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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.
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Rep Council Approves Phased-In Fall
July 29, 2020
By Geoff Kimmerly
Second Half editor
The Representative Council of the Michigan High School Athletic Association today approved the next steps in returning sports for member schools, adopting a plan to phase in competition for Fall sports in hopes of continuing to deter the spread of COVID-19.
The Council affirmed that lower-risk sports – cross country, Lower Peninsula girls golf, Lower Peninsula boys tennis and Upper Peninsula girls tennis, and Lower Peninsula girls swimming & diving – may begin practice on Aug. 12 and begin competition on their traditional start dates of Aug. 19 and 21.
However, moderate and high-risk sports – football, girls volleyball and boys soccer – may begin practice but not competition. Decisions about competition timelines for these three sports will be made by Aug. 20.
Practice for boys soccer and girls volleyball may begin on Aug. 12. Football will delay the start of practice with full player pads and equipment until Monday, Aug. 17. The week of Aug. 10 may include football practice sessions consisting of conditioning, physical training and skill work with no other player equipment except helmets. This week of acclimatization is similar to allowed summer football activities that have been ongoing for schools since June.
The Council – the MHSAA’s 19-member legislative body – also voted to cancel scrimmages in all Fall sports for this school year and approved limitations on numbers of teams that may compete together at regular-season tournaments, invitationals and other multi-team events. The Council believed eliminating scrimmages emphasized the importance of keeping teams from mixing before the first date of competition, and the regular-season limitations may lessen opportunities for viral spread while still allowing meets to be conducted.
As this remains a fluid situation, the MHSAA would release updated timelines for competition for football, girls volleyball and boys soccer by Aug. 20 dependent on how the spread of the virus is trending statewide. Plans remain reliant on sustained metrics measuring virus spread and/or progression by schools and regions across the state according to Governor Gretchen Whitmer’s MI Safe Start Plan. Currently two regions are in Phase 5, which allow for limited indoor activity, while the rest are in Phase 4 and unable to host indoor training, practice or competition.
The start of volleyball and swimming & diving practices are in part contingent on the reopening of indoor facilities. Those sports may begin their practices outdoors if not allowed to be indoors by Aug. 12.
“The Council, reflecting on the positive impact on their athletes this summer from taking part in offseason training, feels it’s of utmost importance to continue athletic activity moving forward,” MHSAA Executive Director Mark Uyl said. “If we take a month off, our students will find opportunities to compete through non-school entities that may not be as focused on safety. Our athletic directors and coaches can provide the safest-possible environment to return to sports, and this phased-in approach to competition will help schools continue building on progress already made.
“The Council chose to make these adjustments to help ensure our athletes have a safe regular season this fall. As we continue to solidify the regular season, we can then turn our attention to building a safe postseason for our athletes.”
The MHSAA also has posted sport-by-sport guidance documents outlining increased precautions designed to limit the viral spread, plus a four-page overview with precautions that apply generally for all sports and include coverage of the following topics:
- Protocol for reporting COVID-19 infections.
- Guidance on face coverings. Athletes participating on the field/court are not required to wear face coverings, but are allowed to do so. However, bench personnel must wear face coverings at all times.
- Transportation, use of locker rooms and facility cleaning.
Specific sport guidelines and the overview are available on the respective sport pages of the MHSAA Website. Recommendations on spectator attendance will follow before the start of competition; spectators will be limited in accordance with Governor Whitmer’s executive orders on large gatherings.
The Council on July 17 approved a return-to-activity plan for the 2020-21 school year retaining the traditional calendar of Fall, Winter and Spring sports, but allowing for the possibility that Fall sports forced to halt activity during the next four months may conclude later in the school year.
“The easy way out would be to postpone all activity to next spring, and we are not taking the easy way out. But we will make wise decisions based on medical guidance,” Uyl said. “We will make these difficult decisions quickly and appropriately. If we don’t play this fall, it won’t be because we didn’t make every effort to do so.”
The Representative Council is the legislative body of the MHSAA. All but five members 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.