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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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43 Percent of Athletes are Multi-Sport
August 19, 2019
By Geoff Kimmerly
Second Half editor
Nearly 43 percent of athletes at MHSAA member high schools continued to participate in two or more sports in 2018-19, according to the Multi-Sport Participation Survey, reinforcing similar data collected for the first time two years ago and providing a foundation for work by the MHSAA’s Multi-Sport Task Force as it prepares to continue efforts this fall to promote the multi-sport high school experience.
Early and intense sport specialization has become one of the most serious issues related to health and safety at all levels of youth sports, as overuse injuries and burnout among athletes have been tied to chronic injuries and health-related problems later in life. In early 2016, the MHSAA appointed the Task Force on Multi-Sport Participation as part of a continued effort to promote and protect participant health and address the issues leading to early sport specialization.
The multi-sport participation survey was created in 2018 to provide data on the prevalence of sport specialization at MHSAA member high schools. This year’s survey received responses from 82.9 percent of member high schools and measured how multi-sport participation exists at schools. The collection of survey results annually is expected to show how schools are succeeding in promoting a multi-sport high school experience, providing another tool as schools work to guide students toward a well-rounded interscholastic sports career.
From schools that responded to this year’s survey, 42.9 percent of students participated in athletics in 2018-19 – 46.3 percent of boys and 39.5 percent of girls. The overall participation number was up nearly half a percent from 2017-18 (42.5), with the boys percentage holding steady and the girls increasing nearly a full percent from a year ago. Class D schools – those with the smallest enrollments – again enjoyed the highest percentage of athletes among the entire student body, at 57.1 percent, followed by Class C (50.7), Class B (45.8) and Class A (39.4).
Of those athletes counted by responding schools, 43 percent participated in more than one sport – including 45.1 percent of boys and 40.4 percent of girls – with all three of those percentages nearly identical to those derived from the first survey a year ago. Class D again enjoyed the highest percentage of multi-sport athletes, 61.8 percent, followed by Class C (56.7), Class B (48.7) and Class A (35.4).
Similar results for overall sport participation and multi-sport participation relative to enrollment size were seen by further breaking down Class A into schools of fewer than 1,000 students, 1,000-1,500 students, 1,501-2,000 students and more than 2,000 students. Similarly to 2017-18 for both sport participation as a whole and multi-sport participation specifically, the smallest Class A schools continued to enjoy the highest percentages, while percentages then decreased for every larger size group of schools.
Also of note, the percentage of two-sport athletes at every school measure around one-third of athletes – from 29.2 percent at Class A schools to 35.7 at Class B, 37.2 at Class C and 35.6 at Class D. However the number of athletes participating in three sports decreased substantially relative to the increase in school enrollment, with 22.5 percent of Class D athletes playing three sports, 18.2 in Class C, 12.4 in Class B and 6.0 percent in Class A.
The MHSAA Task Force on Multi-Sport Participation will be meeting this fall to discuss creating a program to measure multi-sport participation at MHSAA member schools and to recognize “achievers” – that is, schools that surpass the norm given their enrollment and other factors that affect school sports participation.
For 2018-19, in Class A, Marquette posted the highest percentage of multi-sport athletes with 85.9 percent, up 3.3 percent from its top-ranking Class A percentage from 2017-18. Grand Rapids Northview also topped 80 percent multi-sport participation, with 83.1 percent of its athletes playing two or more sports. Orchard Lake St. Mary’s, Detroit East English and Gibraltar Carlson all saw multi-sport participation from at least 70 percent of their athletes.
In Class B, four schools again achieved at least 80 percent multi-sport participation – Coloma (87.2 percent), Gladstone (86.7), Flat Rock (83.2) and Dundee (80.2), while 10 schools had 70 percent or more athletes playing at least two sports.
Six Class C schools reported more than 80 percent of its athletes taking part in more than one sport – Schoolcraft (87.1), Mayville (86.2), Manton (85.3), Houghton Lake (84.9), Cass City (84.7) and Decatur (83.5) – and 12 schools total with 75 percent or more athletes participating in multiple sports. There were 14 Class D schools with multi-sport participation at 80.9 percent or higher, with Gaylord St. Mary (93.2), Waterford Our Lady of the Lakes (91.5) and Watersmeet (90.3) topping the survey not just for Class D but among all schools that responded.
The full summary report on the Multi-Sport Participation Survey is available on the “Health & Safety” page of the MHSAA Website.