NFHS Sports Medicine Advisory Committee Enters 12th Year

By Vito Perriello, M.D.

In 1996, the leadership of the National Federation of State High School Associations (NFHS) recognized the availability of information in the sports medicine area that was relevant to the mission of the organization and formed its first NFHS Sports Medicine Advisory Committee (SMAC). As the SMAC enters its 12th year of existence, the many physicians, certified athletic trainers, referees, coaches and state association members who have served can look back with pride on the committee's contributions to minimizing the risk of sports participation while maintaining the integrity, participation equity and fun enjoyed by more than seven million participants each year.

As a charter member of the committee who has served for 10 of the 12 years of its existence, I believe the committee has gained an understanding and strong respect for the structure and the process of NFHS rules committees and the uniform commitment of the organization to fulfill its mission to our student-athletes. Hopefully, the due diligence, professionalism and intellectual and scientific integrity exercised by the committee and its members has, in like manner, gained some credibility within the greater NFHS community.

Using the Mission Statement of the committee as an outline, following are some of the contributions the committee has made in concert with the various NFHS rules committees, member state associations and NFHS leadership, as well as projects planned in the very near future to further that mission and goal of minimizing risk for student-athletes.

Mission Statement

The Sports Medicine Advisory Committee (SMAC) shall advise the National Federation of State High School Associations (NFHS) concerning sports medicine issues as they relate to rules writing, as well as the other programs and services of the NFHS. It will monitor and disseminate current information to the NFHS and its membership relative to the sports medicine field. Through this committee, the NFHS will work to educate its constituency concerning sports medicine issues. The committee will proactively address health and risk management issues of general concern to the NFHS membership.

The committee and its members have conscientiously reviewed the medical literature for information relevant to goals of the SMAC and discussed those within the committee and the NFHS community. Information has been shared with the NFHS Board of Directors, the NFHS leadership, various NFHS rules committees and the NFHS community through presentations, articles in publications, postings on NFHS and member state association Web sites, and personal communications at state and national levels. A major contribution has been the development of the NFHS Sports Medicine Handbook, which will be published this fall in its third edition. Another has been efforts to facilitate the development of a SMAC in every state association and member associations have done this (See map on page 25).

Goals of the Committee

1. Work cooperatively with the NFHS rules-writing committees to address sports medicine issues as they impact high school rules and the health and risk management of its participants.

The NFHS rules committees have passed 310 rules during the past 12 years that directly or indirectly relate to risk minimization. A few of the most notable and effective include expanding the pole vault pit, placing diving blocks at the deep end of the pool, and mandating eye protection for girls lacrosse, which has virtually eliminated catastrophic injuries in those sports. Many other issues, questions and concerns have been discussed and resolved without the need for new rules or equipment.

2. Work cooperatively and maintain liaison with other key medical and paramedical organizations that can assist the committee in its work.

The SMAC regularly communicates and interacts with about 12 professional organizations. Members of the committee serve as liaisons to their respective organizations such as the American College of Sports Medicine (ACSM), National Athletic Trainers Association (NATA), American Academy of Pediatrics (AAP), American Medical Society for Sports Medicine (AMSSM), etc. Also, the NFHS staff serves on many boards and policy groups such as ASTM and Joint Commission on Sports Medicine and Science.  They have also represented the NFHS on many task force and expert committees such as Soccer Concussion Summit by Institute of Medicine, Centers for Disease Control (CDC) coach tool kit on concussions, Sudden Cardiac Death in Sports, NATA Injury Surveillance System, NCAA Summit on Commotio Cordis, etc. The NFHS name, influence and relevance have grown dramatically in the sports medicine community over the past decade.

3. Assist the NFHS in researching sports medicine issues.

The SMAC and NFHS have encouraged and supported research on concussions, injury surveillance systems, wooden vs. metal bats, wrestling weight-management programs and dangerous weight-loss practices, substance abuse, etc.

4. Develop position statements and guidelines to assist the NFHS leadership and membership in making informed decisions that contribute to minimizing risk for participation.

The SMAC has been very proactive in this area with statements in the NFHS Handbook, all rules books, and on the Web site pertaining to infectious disease issues such as MRSA, blood-borne pathogens and skin diseases. Information on heat and hydration, techniques for monitoring this issue, appropriate re-hydration fluids, emergency planning, lightning safety, asthma management for athletes, commotio cordis, and eye and dental protection have been shared widely in the NFHS community,  The committee has also been proactive in providing education and leadership about Good Samaritan Laws for states, SMAC committees for member state associations and wrestling weight-management guidelines.

5. To develop and administer a national high school sport injury surveillance system. The SMAC will analyze and interpret the scientific injury data that is obtained. This information will allow the SMAC to initiate and support recommendations to the NFHS community intended to reduce risk through possible changes in rules and/or equipment.

The NFHS has been fortunate to be involved with Dr. Fred Mueller and the National Center for Catastrophic Sports Injury Research at the University of North Carolina at Chapel Hill for many years. Information on reducing catastrophic injuries in sports is also critical to addressing risk minimization. The SMAC has collaborated with Randy Dick and the NCAA Injury Surveillance System (ISS) and with Dr. Dawn Comstock and her High School Reporting Information Online (RIO) program at Ohio State University. Discussions about the NFHS starting an injury surveillance system are ongoing and hopefully will be resolved soon. This injury data will be very important in providing objective information for the SMAC and the NFHS rules committees to make the best decisions on risk minimization, equipment, playing rules and management of all students who participate in high school sports.

6. The SMAC will provide the NFHS leadership and membership current information on sports medicine issues through the NFHS Sports Medicine Handbook, the Sports Medicine section of the NFHS Web site and through other NFHS publications.

Another priority of the SMAC, the NFHS leadership and the NFHS Board of Directors is to print the third edition of the NFHS Sports Medicine Handbook. The goal is to have the final revision completed, along with the addition of a few new topics, by the beginning of the 2008-09 school year.
On behalf of all the present and past members of the SMAC, we would like to thank Bob Kanaby, Bob Gardner and the entire NFHS leadership for having the vision to start the committee and the insight to support and nurture its growth. The NFHS staff liaisons have been most helpful in merging the scientific knowledge of the medical professionals with the traditions, institution and process of the NFHS. The future is indeed bright for the NFHS Sports Medicine Advisory Committee.

Dr. Vito Perriello is a practicing doctor with Pediatric Associates of Charlottesville, LLC, in Charlottesville, Virginia. He is the current chair of the NFHS Sports Medicine Advisory Committee.