NFHS Develops Concussion Guidelines for Football

In what has been a long time coming the National Federation of State High School Associations (NFHS) has released the long-awaited guidelines from their concussion summit in July.  The NFHS is basically the governing body that most, if not all, states look to when implementing rule changes in sports, policies for participation and for sports medicine advice/guidelines.  Many states do not act, even with good information, with out the NFHS “seal of approval”.

This has been evidenced in the past when it comes to concussion “mitigation”, in terms of undue risk – contact limitations.  There have been many states that have not waited for the NFHS (California, Arizona, Wisconsin come to mind) while there are others that sat on their hands regarding this topic.  Regardless of where your state is/was it now has some guidelines to follow when it comes to the controversial topic of impact exposure.

Before I post the full press release from the NFHS, I would like to highlight the recommendations from the 2014 NFHS Recommendations and Guidelines for Minimizing Head Impact;

  • “Live” and “Thud” are considered full-contact
    • I really like that there is a clear definition
  • Full-contact should be allowed in no more than 2-3 practices a week; 30 min a day and between 60-90 minutes a week.  Only glossed over was the fact that theNFHS strongly suggests that there should not be consecutive days of full-contact.
    • A great place to start, although there are a vast majority of programs, around here, that do not do more than 2-3 times a week.
    • The time limits are great.
    • Unaddressed is the specific back-to-back days of games to practice.  For example a Monday game and Tuesday full-contact practice.  Sure common sense should prevail, but there will be plenty of loophole finding on this issue.
  • Recognition of preseason practices needing more contact time to develop skills.
    • Obviously a sign that these guidelines are taking everything into consideration.
  • During 2-a-days only one session should be contact.
    • THANK YOU!
  • Review of total quarters played for each player
    • This has been one of my biggest points of contention with any concussion policy.  The risk for injury during a game is much higher and kids that play multiple levels have an exponentially higher risk.
    • Although nothing more was stated than above, this should get people talking and moving.  The issue, of course, will be monitoring this.  Regardless, the fact that this important point is included is a massive thumbs up!
  • Considerations for contact limits outside of traditional fall football season
    • Acknowledging the ever-growing practice of off-season practices.
  • Implementing a coach education program
    • Ideal for understanding all of this and the issues we face.
  • Education of current state laws and school policies (if schools don’t have one they should)
    • Putting pressure on the institutions to take some onus.
  • Emergency Action Plans (EAP) and Athletic Trainers should be utilized
    • AT’s should be at both games and practices.
    • EAP’s should be in place and the best person for taking care of an EAP is an AT.
    • The first “governing” body that has firmly suggested the use of athletic trainers for football at all levels in practice and games.  This is truly noteworthy, and appreciated.

Auspiciously omitted from this document was USA Football’s “Heads Up” tackling program.  They referenced the USA Football definitions of level of contact and coaching courses; but never mention the embattled “Heads Up” program.  I must say, my confidence in the NFHS has skyrocketed after reading this, and a lot has to do with the people on the task force.  I am looking squarely at: Mark Lahr, Tory Lindley, Steve McInerney and John Parsons.  Those gentleman are of the highest quality and character when it comes to athlete safety.

Here is the full press release… 





NFHS Concussion Task Force Recommendations to be Discussed by State Associations for Implementation in 2015


Contact: Bob Colgate

INDIANAPOLIS, IN (November 13, 2014) — The National Federation of State High School Associations (NFHS) has finalized its position paper from the NFHS Concussion Summit Task Force, which met in July to develop recommendations for minimizing the risk of concussions and head impact exposure in high school football.

The recommendations, which have been shared with the 51 NFHS-member state high school associations, and approved by the NFHS Sports Medicine Advisory Committee (SMAC) and the NFHS Board of Directors, will be discussed by state associations at the NFHS Winter Meeting in early January for implementation in the 2015 football season.

The 24-member task force, which featured medical doctors, athletic trainers, high school coaches and key national leaders in high school sports, developed nine fundamentals for minimizing head impact exposure and concussion risk in football. They were designed to allow flexibility for state associations that collectively oversee the more than 15,000 high schools across the country that have football programs. As a result, each state high school association will be developing its own policies and procedures for implementation in the 2015 season.

Many of the recommendations focus on reducing the amount of full contact, including limiting the amount of full contact in practices during the season.

The Concussion Summit was the latest effort by the NFHS to minimize risk for the almost 7.8 million student participants in high school sports. In 2008, the SMAC advocated that a concussed athlete must be removed from play and not allowed to play on the same day. For the past five years, all NFHS rules publications have contained guidelines for the management of a student exhibiting signs, symptoms or behaviors consistent with a concussion. In 2010, the NFHS developed on online course – “Concussion in Sports – What You Need to Know” – and about 1.7 million individuals have taken the course through the NFHS Coach Education Program at

The “Recommendations and Guidelines for Minimizing Head Impact Exposure and Concussion Risk in Football” position paper is posted on the NFHS website at

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 16 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 website at


MEDIA CONTACTS:           Bruce Howard, 317-972-6900

Director of Publications and Communications

National Federation of State High School Associations


Chris Boone, 317-972-6900

Assistant Director of Publications and Communications

National Federation of State High School Associations


7 thoughts on “NFHS Develops Concussion Guidelines for Football

  1. George Visger November 13, 2014 / 15:37

    Great job NFHS. California passed a State law in August of this year limiting full contact practice to 2x/week. Hopefully more states and schools will follow suit. Back in the day we started the season with 2 weeks of 3 full padded practices/day. The equivalent of probably a full season of hitting in 2 weeks.

    I’ve always wondered what effect that had on me developing hydrocephalus years later.

    I’m sure it didn’t help any.

  2. Jake Benford (@JakeBenfordMD) November 13, 2014 / 21:54

    Nice to see. Relatively comprehensive for a large governing body. Still work to do but it would be nice to see some focus on some other sports now as well.

  3. kids SRC Doc November 13, 2014 / 22:45

    The back to back and multiple levels of play were discussed at length. I would expect as time goes by, those issues get addressed. As do the other sports, since we know concussion is not just a football problem — but it really is a problem for football. Very proud the NFHS gave strong recommendations to advocate for the safety of our kids.

  4. BryanATC November 18, 2014 / 14:27

    The biggest issue is that these are “Guidelines” not rules. Every state organization I know already has “Guidelines” and “Recommendations” on things like heat, inclement weather, medical coverage, concussions, etc. Until is is made a “rule” they are free to ignore it. Yes they stand in opposition to those “guidelines” if sued, but most won’t care until that actually happens (which is EXTREMELY rare considering the number of schools out there).

    Now some issues with the guidelines themselves. While I commend them for stating that “live” and “thud” are both full contact, there still is no clear definition of what “thud” is. Most speed/contact focus is usually on the skill players (faster collisions), in team situations most of my non-live concussions have occurred with my lineman who are going “live”, but because they are not taking anyone to the ground escape that definition.

    Along with that, I’ve had several discussions where coaches adopt a very generous definition of the “30 minutes per day” rule. They view it is if they run 1 play every minute, and that play lasts for 15 seconds, then only the 15 seconds counts as “live”. That means they can run 2 hours straight of “live” team and only have 30 minutes of actual contact. No where (even state associations) do they define or describe how you are supposed to count the amount of contact towards the time limit. It’s been purposely left vague so that everyone can say they have a rule instituted, but not be forced to regulate it because there is no specific definition.

    I guess the overall issue is that once again it’s nice for a “governing” body to put forth honest guidelines, it really is just lip service because it doesn’t force anyone to actually follow through. Here is hoping that the states take these and decide to actually put forth rules and not just “guidelines”.

  5. Mike Larson November 29, 2014 / 18:08

    A study has shown that retired NFL players are at a higher risk of developing dementia. Retired players over the age of 50 are 5 times more likely to show signs of dementia than other men their age while those between 30 and 49 years old are 20 times more likely to be diagnosed with the memory related disease.

    Boston University has a Center for the Study of Traumatic Encephalopathy and much of their research focuses on the detection and discovery of Chronic Traumatic Encephalopathy (CTE). This disease is a form of dementia that has been found to be caused by repetitive trauma to the brain. Research has shown that signs of CTE are present in the brains of retired football players who have died and donated their brains to the study of CTE.

    Knowing what we know now about concussions can help us to protect athletes in all sports. Developed protocols and policies to keep athletes safe are important things for all athletes, coaches, and parents to be aware of.

    Daniloff, Caleb. “Football Brains.” Bostonia Web Exclusives. Boston University, 18 Oct. 2014. Web. 13 Nov. 2014. .

    • Dustin Fink December 1, 2014 / 18:28

      It is an interesting step, expected to an extent – whether this state or others… I find it interesting the suit goes back to 1999, a time when we were no where near the information level we are at now, let alone four years ago…

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