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.
From the Director: Back to School
August 7, 2020
By Mark Uyl
MHSAA Executive Director
Since March 12, our world has been anything but normal. These times have tested most everything in life, and as summer turns toward fall, we find ourselves still with far more questions than answers. It has been said that an abnormal reaction to an abnormal situation is normal behavior.
Let me start with these abnormal times. I’ve had many conversations with administrators over the past month about the start of school and school sports. The one constant theme is these are anything but normal times. Many of these conversations have moved to the issue of schools starting the academic year virtually while considering whether or not to offer school sports opportunities this fall. Let me share the things that have been part of almost all conversations on this topic.
The loudest message I hear is kids are going to be playing sports this fall someplace. Period. If we believe that kids are going to take the fall off if school sports aren’t offered, we haven’t been paying much attention since May. Since that time, athletic activity has taken place in the club, travel, AAU and non-school space nearly every day. From first-hand experience, many of these events have implemented ZERO of the safety standards and protocols that businesses and schools have adopted for their plans of return. The non-school world generally has plowed ahead this summer with few-to-no rules, regulations, enforcement, oversight and accountability to anyone. If kids are going to be playing sports, our member schools are telling us that activity needs to be in the safest environment possible – which is with professional educators and trained coaches in our school sports world.
Schools are quick to point out that kids have been conditioning and training with school coaches in school-sponsored workouts most of the summer. We believe that the absence of virus outbreaks among our 749 high schools’ summer activities, involving thousands of kids, has been because schools have been following the return-to-activity plans. Districts have told us they can continue doing what they’ve been doing safely since June by following all COVID guidance and regulations we have put in place with government’s leadership and partnership.
Schools starting the year virtually are telling us they will use the lessons learned from the start of sports for when students return to campus later in the fall. School administrators have shared this view privately as this has become a highly-charged topic among various groups within our school communities. Sports allow schools to bring students back to campus in small, consistent and defined groups with the same adults working with those students each day. In school sports, there is little mixing of students from one sport with those students in another – making it much easier to monitor, track and trace kids when needed than if all students were in the buildings, hallways and classrooms all day. We hear from administrators that valuable lessons can be learned with athletics in August and September for a successful school start-up with students back on campus in October.
All of us share the fundamental belief that we must protect the health and safety of individuals first. This doesn’t include only COVID prevention measures, but also the mental health of teenage students and adults as well. In districts that are starting the school year online, they see athletics being the one shred of normalcy students, and staff members who choose to coach, will have during the fall. It’s a chance to safely interact with peers and get needed physical activity that hasn’t been happening for some kids since March. Health and safety has to include all facets of the individual, and more research is being shared each day about how mental health is becoming a critical issue. For many at-risk kids, sports is the one motivating factor to keep them in school and progressing toward graduation. Given the challenges of all online education for these at-risk kids, sports and the daily routine they bring perhaps would be more important for this group of students than ever before.
With no school sports, the affluent communities and families can navigate online learning during the day and then afford the non-school athletic opportunities that kids and families in less-affluent areas simply cannot. In many communities, school sports can provide opportunities and open doors that would not appear if kids become priced-out from participating and competing.
The past five months have been the most abnormal in a century. School sports being the one pathway back to school for students in our state – the one norm for this fall – run by professional educators who put kids first, would be an incredible boost to the physical and mental health of all of us. We believe that school sports can be done safely and smartly, and the MHSAA has developed plans that do just that. While the optics of sports taking place while waiting for in-person education is not what any of us prefer, we believe we must react to these abnormal times by thinking differently and looking at these unique times through a unique lens.
Trying to find one normal for our kids in these abnormal school days might just be the best thing we can do.