, parents and students. What is missing is the commitment of overburdened schools, sports organization and parents to make the time to attend the classes or complete the online trainings or read the flyers. We need leaders now find ways to ensure education takes place, to encourage individual states to update their concussion laws with mandatory requirements, and find sources of funding so the needed research is done.
Good News, Bad News in long awaited Nat'l Concussion Reports
Reblogged from www.SportsCAPP.com Good News...
The IOM and the National Research Council formed an expert committee to review the science of sports-related concussions in youth from elementary school through young adulthood, as well as in military personnel and their dependents. The committee’s report recommends actions that can be taken by a range of audiences – including research funding agencies, legislatures, state and school superintendents and athletic directors, military organizations, and equipment manufacturers, as well as youth who participate in sports and their parents – to improve what is knows about concussions and to reduce their occurrence.
The report finds that while some existing studies provide useful information, much remains unknown about the extent of concussions in youth; how to diagnose, manage, and prevent concussions; and the short- and long-term consequences of concussions as well as repetitive head impacts that do not result in concussion symptoms.
Bad News... There is no mention of any funding.
Good News... Here is who sponsored the IOM Report:
Bad News? Here is who the IOM Committee recommends to lead the effort...
Interesting neither group helped sponsor the study?
NCAA is not well thought of by many concussion field. In March, I had a face to face conversation with Mark Emmert NCAA President where I asked about limiting full contact practice in the NCAA schools to match the NFL and Ivy Schools reduced schedule, and he told me there wasn't enough evidence and there needed to be more studies before he felt he could act. I am wondering if the many lawsuits are helping to motivate him to move on something here?
I am going to contact the NFHS and ask how they see their role in the future. Here is what the NFHS said.
Good News... We now have a National Sports Concussion Coalition.
Bad News... This coalition was not mentioned in the IOM Report.
So in summary...
Good News... This week we do have two new reports - a very informative the IOM Concussion and Youth Sports Report with ideas and recommendations along with the new road map for schools in APP report on Concussions and Schools.
Bad News... There doesn't seem to be any funding mentioned in either report to fund any of these recommendations.
Pink Concussions: Study Explores Head Injuries in Female Athletes
There’s nothing like the pain of a concussion: a headache so bad, it’s vomit-inducing, and sensitivity to light and sound that can force isolation for weeks or months, sparking depression and anxiety.
Concussions have physical and emotional affects on all athletes, but Katherine Price Snedaker is spearheading research to look at female athletes’ experiences with concussions. She is hoping to use the research as a push for more education about head injuries in sports and a cultural change in the way concussed athletes are treated.
The study is an online survey for females 18+ who have had head injuries related to sports. Almost 350 women have already signed up to take the survey.
“I had concussions as a teenager, between sports and car accidents, and I was taken to the ER with headaches but nobody told me anything about concussions. I lived with that and in my 20′s, I noticed I kept getting concussions and when other (women around me) weren’t,” said Snedaker.
Then Snedaker’s son, who is in sixth grade, received a concussion during recess that kept him out of school for almost four months. But they didn’t stop – he received a number of additional concussions once returning to normal activities, and Snedaker became worried. His personality was flat, she said, and so she did research on the injury.
Snedaker, who has coached lacrosse and soccer, became passionate about concussion education and started clinics to teach parents, coaches and athletes about traumatic brain injuries.
In 2012, Snedaker who has a Masters Degree in Social Work, ran a post-concussion (support) group for teens through The Concussion Specialists of Connecticut. “In this group, 13 of 15 teens were girls,” she said. “And the the girls seemed much slower to heal, many had had repeat concussions, and all were isolated from their friends. Studies have shown girls take longer to recover from concussions. The dirty secret is some of us who get (concussions) as kids continue to have them throughout our adult lives. People have this fantasy that if they leave their sport, they don’t concuss anymore. It’s not always like that.”
So Snedaker launched PinkConcussions.com and consistently tried to update it with research relating to concussions in female athletes – except, there wasn’t much research being done.
She took to social media and connected with Dr. Jimmy Sanderson and Dr. Melinda Weathers, two researchers from Clemson University, and inquired about doing a study on the topic by posing questions to a general population of female athletes.
“The NFL is paying researchers to look at concussions (in football players), so that’s what researchers are doing,” she said. “There’s no money to be made in researching concussions in female athletes but we are hoping this will generate interest.”
Snedaker hopes to learn more about females’ experiences after being diagnosed with a concussion, reporting their concussions or playing through the pain. She also hopes to learn more about the emotional affects of the brain injury.
“There is new research being done with male football players and suicide relative to concussions, depression and alcohol,” she said. “We haven’t done the research to see how girls’ experience of concussion differs. I think girls are very social and struggle with the isolation. If they cannot text or go to the movies, school or their sport, it can be very depressing for many teenage girls recovering from concussions.”
In the future, Snedaker hopes to spearhead more research exploring many different aspects of concussions in female athletes. In the mean time, she will also continue to speak about the importance of education on the topic and implementing educational programs for coaches, parents and athletes.
“I would like concussion education to be like swimming lessons. We don’t call them drowning lessons…You reach a certain age and that’s just what you do. We don’t want you to drown. I think there should be an education piece as part of a curriculum in health where kids, parents and coaches learn about it, ” she said. “And it’s for every kid, not just athletes. Both active and non-active kids.”
Snedaker said she’s hoping the education can help people recognize concussions and learn how to manage them. She’d like to see more girls playing hockey, soccer, and other contact sports – with the right training on head injuries.
“I want more kids playing sports because when you have coaches and referees, you are more likely to get concussion care if you get hurt in a sporting event rather than in your back yard,” she said.
Snedaker also wants to help those who have felt isolated due to their concussions.
“People don’t know how to support people with head injuries, so I want to reach out and talk about how we can help these families as a community. That’s how I sell it to parents: someone’s kid is going to get a concussion; how can you help the person sitting next to you?”
The survey will be live through Oct. 31 and Snedaker hopes to reach at least 1,000 women. Women from any country can take the survey. Participants can also agree to stay in contact with the organization for future possible studies.
For more information on the survey and concussions in female athletes, click here.
More about the Female Athletes and Concussion Study…
What outcomes do we hope to have in our study?
We are launching a new study of female athletes from all sports, and their past and present experiences with concussions. I am working with Dr. Jimmy Sanderson and Dr. Melinda Weathers, two researchers from Clemson University, who are very passionate about concussion education. The study has been approved by the IRB at Clemson University and we plan to publish the results. Through social media and our sports contacts, we hope to find female athletes, age 18 and over, who are willing to participate and have them sign up via PinkConcussions.com. On October 1, participants will be emailed a link to a twenty-minute online survey about their experiences with sports and non-sport concussions and reporting concussions. After October 1, participants can simply launch the survey via a link on PinkConcussions.com.
This is a qualitative study, meaning that rather than trying to predict or control, we are looking to understand from an experiential standpoint, what female athletes experiences are from their point of view. Then we think those results can inform additional studies with other groups that can then be used to generalize. There also is the potential for this study is to look at experiences as well as WHY athletes (in this case female athletes) are not reporting concussions. One of the most visible issues in sports is players, trainers, parents not reporting concussions to coaches, administrators, or doctors, and we wanted to try explore why does communication apprehension or reticence, occur in this context?
Finally, we also hope to create a database of women’s names, ages, sports, concussions, etc with their permission; and hopefully other researchers will want to do follow-up studies in the future.
Most importantly, just simply conducting this study, we want to raise public awareness for women with concussions. The study itself will allow any woman who wishes a chance to tell her story – in survey form – and for her to feel she is a part of our project and hopeful not alone. We hope this study helps in some small way to make this issue visible to the public and press, and creates a community feeling for the women involved.
Short Description of the Study
Dr. Jimmy Sanderson and Dr. Melinda Weathers in the Department of Communication Studies at Clemson University, along with Ms. Katherine Snedaker, MSW, of PinkConcussions.com, are conducting research to explore female athletes experiences with concussions and reporting concussions.
This research will be beneficial in shedding light on female athletes’ experiences with concussions and reporting concussions. Often female athletes are omitted from the public discourse surrounding concussions and the results of this research will assist concussion advocates in raising more awareness about concussion issues in sports.
The Sample Size
This is how we described how we would find participants for this study for the Clemson IRB application. We are accepting participants from any country.
Katherine “will recruit female athletes using her professional network of contacts. This will involve snowball sampling and networking through social media outletes such as Twitter. Only female atheltes over the age of 18 will be included in the study.”
The Survey
The survey will be “live” on October 1, and the women who volunteer to be in this study will be emailed the link to the study at that time. We plan to continue to enroll women in the study after October 1 through October 31st, 2013, and will directly send them the link at that time.
Type of Sports
We are accepting female participants, age 18 and older, who have played any sports. On the survey, we have an open text box for participants to type in all the sports they have played.
We wanted to be able to see what sports these women played, to learn in which sports they were concussed, and to find out about any non-sport concussions without limiting the participants’ choices. This is a study where women are volunteering to come forward and share their experiences so we really have no idea which women will come forward, from which sports, or what they will share.
______________________________________________________________________________________________
Press Release
For Release: Wednesday, September 18, 2013
Launch of National Study of Female Athletes and Concussions
Study begins October 1, to explore Female Athletes’ Experiences with Concussions
Contact:
Katherine Snedaker, MSW, PinkConcussions.com / 203-984-0860 PinkConcussions@gmail.com
Dr. Jimmy Sanderson, Clemson University / 864-656-3996 jsande6@clemson.edu
Norwalk, CT – Men’s football concussions are in the news daily from former and current players, but there’s rarely news about female athletes’ experiences with concussions. Female athletes experience a significant number of concussions, yet they seem too often overlooked when concussions are discussed in mainstream media. Mentioned in the report American Medical Society for Sports Medicine Position Statement: Concussion in Sport 2012, data suggest that in sports with similar rules female athletes sustain more concussions than their male counterparts. In addition, female athletes experience or report a higher number and severity of symptoms as well as a longer duration of recovery than male athletes in several studies.
This new study will be focused on female athletes from all sports, and their past and present experiences with concussions. Current and former athletes are eligible for this study conducted by researchers from Clemson University with the advocacy group, Pink Concussions. For this study, female athletes, age 18 and over, who are willing to participate can sign up now at PinkConcussions.com. On October 1, participants will be emailed a link to a twenty-minute online survey about their experiences with sports and non-sport concussions and reporting concussions.
This research study will also explore female athletes’ experiences with reporting concussions, another salient avenue in the concussions dialogue, as many athletes do not report concussions willingly or are mis-diagnosed.
The research also will investigate female athletes’ willingness to have genetic testing that may show links to the repair and recovery of brain cells after concussion. After finishing the survey, participants in the study can opt for an additional study and consider submitting DNA collected by a cheek swab to be tested for variants at the Apolipoprotein E (APOE) gene. Testing for certain genes has previously documented an association between specific genetic factors and outcomes from injuries such as concussion.
Apolipoprotein E is a protein that is important in the repair and recovery of brain cells that have been damaged due to concussion. The clinical studies point to a relationship between certain genetic signatures and poorer overall concussion response. While additional evidence is needed to better understand the relationship between APOE status and concussion outcomes, the American Academy of Neurology introduced APOE testing into concussion management guidelines this year.
The results of this research will help further concussion research by focusing on the communicative element present in this issue, and the results of the study will be helpful for athletes, parents, administrators, physicians, and advocates. This research will be beneficial in shedding light on female athletes’ experiences with concussions and reporting concussions. Often female athletes are omitted from the public discourse surrounding concussions and the results of this research will assist concussion advocates in raising more awareness about concussion issues in sports.
Co-Researchers in this study are Dr. Jimmy Sanderson and Dr. Melinda Weathers in the Department of Communication Studies at Clemson University, along with Ms. Katherine Snedaker, MSW, of PinkConcussions.com.
# # #
For more information about this study, help in recruiting athletes or to participate in the study, please fill the contact form at PinkConcussions.com or contact: Dr. Jimmy Sanderson
Clemson University