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2017-18 Report Shows Fewer Concussions
August 8, 2018
By Geoff Kimmerly
Second Half editor
Concussions are down, according to data compiled by the Michigan High School Athletic Association during its third year of collecting head injury reports from member high schools.
The work is not done – but this year’s data reinforces trends that emerged during the first two years of reporting and will assist the MHSAA as it explores solutions to continue reducing the incidence of head injuries in school sports.
The 2017-18 concussion report found a 9.6-percent decrease in the number of confirmed concussions from the previous year. Student-athletes at MHSAA member high schools encountered during 2017-18 a total of 3,580 head injuries – or 4.8 per member school, compared to the 2016-17 average of 5.2. Total participation in MHSAA sports for 2017-18 was 284,920 – with students counted once for each sport he or she played – and only 1.3 percent of participants experienced a head injury, down from 1.4 in 2016-17 and 1.6 percent the first year of the study.
As first mandated in 2015-16, member schools are required to report head injuries to the MHSAA identifying the sport that each student-athlete was participating in and whether the injury was sustained during practice or competition. Schools also are required to designate at which level – varsity, junior varsity or freshman – the injury occurred.
The full report of all head injuries experienced during 2017-18 by student-athletes at MHSAA member high schools – including percentages by sport (per 1,000 participants), gender and team level, as well as data tracking when athletes returned to play – is available by clicking here.
Consistent with the first two years of the study, the MHSAA received data from more than 99 percent of its member high schools after the fall, winter and spring seasons and continued to track each injury report through its conclusion this summer. Member junior high and middle schools also were allowed, although not mandated, to report their potential head injuries; and those findings are not part of the published report.
The decrease in overall head injury reports collected for 2017-18 follows a similar reduction from 2015-16 to 2016-17 – and brings the total decrease to 19.6 percent fewer reports since the first year of the study.
MHSAA Executive Director John E. “Jack” Roberts noted that the decreases in reports, both year to year and since the first year of the survey, likely have some relation to year-to-year fluctuation, refinement of the follow-up reporting process and a better understanding by schools of what is not to be included for the survey – including head injuries not diagnosed as concussions and head injuries that did not take place during MHSAA-sponsored activities.
However, the findings of this year’s study – and their similarities to the findings from the first two surveys – has begun to clarify the identification and understanding of trends. Continuing to emerge perhaps most prominently is the higher incidence of concussion reports from girls sports – and pertinent questions about physiological and social causes behind those results.
“With three years of reporting by virtually 100 percent of our high schools, what we’re learning is no longer anecdotal; the results are beginning to identify valid trends and genuine issues that need to be addressed,” Roberts said. “For example, it’s even clearer than before that girls are reporting three times the number of concussions as boys when comparing similar sports – soccer, basketball and baseball versus softball. As a result, we’ve already begun to incorporate these gender differences into our coaches education, and the writers of high school playing rules are obligated to focus on these gender differences as well.”
Although the total number of confirmed concussions was significantly lower again in 2017-18, a number of findings detailing those injuries fell in line with results of the first two surveys.
Boys experienced 2,373– or 66 percent – of those injuries, the same ratio as 2016-17, and not surprisingly as boys have a much higher participation in contact sports. More than half of head injuries – 56 percent – were experienced by varsity athletes, which for the second year also fell within a percent difference of the previous year’s findings.
A total of 2,330 head injuries – or 65 percent – came in competition as opposed to practice. More than half took place during either the middle of practice or middle of competition as opposed to the start or end, and 52 percent of injuries were a result of person-to-person contact. The MHSAA also asked schools to report the number of days between the head injury and the athlete’s return to activity – and the two largest groups, both at 24 percent, returned to activity after either 6 to 10 days of rest or 11 to 15. All of these findings were within 1-3 percent of those discovered from the 2016-17 data.
Contact sports again revealed the most head injuries. Ranking first was football, 11 and 8-player combined, with 41 head injuries per 1,000 participants – a decrease for the second straight year, this time from 44 head injuries per 1,000 participants in 2016-17 and down from 49 head injuries per 1,000 football participants shown by the first study in 2015-16.
Ice hockey repeated with the second-most injuries per 1,000, with 32 (down from 36 injuries per 1,000 from 2016-17 and 38 per 1,000 in 2015-16), and girls soccer and wrestling tied for third with 25 head injuries per 1,000 participants – girls soccer down from 28 head injuries per 1,000 participants and wrestling down from 26 per 1,000 in 2016-17.
Also consistent with 2016-17, the next five sports (after football and hockey) to show the highest incidences of head injuries were girls sports – girls soccer followed by girls basketball (22 per 1,000), girls competitive cheer (20) and girls lacrosse (20). Boys lacrosse (17), girls gymnastics (16) and boys soccer (12) were the only other sports to show double-digit head injuries per 1,000 participants.
Females again reported significantly more concussions than males playing the same or similar sports – soccer, basketball and baseball/softball. Female soccer players reported more than double the concussions per 1,000 participants as male soccer players (25 to 12), while female basketball players also reported more than double the number of concussions per 1,000 participants (22 to 9). Softball players reported seven concussions per 1,000 participants, and baseball players reported three per 1,000. Although the percentage differences vary from year to year, the results of all three comparisons remained consistent with what the survey found in 2015-16 and 2016-17.
The MHSAA in 2018-19 is directing its sport committees to focus on a pair of questions – how to increase participation and how to make their specific sports safer – the latter aiming to put some of what has been learned from concussion reporting into practice. The MHSAA also is continuing to invite Michigan’s universities, health care systems and the National Federation of State High School Associations (NFHS) to take part in analyzing the data and resulting questions that have arisen during the past three years.
“Regrettably, I do not see a nationwide head injury reporting effort likely,” Roberts said. “First, it’s hard to coordinate 50 states’ efforts. And second, if left to medical professionals, the survey tool might become so cumbersome that schools would be reluctant to participate – and certainly, it would not get the 99.9 percent cooperation that we’ve enjoyed from schools over these three years.”
Schools report possible concussions online via the MHSAA Website. Reports are then examined by members of the MHSAA staff, who follow up with school administrators as those student-athletes continue to receive care and eventually return to play. Student privacy is protected.
The reporting of possible concussions is part of a three-pronged advance by the MHSAA in concussion care begun during the 2015-16 school year. The MHSAA completed in spring 2017 the largest-ever state high school association sideline concussion testing pilot program, with a sample of schools from across the state over two years using one of two screening tests designed to detect concussions. The MHSAA also was the first state association to provide all participants at every member high school and junior high/middle school with insurance intended to pay accident medical expense benefits – covering deductibles and co-pays left unpaid by other policies – resulting from head injuries sustained during school practices or competitions and at no cost to either schools or families.
Previously, the MHSAA also was among the first state associations to adopt a return-to-play protocol that keeps an athlete out of activity until at least the next day after a suspected concussion, and allows that athlete to return to play only after he or she has been cleared unconditionally for activity by a doctor (M.D. or D.O.), physician’s assistant or nurse practitioner.
In addition, the MHSAA’s Coaches Advancement Program – which includes courses that must be completed by all varsity head coaches hired for the first time at a member school – provides substantial instruction on concussion care. Separately, rules meetings that are required viewing for high school varsity and subvarsity head and assistant coaches at the start of each season include detailed training on caring for athletes with possible head injuries.
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Participation Again Outpaces Population
August 26, 2019
By Geoff Kimmerly
Second Half editor
For the third straight school year, Michigan in 2018-19 had the eighth-most participants in high school sports nationally according to statistics recently released by the National Federation of State High School Associations, again outpacing the state’s national ranking of 10th for total number of residents of high school age.
Michigan’s participation ranking was based on a number of 292,947, with 126,342 girls and 166,605 boys taking part in high school athletics, and included sports in which the Michigan High School Athletic Association does not conduct postseason tournaments. The totals count students once for each sport in which he or she participates, meaning students who are multiple-sport athletes are counted more than once.
The state’s girls participation ranked eighth nationally for the third straight year, while boys participation fell back to eighth, after moving up one spot to seventh during 2017-18. However, as with overall population, Michigan continued to rank 10th for both females and males ages 14-17 according to the latest U.S. Census Bureau estimates from 2018.
A total of 19 sports bested the state’s overall national participation ranking of eighth by placing seventh or higher on their respective lists. Four Michigan sports improved in national ranking during 2018-19, while the state fell in the rankings of five sports.
Perhaps the most notable improvement among Michigan sports came in boys bowling, where Michigan moved up one spot to second – its highest ranking in any of the 28 sports under MHSAA administration. Michigan previously ranked second nationally in boys bowling as recently as 2013-14 before falling to third for the last four years. Michigan’s boys tennis participation moved up one spot as well to fifth on its ranking list, while girls track & field moved up one spot to seventh and girls lacrosse moved up one spot to 13th after a one-year drop back in 2017-18.
Three of five sports that fell on participation lists still outpaced Michigan’s overall participation rank – girls volleyball fell one spot to fifth, while girls golf and girls competitive cheer both fell one spot to sixth on their respective rankings lists. Other Michigan sports that ranked eighth or higher in 2018-19 were baseball (eighth), girls basketball (sixth), boys basketball (seventh), girls bowling (fourth), girls and boys cross country (both seventh), 11 and 8-player football (sixth and seventh, respectively), boys golf (sixth), boys ice hockey (fourth), girls and boys skiing (both third), girls softball (seventh), girls tennis (third) and boys track & field (seventh).
Boys lacrosse, girls soccer and boys and girls swimming & diving participation all slotted ninth on their respective lists, holding to their 2017-18 rankings and placing still ahead of where Michigan slotted for high school-aged population. Michigan wrestling participation fell two spots to ninth nationally, but still outpaced population, and boys soccer fell one spot to 10th. Girls gymnastics participation ranked 11th nationally for the second straight year.
National participation in high school sports in 2018-19 declined for the first time in 30 years – but the total of 7,937,491 participants still ranked third highest all-time, consisting of 4,534,758 boys and 3,402,733 girls.
Girls volleyball saw the largest increase in participants nationally with 6,225 more this past year over 2017-18, followed by boys track & field (+5,257), girls soccer (+3,623) and girls lacrosse (+3,164).
Football, despite a 5.8-percent decrease from 2017-18, remained the most-played high school sport nationally with 1,006,013 participants. Boys track & field (605,354), boys basketball (540,769), girls track & field (488,267), baseball (482,740), boys soccer (459,077) and girls volleyball (452,808) all saw at least 400,000 participants, while girls basketball (399,067) and girls soccer (394,105) approached that total.
The top 10 states by participants remained the same in 2018-19. Texas and California topped the list again with 825,924 and 824,709 participants, respectively, followed by New York (369,266), Ohio (339,158), Illinois (333,838), Pennsylvania (316,429), Florida (308,173), Michigan (292,947), New Jersey (281,058) and Minnesota (240,487). Only Texas, California and Minnesota reported higher figures than the previous year.
The participation survey has been compiled in its current form by the NFHS since 1971 through numbers it receives from its 51 member state associations, including the District of Columbia. Click to see the complete 2018-19 High School Athletics Participation Survey.
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 19,500 high schools and 12 million participants in high school activity programs, including almost 8 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.
The MHSAA is a private, not-for-profit corporation of voluntary membership by more than 1,500 public and private senior high schools and junior high/middle schools which exists to develop common rules for athletic eligibility and competition. No government funds or tax dollars support the MHSAA, which was the first such association nationally to not accept membership dues or tournament entry fees from schools. Member schools which enforce these rules are permitted to participate in MHSAA tournaments, which attract more than 1.4 million spectators each year.