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Health & Safety Journey

September 30, 2014

The Michigan High school Athletic Association is a bit more than halfway through an eight-year effort to shine the light on, and provide leadership for, four health and safety issues for school sports.
Four and five years ago our health and safety focus was adding more health history to the preparticipation physical examination process and printed forms. With the essential assistance of the Michigan Department of Community Health, this was done, and it earned widespread, positive reaction from Michigan’s diverse medical community.
Two and three years ago our focus was the head; and our early adoption of an all-sports return-to-play protocol after concussion symptoms became a national model.
Last year and this, heat and hydration has been the focus. The MHSAA imposed on its own tournaments, and recommended for member schools’ practices and contests, policies to manage heat and humidity that include a reduction or modification of activities when the heat index reaches a certain level and cessation of all activities when the heat index reaches an even higher level.
Next school year and in 2016-17 the focus will be the fourth “H”: hearts. Tests for heart defects are expensive and results are often misleading, and the triggers of sudden cardiac arrest are unpredictable. Therefore, we will be pointing to the two actions medical authorities appear to agree upon most: (1) the need for planned and practiced emergency procedures, and (2) the need to have AEDs nearby, in good working order.
We urge MHSAA member schools not to wait for the MHSAA focus to make this a local school focus, and we recommend the MI HEARTSafe Schools initiative. See the HeartSafe Action Plan or the HeartSafe School information for details.

Girls, Boys and Concussions

September 13, 2016

On Monday the Michigan High School Athletic Association announced the major findings from the first year that member high schools were required to report all suspected concussions in the practices and competitions conducted in the 28 sports served by the MHSAA.

It surprises no one that 11-player and 8-player football ranked first and third, with 49 and 34 head injuries per thousand participants, respectively.

And while I’m told it’s not surprising to the experts that girls report more head injuries than boys, it is stunning to me how very many more head injuries are reported for girls than boys.

In sports with identical playing rules, girls reported head injuries with approximately twice the frequency that boys did.

In soccer, girls reported 30 head injuries per 1,000 participants, compared to 18 per 1,000 for boys.

In basketball, girls reported 29 head injuries per 1,000 participants, compared to only 11 per 1,000 for boys.

Girls reported concussions at the rate of 11 per 1,000 participants in softball, while boys reported just 4 per 1,000 in baseball.

Only a small percentage of either girls or boys were cleared by licensed medical personnel to return to activity in less than six days, and more than half were withheld between six and 15 days in soccer and basketball. The data suggests that clearance for girls to be returned to activity was slightly more gradual than it was for boys.

Researchers and reporters may find dozens of other observations and curiosities from the summary of 4,452 confirmed head injury reports submitted by the MHSAA’s 755 member high schools for MHSAA-supported sports in 2015-16; but what has the MHSAA’s attention is this giant gender difference.

Is this gender difference accurate, and if so, what are the physiological factors involved that make it so?

Is there a tendency for over-reporting by females, or under-reporting by males, and if so, what are the social and/or psychological factors that may cause this?

Regardless, what does this mean for how coaches work with boys and girls; and what does that mean for how we prepare coaches through the MHSAA Coaches Advancement Program?

The MHSAA will take to an even deeper level its nearly 30-year partnership with the Institute for the Study of Youth Sports at Michigan State University to explore the issues related to coaches education that have emerged as a result of the first year of mandated concussion reporting for Michigan high schools.

The 2015-16 school year was only a start; it identified some initial themes. The more important value will be realized after the 2016-17 school year, and subsequent school years, when year-over-year comparisons will be made and trends will become apparent that will demand action to further promote the welfare of participants in school-sponsored sports.