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.
MHSAA Provides Reopening Guidelines
May 29, 2020
By Geoff Kimmerly
Second Half editor
The Michigan High School Athletic Association today submitted to its member schools a series of updated timelines and recommendations to guide the return of sports, which have been suspended since mid-March to alleviate the potential spread of COVID-19.
The state’s current “Safer-at-Home” order runs through Friday, June 12. There can be no use of any school facilities (indoor and outdoor) and there can be no organized on-site athletic activity, including conditioning or competition, until the current stay-at-home order expires or is lifted by Governor Gretchen Whitmer. When the “Safer-at-Home” order expires or is lifted, the return-to-activity recommendations may be implemented locally by school district leadership, provided the district declares its facilities open to students and staff and the 2019-20 school year has ended for that district (based on its last originally-scheduled school day).
The “MHSAA/NFHS Guidance for Re-Opening School Sports” is based primarily on direction provided by the MHSAA and National Federation of State High School Associations’ (NFHS) Sports Medicine Advisory Committees, in addition to reopening plans provided by the Michigan and federal governments and recommendations from the Center for Disease Control and Prevention (CDC). Concepts from the United States Olympic & Paralympic Committee also were consulted.
The MHSAA/NFHS plan recommends a three-step process to returning to full athletic participation, and for each step outlines actions to be taken in five major areas: pre-workout/contest screening of athletes and coaches for sickness, limitations of the number of participants who may be involved in a gathering, proper cleaning for facilities, the use of equipment during activity and best practices for keeping participants safely hydrated. The plan also places sports into categories based on risk for transmitting the virus (low/moderate/high), with adjusted return-to-activity steps based on that level of risk.
The MHSAA serves more than 1,500 public and private schools, including 750 high schools.
“The MHSAA and its Representative Council believe restarting school sports is essential to the physical and mental well-being of students, and the guidelines outlined for schools today provide the ‘How’ for schools to return to athletics when they’ve received the go-ahead from state and county health officials,” MHSAA Executive Director Mark Uyl said. “We are thankful for our state government, state education and health departments, our medical partners and the NFHS for their guidance these last few months, and we will continue to follow and pass on their recommendations as we prepare our schools to bring back this part of student life that’s been sorely missed.”
At the present time, the only activity allowed continues to be individual, outdoor recreational activity including walking, hiking, running, etc. (as announced in Executive Order 2020-96). If this type of conditioning activity takes place with more than one person present, it must be in groups of fewer than 10 people with social distancing followed, and the activity cannot involve school coaches, be school sponsored or occur at any school facility (indoor or outdoor) until at least June 13.
Voluntary virtual (not in-person) communication and instruction from coaches to any number of students is permitted under MHSAA rules in all sports during the summer.
“The concept is that students can continue to individually condition themselves (by walking, hiking, running), but there should be no organized, group activity by any person until at least June 13. We must all continue do our part to flatten the curve in hopes of increased activity over the coming weeks,” Uyl said. “Again, it is important to note that this document addresses ‘How’ schools can return to activity; the decision on ‘When’ schools can return to activity will be done under the direction of state government and health department officials. As government actions impact this timeline, the MHSAA will continue to update all involved.”
The return-to-activity guidelines are aimed to provide direction for schools as they continue to limit potential exposure to respiratory droplets, the primary avenue for transferring COVID-19. Specifically, the MHSAA/NFHS plan addresses social distancing, use of cloth and other face coverings, event scheduling and transportation, and the possibility that schools may have to break from or completely discontinue activity including competition during the fall or winter because of recurrent outbreaks of the coronavirus.
School district administrators will determine at which step in the MHSAA/NFHS plan their schools are operating based on the number of people allowed to gather by state medical officials.
The document in full is available from the MHSAA Website. Further guidance will be provided over the weeks ahead as new information is available and the prevalence of COVID-19 changes. Updates to the MHSAA/NFHS guidelines will continue to be in accordance with those published by the Governor’s office.
The MHSAA has remained in regular contact with the Governor’s office, Michigan Department of Health & Human Services and Michigan Department of Education throughout the pandemic, in addition to leadership from the state’s superintendents, school principals, athletic administrators and school boards associations.
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.