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Few States Meeting Guidelines for H.S. Football Concussion Prevention

In 2014, the National Federation of State High School Associations released guidelines to reduce head impact and limit concussion risk in high school football. Two years later, only 12 of 50 states are meeting even three of the five recommendations, while six aren't adhering to any of them, according to a recent report from two concussion-policy advocates.

The report authors awarded compliance points to each state for adhering to the NFHS' guidelines for preseason contact limits, regular-season contact limits, an offseason contact ban, a limit on the maximum number of quarters for athletes per week, and heat acclimatization. During the preseason, the national organization recommended limiting contact practices to no more than one per day, having a maximum of two consecutive contact practice days, and placing a time limit on the amount of contact practice allowed within a given day. In the regular season, the NFHS suggested limiting contact practices to 60-90 minutes per week, holding no more than 30 minutes of contact practice in a given day, and only holding 2-3 contact practices per week.

Twelve states, including Alabama, California, Georgia, and Wisconsin, are in compliance with at least two of the three preseason recommendations, while 19 meet two of the three regular-season guidelines. The restriction on offseason contact is far more widely adopted, as all but 12 states ban it during the spring and all but 14 do so during the summer. Thirty-eight states have some form of a limit on the number of quarters per athlete each week, although a majority exceed the recommended five quarters. When it comes to having a heat acclimatization policy, only 17 states meet the NFHS guidelines of prohibiting full contact for the first five days of preseason and allowing for conditioning for heat.

"As much as we want to encourage fitness and teamwork, reducing unnecessary risk is common sense," said Dorothy Bedford, one of the authors of the report and a former school board member in New Jersey, in a statement. "Students deserve to complete their high school football careers with brains intact, ready for further studies, the workplace, or military service, plus healthy personal relationships. Lasting concussion symptoms may adversely impact all aspects of personal and family life."

Based on their findings, the two report authors sent a letter to the NFHS, imploring them to issue rules for concussion prevention rather than recommendations. Beyond that, they also suggested the NFHS create rules that are more clearly defined and enforceable, as "current attempts to reduce exposure, in the form of limited contact practices, specific rules governing preseason" and others, "are not always well-defined, and therefore not always enforced." That means, for instance, implementing a clear limit on the amount of time allowable in contact practices or banning players from playing both offense and defense, which doubles their exposure to head trauma.

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