High School Football Research Articles

Diagnosed Concussion and Undiagnosed Head Trauma Is Associated With Long-Term Concussion-Related Symptoms in Former College Football Players.

Head trauma experienced in contact football is a growing health concern, but limited research has been conducted to assess associations between head trauma exposure and long-term concussion-related symptoms among former college football players. We surveyed 275 former college football players who were at least 10 yrs after competition to determine the association between head trauma exposure and concussion-related symptoms later in life. Respondents provided data on their youth, high school and college playing experience, undiagnosed head injury, diagnosed concussions, and eight concussion-related symptoms. A Poisson regression was conducted to examine the association between playing experience and reported head trauma with reported symptom count, and significance was set at P ≤ 0.05. Few participants reported diagnosed concussions in college (17.5%), but a large number reported undiagnosed football-related head injuries (68.8%) that might have resulted in a concussion. A few participants (40.7%) reported concussion-related symptoms. After controlling for age, high school football participation, and nonfootball concussions (lifetime), diagnosed concussions in high school or college did not significantly predict concussion symptoms later in life. However, undiagnosed football head injury (range = 1-8 injuries) reported 350%-855% greater concussion-related symptoms later in life. Undiagnosed head injuries, which are less likely to be managed by a healthcare professional, were significantly associated with concussion-related symptoms later in life. These findings suggest that proper identification and management of concussions may prevent later symptoms, but more research is needed to test this conclusion.

High-School Football and Midlife Brain Health Problems.

Objective:To examine whether middle-aged men who played high-school football experience worse mental health or cognitive functioning than men who did not play high-school football.Design:Cross-sectional cohort study.Setting:Online survey completed remotely.Participants:A total of 435 men between the ages of 35 and 55 completed the study, of whom 407 were included in the analyses after excluding participants who answered embedded validity items incorrectly (n = 16), played semiprofessional football (n = 2), or experienced a recent concussion (n = 10).Assessment of Risk Factors:Self-reported high school football participation, compared with those who played contact sports, noncontact sports, and no sports.Main Outcome Measures:A lifetime history of depression or anxiety; mental health or cognitive problems in the past year; current depression symptoms, and post–concussion-like symptoms.Results:Middle-aged men who played high-school football did not have a higher prevalence of being prescribed medication for anxiety or depression or receiving treatment from a mental health professional. Similarly, there were no significant differences between groups on the rates in which they endorsed depression, anxiety, anger, concentration problems, memory problems, headaches, migraines, neck or back pain, or chronic pain over the past year. A greater proportion of those who played football reported sleep problems over the past year and reported being prescribed medication for chronic pain and for headaches.Conclusions:Men who played high-school football did not report worse brain health compared with those who played other contact sports, noncontact sports, or did not participate in sports during high school.

A new open-access platform for measuring and sharing mTBI data

Despite numerous research efforts, the precise mechanisms of concussion have yet to be fully uncovered. Clinical studies on high-risk populations, such as contact sports athletes, have become more common and give insight on the link between impact severity and brain injury risk through the use of wearable sensors and neurological testing. However, as the number of institutions operating these studies grows, there is a growing need for a platform to share these data to facilitate our understanding of concussion mechanisms and aid in the development of suitable diagnostic tools. To that end, this paper puts forth two contributions: (1) a centralized, open-access platform for storing and sharing head impact data, in collaboration with the Federal Interagency Traumatic Brain Injury Research informatics system (FITBIR), and (2) a deep learning impact detection algorithm (MiGNet) to differentiate between true head impacts and false positives for the previously biomechanically validated instrumented mouthguard sensor (MiG2.0), all of which easily interfaces with FITBIR. We report 96% accuracy using MiGNet, based on a neural network model, improving on previous work based on Support Vector Machines achieving 91% accuracy, on an out of sample dataset of high school and collegiate football head impacts. The integrated MiG2.0 and FITBIR system serve as a collaborative research tool to be disseminated across multiple institutions towards creating a standardized dataset for furthering the knowledge of concussion biomechanics.

Notes from the Field: SARS-CoV-2 Transmission Associated with High School Football Team Members - Florida, September-October 2020.

Notes from the Field: SARS-CoV-2 Transmission Associated with High School Football Team Members - Florida, September-October 2020.

Did court find suspended student was denied due process?

A male high school student attended a Fellowship of Christian Athletes football camp at Tennessee Tech University while a member of the David Crockett High School football team. The DCHS administration received an anonymous report that the male student and others had hazed younger players at the camp in a sexual manner. DCHS investigated the allegations and interviewed camp attendees. The record revealed that several students touched underclassman with their genitals and gave spankings to the students as a form of initiation. After its investigation, DCHS dismissed the male student and three other students from the football team and mandated they attend alternative school for the entire academic year.

At the forefront of racial tolerance?: African-Americans and high school football in Iowa in the 1930s

ABSTRACT In the upper Midwest, at least until the late 1930s, there was a modest presence of black athletes in American football and track and field in particular, with a smaller number in basketball and other sports. We know a great deal about how the post-war desegregation in professional baseball and football began to slowly change the landscape of elite American sports. But despite this overarching national narrative of small numbers of black athletes in integrated sports in the north and segregated structures in the south, we still know very little about specific contexts, especially at the high school level where the vast majority of organized sporting competition is held in the USA Key questions remain: was there a qualitative difference between the treatment of African-American athletes in different regions of the United States during the first four decades of the twentieth century? Was there a difference in racial attitudes in places where African-Americans were resident in small numbers such as in the towns and medium sized cities of the upper Midwest? Indeed, Iowa was regarded as relatively welcoming of African-American athletes by the 1930s whether that reputation was fully deserved or not. In this article we examine this question from a case study point of view.

Athlete Enjoyment of Prior Education Moderates change in Concussion-Reporting Intention after Interactive Education.

Undiagnosed concussions increase risk of additional injuries and can prolong recovery. Because of the difficulties recognizing concussive symptoms, concussion education must specifically target improving athlete concussion reporting. Many concussion education programs are designed without significant input from athletes, resulting in a less enjoyable athlete experience, with potential implications on program efficacy. Athlete enjoyment of previous concussion education programs moderates the improvement in concussion-reporting intention after experiencing the research version of CrashCourse (CC) concussion education. Prospective cohort study. Level of evidence: Level IV. Quantitative assessment utilizing ANOVA with moderation analysis of 173 male high school football players, aged 13 to 17, who completed baseline assessments of concussion knowledge, concussion reporting, and attitudes about prior educational interventions. Athletes were subsequently shown CC, before a follow-up assessment was administered assessing the same domains. At baseline, only 58.5% of athletes reported that they enjoyed their previous concussion education. After CC, athletes were significantly more likely to endorse that they would report a suspected concussion (from 69.3% of athletes to 85.6%; P < .01). Enjoyment of previous concussion education moderated concussion-reporting intention after CC (P = .02), with CC having a greater effect on concussion-reporting intention in athletes with low enjoyment of previous concussion education (b = 0.21, P = .02), than on individuals with high enjoyment of previous concussion education (P = .99). Enjoyment of CC did not have a moderating effect on concussion-reporting intention. Athletes who previously did not enjoy concussion education exhibited greater gains in concussion-reporting intention than athletes who enjoyed previous education. Given the potential risks associated with undiagnosed concussions, concussion education has sought to improve concussion reporting. Because most athletes participate in concussion education programs due to league or state mandates, improving concussion-reporting intention in these low-enjoyment athletes is of particular relevance to improving concussion-reporting intention broadly.

Prevalence of Protein and Pre-Workout Supplement Use among High School Football Players and Potential Product Contamination.

The purpose was to determine the prevalence of protein and pre-workout supplement usage in high school football players and how many products contained banned substances or dangerous ingredients. A national sample of 102 high school football players was recruited via Qualtrics Research Panels to complete a cross-sectional online questionnaire. Data were summarized as means with standard deviations (SDs) and frequencies with proportions (%). A majority (59.8%) of high school football players reported currently using a protein supplement. Just under one-third (29.4%) reported currently using pre-workout supplements. Five participants reported using a pre-workout product that contained a known NCAA banned substance. Many of the products used contain banned, regulated elsewhere, or unknown substances. Secondary school ATs must educate athletes regarding the use of nutritional supplements and the potential dangers of ingesting banned or unknown substances.

Effects of Hydration Educational Intervention in High School Football Players.

Atkins, WC, McDermott, BP, Kanemura, K, Adams, JD, and Kavouras, S. Effects of Hydration Educational Intervention in High School Football Players. J Strength Cond Res XX(X): 000-000, 2020-The purpose of this study was to assess the effects of a one-time educational intervention (EI) on hydration behaviors, status, and knowledge. In a pre-test, post-test quasi-experimental design, 41 in-season American high school football players (16 ± 1 years) voluntarily participated. Teams were assigned to EI or no intervention (NI) groups. Educational intervention included a 5-minute presentation on hydration importance, self-assessment, urine-color charts, water bottles, and hydration status feedback. Baseline data included 24-hour fluid intake logs, urinalysis, and questionnaires. Data collection was repeated 3 and 24-days post-EI. Subjects provided urine samples and recorded fluid intake. Twenty-four hour mean fluid consumed (FC) and water consumed (WC) were calculated. Questionnaires quantified hydration knowledge. Significance was set a priori at p ≤ 0.05. Urine specific gravity was not significantly different at baseline (EI: 1.026 ± 0.006; NI: 1.023 ± 0.009; p = 0.118, confidence interval [CI] 95% [-0.001 to 008]), improved 3-days post-EI (EI: 1.017 ± 0.010; NI: 1.026 ± 0.007; p = 0.004, CI 95% [-0.015 to -0.003]), and was not different 24-days post-EI (EI: 1.021 ± 0.009; NI: 1.025 ± 0.007; p = 0.213, CI 95% [-0.008 to 002]) between groups. Three days post-EI, 24-hour WC increased significantly in the EI (EI: 888 ± 713 ml; t(19) = -5.685, p < 0.001, CI 95%: [-1,208.9 to -560.0]) but not NI (119 ± 583 ml; t(20) = -0.915, CI 95%: [-392.0 to 153.5]) and EI increased FC by 19%, whereas NI showed a 6% FC decrease. There were no significant group (F(1,19) = 0.025, p = 0.876, = 0.001) or interaction effects for hydration knowledge (F(2,38) = 0.677, p = 0.514, = 0.034). Educational intervention improved hydration status and behaviors despite no change in knowledge. Hydration education should be implemented and reinforced by team personnel as benefits to an EI are reduced at 24-days post-intervention.

Age of First Exposure to Football Is Not Associated with Midlife Brain Health Problems.

The purpose of this study was to determine if earlier age of first exposure (AFE) to football is associated with worse brain health in middle-aged men who played high school football. We assessed 123 men 35-55 years of age, who played high school football, using (1) a survey of demographic information as well as medical, sport participation, and concussion history; (2) the Patient Health Questionnaire-8 (PHQ-8); and (3) the British Columbia Post-Concussion Symptom Inventory (BC-PSI). Sixty-two (50.4%) men reported football participation starting before the age of 12 (i.e., AFE <12 years) and 61 (49.6%) reported football participation at or after the age of 12 (AFE > 12 years). Compared with those with AFE >12 years, a similar proportion of former high school football players who began playing tackle football before age 12 reported that they had been prescribed medications for mental health problems or that they had recently experienced symptoms of anxiety, depression, memory loss, chronic pain, or headaches. Moreover, there was no significant difference in their lifetime history of treatment by a mental health professional. The groups did not differ significantly on PHQ-8 (U = 1839.0, p = 0.791) or BC-PSI total scores (U = 1828.5, p = 0.751). These findings suggest that earlier AFE to football is not associated with worse brain health in middle-aged men in this sample who played high school football.

Johnny Tested Positive for COVID-19, What Is Next for the Team?

Johnny Tested Positive for COVID-19, What Is Next for the Team?

Abstract 16076: Elevated Body Mass Index and Blood Pressure Among Male High-School American Style Football Athletes

Introduction: The impact of American Style Football (ASF) participation on cardiovascular health is unclear. Early-life weight gain among ASF athletes is common and is associated with risk of multiple later-life health afflictions. Despite the popularity of ASF participation among the youth, a rigorous comparison of the cardiovascular health profiles between ASF and non-ASF athletes at the high-school level has not been undertaken. We performed an observational cross-sectional study comparing the body mass index and blood pressures of ASF and non-ASF high-school athletes. Methods: Between October 2012 to November 2018 we performed voluntary cardiac screens including height, weight and blood pressure among predominantly high-school students. Inclusion criteria included the following: male sex; &gt;10 hours of exercise per week; single-sport athlete; age &gt;14 years old. Of the 6973 young individuals who underwent screening, 508 athletes were included in the analyzed data. Results: ASF athletes represented 18% of all high-school athletes. The mean age of ASF and non-ASF athletes was 18.5 and 18.0 years, respectively. BMI was higher in ASF athletes compared to non-ASF participating athletes (26.9 vs 21.2 p&lt;0.0001). There was a higher prevalence of class I and class II obesity among ASF athletes (class I obesity: 15% vs 1%; class II obesity: 10% vs 1%, p&lt;0.0001 for each). ASF athletes had an increased systolic (SBP) and diastolic blood pressure (DBP) compared to non-ASF participating athletes (SBP: 121 vs 114 p&lt;0.0001; DBP: 73 vs 70 p=0.0028). Among all athletes, there was a positive correlation between blood pressure and BMI (SBP: R=0.4149, DBP: R=0.2076, p&lt;0.0001 for each). Conclusions: High-school athletes that participate in ASF have a higher BMI, prevalence of obesity and blood pressure compared to their non-ASF counterparts. It is important to screen young ASF athletes for obesity and hypertension in order to optimize cardiovascular health at an early age.

Association Between Proteomic Blood Biomarkers and DTI/NODDI Metrics in Adolescent Football Players: A Pilot Study.

While neuroimaging and blood biomarker have been two of the most active areas of research in the neurotrauma community, these fields rarely intersect to delineate subconcussive brain injury. The aim of the study was to examine the association between diffusion MRI techniques [diffusion tensor imaging (DTI) and neurite orientation/dispersion density imaging (NODDI)] and brain-injury blood biomarker levels [tau, neurofilament-light (NfL), glial-fibrillary-acidic-protein (GFAP)] in high-school football players at their baseline, aiming to detect cumulative neuronal damage from prior seasons. Twenty-five football players were enrolled in the study. MRI measures and blood samples were obtained during preseason data collection. The whole-brain, tract-based spatial statistics was conducted for six diffusion metrics: fractional anisotropy (FA), mean diffusivity (MD), axial/radial diffusivity (AD, RD), neurite density index (NDI), and orientation dispersion index (ODI). Five players were ineligible for MRIs, and three serum samples were excluded due to hemolysis, resulting in 17 completed set of diffusion metrics and blood biomarker levels for association analysis. Our permutation-based regression model revealed that serum tau levels were significantly associated with MD and NDI in various axonal tracts; specifically, elevated serum tau levels correlated to elevated MD (p = 0.0044) and reduced NDI (p = 0.016) in the corpus callosum and surrounding white matter tracts (e.g., longitudinal fasciculus). Additionally, there was a negative association between NfL and ODI in the focal area of the longitudinal fasciculus. Our data suggest that high school football players may develop axonal microstructural abnormality in the corpus callosum and surrounding white matter tracts, such as longitudinal fasciculus. A future study is warranted to determine the longitudinal multimodal relationship in response to repetitive exposure to sports-related head impacts.

Head acceleration event metrics in youth contact sports more dependent on sport than level of play.

The goal of the study was to evaluate how repetitive head traumas sustained by athletes in contact sports depend on sport and level of play. A total of 16 middle school football players, 107 high school football players, and 65 high school female soccer players participated. Players were separated into levels of play: middle school (MS), freshman (FR), junior varsity (JV), junior varsity-varsity (JV-V), and varsity (V). xPatch sensors were used to measure peak translational and angular accelerations (PTA and PAA, respectively) for each head acceleration event (HAE) during practice and game sessions. Data were analyzed using a custom MATLAB program to compare metrics that have been correlated with functional neurological changes: session metrics (median HAEs per contact session), season metrics (total HAEs, cumulative PTA/PAA), and regressions (cumulative PTA/PAA versus total HAEs, total HAEs versus median HAEs per contact session). Football players had greater session (p<.001) and season (p<.001) metrics than soccer players, but soccer players had a significantly greater player average PAA per HAE than football players (p<.001). Middle school football players had similar session and season metrics to high school level athletes. In conclusion, sport has a greater influence on HAE characteristics than level of play.

Barriers and Facilitators Faced by Athletic Trainers Implementing National Athletic Trainers' Association Inter-Association Task Force Preseason Heat-Acclimatization Guidelines in US High School Football Players.

The aim of the National Athletic Trainers' Association Inter-Association Task Force (NATA-IATF) preseason heat-acclimatization guidelines was to acclimatize high school athletes to the environment during the first 2 weeks of the preseason and reduce the risk of exertional heat illness. To identify barriers and facilitators that high school athletic trainers (ATs) encountered when implementing the NATA-IATF guidelines. Qualitative study. Individual phone interviews with all participants. Thirty-three ATs (16 men, 17 women; age = 36.0 ± 12.0 years, athletic training experience = 12.9 ± 10.5 years) representing 19 states (4 with state mandates) were interviewed before data saturation was achieved. Participants were purposefully sampled from a larger investigation based on stratification of US Census region and preidentified high school compliance with the NATA-IATF guidelines. A cross-sectional, semistructured phone interview (6 steps) was conducted with each participant and then transcribed verbatim. A 7-person research team (5 coders, 2 auditors) coded the data into themes and categories, focusing on consensus of data placement to reduce bias and ensure accuracy. Facilitators and barriers that influenced successful guideline implementation were (1) perceived stakeholder access, (2) perceived stakeholder role, (3) capability and capacity, (4) school culture, (5) logistical support, (6) resources, (7) physical environment, and (8) consistency of the guidelines. Overall, participants discussed facilitators and barriers within each category based on their experiences and circumstances. Athletic trainers faced numerous concerns regarding compliance with the NATA-IATF preseason heat-acclimatization guidelines. Multiple levels of influence should be targeted to improve implementation. These include intrapersonal factors by giving ATs the education and self-efficacy to support advocacy for implementation, interpersonal components by establishing strong collaborative networks for change, community and environmental factors by optimizing school culture and community resources for implementation, and policy aspects by establishing consistent guidelines across all bodies.

Clearing the cobwebs: An analysis of the timing of youth concussion legislation in U.S. states.

After decades of ignoring head injury in youth sports, U.S. states passed youth concussion legislation with stipulations about when athletes can return to play. Why were some states slower to pass laws than others? We consider this question through the lens of institutional medicalization, where medically informed policies are enacted. Our study recognizes the uneven nature of policy enactment across time and space with event history methods. We explore the influence of high school sport participation and other variables on the timing of legislation in all fifty states, 2007-2014. States with more high school football participation, as well as states with a strong college football presence, passed concussion laws later. Conversely, states with stronger orientations toward gender egalitarianism adopted laws sooner. These factors reflect sources of receptivity and resistance that underlie the process of institutional medicalization. Our approach offers one of the few quantitative studies of institutional medicalization and provides a template for future quantitative research in this area.

The cost of a single concussion in American high school football: a retrospective cohort study.

Aim:The potential financial burden of American football-related concussions (FRC) is unknown. Our objective was to describe the healthcare costs associated with an FRC and determine factors associated with increased costs.Methodology/results:A retrospective cohort study of concussed high school football players presenting between November 2017 and March 2020 was undertaken; 144 male high school football players were included. Total costs were about $115,000, for an average direct healthcare cost of $800.10/concussion. Visiting the emergency department (β = 502.29, 95% CI: 105.79–898.61; p = 0.01), the initial post-concussion symptom scale score (β = 0.39, 95% CI: 0.11–0.66; p = 0.01) and a post-concussion syndrome diagnosis (β = 670.37, 95% CI: 98.96–1241.79; p = 0.02) were each independently associated with total costs.Conclusion:A granular understanding of cost-driving factors associated with FRC is the first step in understanding the cost–effectiveness of prevention and treatment methods.

“Friday Night is their Super Bowl”: A Relational Investigation Regarding Occupational Stress Among American High School Football Officials

This interpretive research explores American high school football officials’ perceptions of occupational stress experienced both on and off the field. Within the United States, there is a current shortage of high school football officials. Overall individualistic identification within the association and how members make sense of their position on and off the field contribute to occupational stress. The research focused on one Southern Californian high school football organization officiating for youth, high school, and some college football. Data was collected through both semi-structured face-to-face interviews as well as analysis of field notes from football games and similar settings. This research utilized the theoretical framework of sensemaking as well as thematic analysis as a method in order to better understand and make sense of how members within the organization identify and manage stressful and hostile football-related situations. (Inter)personal relational stress-impacted themes emerged from the data: (1) with coaches, (2) with parents, and (3) with other officials.

The Effectiveness of Regulations and Behavioral Interventions on Head Impacts and Concussions in Youth, High-School, and Collegiate Football: A Systematized Review.

The purpose of this study was to assess the effectiveness of regulations and behavioral interventions on head impacts and concussions in youth, high-school, and collegiate football, using a systematic search strategy to identify relevant literature. Six databases were searched using key search terms related to three categories: football, head-injuries, and interventions. Studies that met inclusion criteria were included in the study and underwent data extraction. Twenty articles met inclusion criteria and were included in the final systematized review. Of the 20 included studies, 8 studies evaluated interventions in high-school football, 5 studies evaluated interventions in collegiate football, 6 studies evaluated interventions in youth football, and 1 study evaluated interventions in both, high-school and collegiate football. The four categories of interventions and regulations included rule changes, training, education/instruction/coaching tactical changes, and tackle football alternatives. Studies evaluating the effectiveness of interventions and regulations on reducing head impact exposures or head injuries have shown mixed results. Some regulations may be more effective than others, but methodological design and risk of bias pose limitations to generalize effects.

Postactivation Potentiation Effect of Heavy Sled Towing on Subsequent Sprints.

Williams, JJ, Heron, R, Spradley, B, and Saracino, P. Postactivation potentiation effect of heavy sled towing on subsequent sprints. J Strength Cond Res 35(5): 1229-1233, 2021-Recent research supports heavy sled towing as a tool used to improve subsequent sprints as part of postactivation potentiation (PAP) protocols. The purpose of this study was to examine the effect of heavy sled towing using a velocity decrement (Vdec) on subsequent unloaded sprinting in high school football (soccer) athletes sprinting on artificial turf. A sled load equating to a 40-50% Vdec range was used (66-70% body mass). Fifteen (n = 9 boys and n = 6 girls) high school football players volunteered for this study. The sled-towing intervention consisted of a dynamic warm-up, 3 submaximal sprint efforts (50, 75, and 95%), and 3 maximum speed 15-m sled sprints, separated by 2-minute rests, of which the fastest time was recorded for analysis. Peak preintervention 15-m baseline sprint times were compared with peak post sled-towing 15-m sprint times using a paired samples t-test. Thirteen of 15 athletes ran faster peak post sled-towing sprint times than peak preintervention baseline sprint times (9 boys and 4 girls). On average, peak post sled-towing sprint times (2.60 ± 0.10 seconds) were 0.10 seconds faster (p < 0.0001; Cohen's d = 0.92) than peak preintervention baseline sprint times (2.70 ± 0.09 seconds). This research established that sled-towing protocols using loads corresponding to Vdec of 40-50% significantly improved subsequent sprints in high school football (soccer) athletes running on artificial turf.