2018-19 Concussion Data Reinforces Trends
September 26, 2019
By Geoff Kimmerly
Second Half editor
Data on student-athlete concussions collected by the Michigan High School Athletic Association from member high schools during the 2018-19 school year further reinforced findings from the first three years of reporting, and will contribute significantly as a number of MHSAA-associated groups work during the coming year to reduce the incidence of those injuries.
The 2018-19 concussion report found student-athletes at MHSAA member high schools encountered a total of 3,686 head injuries during the past school year – 3.0 percent more than in 2017-18. But that slight increase barely affected two key ratios. The number of injuries per member school was 4.9, up just a tenth of a percent from 2017-18, and for the second straight year only 1.3 percent of participants in MHSAA sports experienced a head injury, still down from 1.4 in 2016-17 and 1.6 percent the first year of the study. Total participation in MHSAA sports for 2018-19 was 281,992 – with students counted once for each sport they played.
The MHSAA has continued 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. The 2018-19 results will be examined by the MHSAA’s newly-formed Sports Medicine Advisory Committee and also undergo analysis by representatives of Michigan State University’s Institute for the Study of Youth Sports. Furthermore, the MHSAA is directing its sport committees to study the data as they consider adjustments that could be made to rules for practice and competition.
“The 2018-19 concussion survey further reinforced the findings and trends we have seen emerge; not only in specific sports, but across all of our activities – and this latest set of results also raises new questions,” MHSAA Executive Director Mark Uyl said. “We must continue to look at how changes to playing rules and improvements in equipment may be beneficial moving forward, and also how we can further educate administrators, coaches, athletes and parents to identify and provide treatment for these injuries as soon as possible. We also are excited for the opportunity to have more eyes on these results as we continue to explore more ways to make our games safer.”
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 2018-19 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 on the Health & Safety page of the MHSAA Website.
Keeping with the first three years of this survey, the MHSAA continued to receive data from more than 99 percent of its member high schools after the fall, winter and spring seasons. Member junior high and middle schools also were allowed, although not mandated, to report their head injuries; and those findings are not part of the published report.
Boys in 2018-19 experienced 2,404 – or 65 percent – of concussion injuries, just a percent less than during 2017-18, and not surprisingly as boys have a much higher participation in contact sports. More than half of head injuries – 59 percent – were experienced by varsity athletes, a slight increase of three percent from the previous year. A total of 2,441 head injuries – or 66 percent – came in competition as opposed to practice. Just more than half took place during either the middle of practice or middle of competition as opposed to the start or end, and 51 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 returned to activity after either 6 to 10 days of rest (24 percent) or 11 to 15 days (23 percent). All of these findings were within 1-3 percent of those discovered from the 2017-18 data.
Contact sports again revealed the most head injuries. Ranking first was football, 11 and 8-player combined, with 44 head injuries per 1,000 participants – an increase of three per 1,000 from 2017-18 but the same ratio as 2016-17 and still down from 49 head injuries per 1,000 football participants shown by the first study in 2015-16. Ice hockey again revealed the second-most injuries per 1,000, with 35 (also up three from a year ago but still down from 36 injuries per 1,000 from 2016-17 and 38 per 1,000 in 2015-16), and girls soccer was third with 25 head injuries per 1,000 participants for the second year in a row. Wrestling followed with 22 head injuries per 1,000 participants.
Continuing a noticeable trend of the last few years, the next three sports to show the highest incidences of head injuries were girls sports – girls lacrosse, competitive cheer and basketball also revealed 20 per 1,000 participants, although basketball was down two injuries per 1,000 participants or nearly 10 percent from the previous year. Boys lacrosse (16), boys soccer (14), girls volleyball (11), softball (11) and gymnastics (10) also showed 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 nearly double the concussions per 1,000 participants as male soccer players (25 to 14), while female basketball players reported nearly triple the number of concussions per 1,000 participants (20 to 7). Softball players also reported nearly triple the concussions per 1,000 participants of baseball players (11 to 4).
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 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.
Rep Council Approves Sponsorship of New Sports, Adjusts Winter Schedule at Spring Meeting
By
Geoff Kimmerly
MHSAA.com senior editor
May 9, 2024
The Representative Council of the Michigan High School Athletic Association took several actions during its Spring Meeting, May 5-6 in Gaylord, including approving the addition of boys volleyball and girls field hockey to the lineup of MHSAA-sponsored tournament sports beginning in 2025-26 and reorganizing the winter championship calendar to end one week earlier.
The Spring Meeting of the 19-member legislative body of the Association’s more than 1,500 member schools is generally the busiest of its sessions each year. The Council considered 28 committee proposals and dealt with a variety of eligibility rule, postseason tournament and operational issues.
After a yearlong conversation about emerging sports at MHSAA member schools, the Council approved a Volleyball Committee recommendation to begin sponsorship of boys volleyball with the 2025-26 school year. The Council also voted to begin sponsorship of girls field hockey beginning with 2025-26. Girls field hockey will be played during the Fall season, and boys volleyball during the Spring season, with the 2024-25 school year to serve as a development period as the MHSAA works with the current governing organizations for those sports. These will be the first sports added to the MHSAA’s tournament offerings since girls and boys lacrosse joined the lineup during the 2004-05 school year.
Changes to the MHSAA Winter Calendar will take effect in 2025-26 and include several adjustments to Finals schedules and practice starts that overall will lead to the winter sports season ending one week earlier – reflecting a fall survey that showed nearly 80 percent of MHSAA member schools felt the winter should be shortened. The reshaped winter sports calendar also completes competition before schools begin their spring breaks – which are being scheduled earlier than in the past – and places championships on dates that avoid potential facility conflicts.
Beginning with 2025-26, the last weekend in February will include the Team Wrestling, Bowling and Competitive Cheer Finals (with Skiing Finals remaining on the Monday of that week). The first weekend in March will include the Individual Wrestling, Boys Ice Hockey and Girls Gymnastics Finals. The Boys Basketball Finals will move to the second weekend of March with the Lower Peninsula Boys Swimming & Diving Finals, and the Girls Basketball Finals will permanently conclude the winter season during the third weekend of March. The Upper Peninsula Girls & Boys Swimming & Diving Finals will remain in mid-February. With basketball seasons ending earlier, basketball practices will be able to begin five days earlier (on a Wednesday) to keep tryouts/first practice dates from falling during Thanksgiving week.
More changes to MHSAA Tournament competition will begin in 2024-25. The Council voted to add a team championship for girls wrestling to be awarded to the school with the most success in the girls bracket of the Individual Finals. A girls individual bracket was added for the 2021-22 season, and the team championship will be awarded based on individual finishes similarly to how boys team championships were awarded before the dual format Finals were created with the 1987-88 season. Also for 2024-25, the Council approved Basketball and Soccer Committee recommendations to seed the entire District tournaments in those sports using Michigan Power Ratings (MPR) data, which previously was used to seed only the top two teams in each bracket for girls and boys basketball and girls and boys soccer.
The Council also approved a classification change in football intended to protect the state’s smallest schools sponsoring the 11-player format. Continuing a conversation from its Winter Meeting in March, the Council approved a Football Committee recommendation to cap the enrollment of Division 8 schools at 250 students, and then divide the rest of the 11-player schools evenly to determine the enrollment lines for the other seven divisions. As more small schools have switched to 8-player, larger schools have shifted into Division 8 for 11-player – and this change guarantees Division 8 schools will play only similarly-small schools during the postseason, taking effect with the 2025-26 school year.
To continue supporting schools providing teams at multiple levels despite low participation, the Council voted to allow athletes in two more sports to compete on teams at two levels on the same day. The Council approved a Bowling Committee recommendation allowing bowlers to participate in subvarsity and varsity competition on the same day, provided the events are separate – bowlers may still be listed on only one match roster and bowl for one team during each event – and also approved a Girls Lacrosse Committee recommendation to allow athletes to play in no more than five quarters in one day, with overtime an extension of the fourth quarter. At multi-team girls lacrosse tournaments where both school teams are playing, an athlete would be allowed to play in as many halves or quarters as what the school’s highest team level that day is playing.
The Council bolstered the penalty for inappropriate behavior toward game officials, approving an Officials Review Committee recommendation modifying the penalty for any coach or athlete who is ejected for spitting at, hitting, slapping, kicking, pushing or intentionally and/or aggressively physically contacting a game official at any time during that competition or after being ejected. The offending coach or athlete shall be suspended from competition for the next 14 calendar days and must complete an online sportsmanship course. The offending coach also will not be eligible to coach in the MHSAA Tournament for that sport during that season, nor be allowed to be present at the site or within sight, sound or communication of a tournament event for that team.
Here is a summary of other notable actions taken by the Representative Council at the Spring Meeting, which will take effect during the 2024-25 school year unless noted:
Regulations
• The Council approved a change to the athletic-related transfer (link) rule stating that an athlete is ineligible in all sports participated in during the current or previous school year if that student has transferred to a school where a coach is employed who previously was a school employee or third-party contractor at the athlete’s former school. This change of language bolsters the regulation to include links to a coach at the new school who previously was employed in any way by the previous school.
• The Council approved a change to the football practice and competition rule to state that a school may not take part in an interscholastic scrimmage with another school until the Wednesday of the second week of practice and only if the team has conducted football practice on at least seven separate previous days. A joint practice with another school is considered a scrimmage and may not take place until those seven days of practice have been completed.
Sports Medicine
• The Council approved a Sports Medicine Advisory Committee recommendation to require high schools to attest by each season’s established deadline that their high school sports coaches have emergency action plans specific to location which are posted, dispersed, rehearsed, discussed and documented within their practice plans.
• The Council also approved a Committee recommendation requiring MHSAA Tournament host sites to have an AED (automated external defibrillator) within visible distance of the event.
Officials
• The Council approved an Officials Review Committee recommendation requiring a set minimum number of officials required to work an event, designated by sport and level (varsity or subvarsity).
Sport Matters
• BASEBALL: The Council approved a Baseball Committee recommendation requiring varsity teams to submit their pitch count information electronically by noon the day following every game(s).
• BOWLING: The Council approved a Bowling Committee recommendation allowing for Regionals – Team and Singles – to be competed on consecutive days between Wednesday and Saturday of that week to increase the possibility of more bowling centers being able to host. Previously Regionals could be bowled only on Fridays and Saturdays.
• COMPETITIVE CHEER: The Council approved three Competitive Cheer Committee recommendations related to stunting while also prioritizing safety. In a braced suspended forward roll pyramid, the flyer and at least one bracer will be required to have a hand-to-hand/arm connection, with one or both hands/arms of the bracer connected to one hand/arm/foot of the flyer, and with this maneuver performed only to a cradle position or in a forward suspended role without twists.
Another change will allow a backward suspended roll when it originates from the cheering surface as long as both hands of the flyer maintain continuous hand-to-hand or hand-to-arm contact with the original bases or back spot.
A third change allows during an inversion the temporary loss of contact with the flyer while transitioning to a double-based sponge with both feet of the flyer in the hands of the bases, or to a cradle or shoulder-level or below stunt.
• GOLF: The Council approved a Golf Committee recommendation to form a Golf Site Selection Committee to review Regional tournament groupings and determine host schools and courses.
• SOCCER: The Council approved another Soccer Committee proposal to institute a running clock during the first half of matches when the goal differential is eight or more.
• SWIMMING & DIVING: The Council approved a Swimming & Diving Committee recommendation requiring all times entered for MHSAA Finals for both individual and relay swim events to be the times that are the fastest achieved in varsity competition during the current season and electronically verifiable on SwimCloud.com.
• TENNIS: The Council approved a Tennis Committee recommendation requiring the MHSAA to reduce the number of Regional tournaments for a season from eight to six if the number of teams participating that season is fewer than 288.
• TRACK & FIELD: The Council approved a Cross Country/Track & Field Committee recommendation allowing for athletes to qualify for MHSAA Finals by reaching predetermined standards during a window beginning April 1 of that season and extending until that athlete’s Regional meet.
• WRESTLING: The Council approved a Wrestling Committee recommendation to amend the penalty for a team when a wrestler competes at an ineligible weight class during a dual event. If the ineligible wrestler is discovered during the involved match, that wrestler forfeits that match and the opposing team will be awarded six team points, plus the head coach of the team with the ineligible wrestler will be assessed an unsportsmanlike conduct penalty resulting in a one-point team score deduction. If the ineligible wrestler is discovered after the involved match, any points earned by the offending wrestler are removed from the team score, along with the point for unsportsmanlike conduct, and six points are added to the offended team’s total. In both instances, neither wrestler involved in the match in question may compete again in that dual. If the ineligible wrestler is discovered after the dual is completed, the teams have left the mat area and the scorebook has been signed by the official, the results and team score will stand.
The Council also reviewed reports on membership, with 754 senior high schools and 774 junior high/middle schools in 2023-24 plus 60 elementary schools with 6th-grader participation; cooperative programs, with 392 high school programs for 720 teams during 2023-24; eligibility advancement applications, which totaled one; the use of Educational Transfer Forms, of which there were 128; school violations, attendance at athletic director in-service workshops and Coaches Advancement Program sessions; officials’ registrations (which were up 4.8 percent from 2022-23), rules meetings attendance, and officials reports submitted for the past three sports seasons. The Association’s $14.8 million budget for the 2024-25 school year also was approved.
The Representative Council is the 19-member legislative body of the MHSAA. All but five are elected by member schools. Four members are appointed by the Council to facilitate representation of females and minorities, and the 19th position is occupied by the Superintendent of Public Instruction or designee.
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.