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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 Wrap-up: Spring 2020
May 8, 2020
By Geoff Kimmerly
Second Half editor
The addition of seeding at the Regional level in ice hockey and adjustments to provide byes for top-seeded teams in basketball and soccer were among the most notable actions taken by the Representative Council of the Michigan High School Athletic Association during its annual Spring Meeting on May 4.
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 three sessions each year. The Council considered 32 committee proposals and dealt with a variety of eligibility rule, postseason tournament and operational issues. As with the Council’s Winter Meeting in March, the Spring Meeting was conducted remotely to keep with social distancing required by the COVID-19 pandemic.
Beginning with the 2020-21 school year, ice hockey will employ a seeding process to place the top two teams in every Regional on opposite sides of that bracket, guaranteeing those two teams could not play each other before the Regional championship game. The two teams are to be seeded in each Regional using the Michigan Power Rating computer formula based on regular-season results against other MHSAA Tournament-eligible teams and opponents’ strength of schedule, the same system used in basketball and soccer and as one of multiple methods to seed in boys lacrosse. (Games against out-of-state or non-MHSAA opponents do not count in the MPR formula.) The MHSAA will draw all ice hockey brackets 15 days before the start of Regional play. The addition of hockey seeding was proposed by the MHSAA Hockey Committee.
The Council also adopted a change to seeding to take affect for hockey, basketball and soccer to provide any existing byes to the #1, and then #2 seed, in that order, if multiple byes are part of a bracket. The draw process then will continue to place the remaining teams on the bracket based on a randomly-selected order determined earlier in the season.
Similar rules changes in football and basketball approved by the Council and recommended by the MHSAA committees for those respective sports aim to create more opportunities, especially for programs struggling to field teams at multiple levels. In football, while an athlete may still play only four quarters in one day, that athlete may play in up to five quarters per week. In basketball, an athlete may compete in up to five quarters per day, during no more than three dates per week and 20 dates per team or individual. Both changes will allow athletes to contribute to both varsity and subvarsity teams simultaneously, potentially bolstering numbers and opportunities to retain those squads.
The Council also took action on a number of MHSAA Handbook regulations requiring adjustment because of the COVID-19 pandemic and disruption it has caused to Michigan high school athletics. Notably, the Council voted to waive the 2020-21 pre-participation physical exam requirement for athletes who received one during the 2019-20 school year, although they are still required to fill out and sign the MHSAA Annual Sports Health Questionnaire. The Council also authorized schools to make decisions on multiple summer matters, including an opportunity for athletic directors to request a waiver from the MHSAA to wear school competition uniforms during events that are school-sponsored and designed to recognize graduating 12th-graders. Additionally, the Council voted to give schools the opportunity to waive the annually-required week-long period of no summer activity, if they choose to do so.
Here is a summary of other notable actions taken by the Representative Council at the Spring Meeting, which will take effect during the 2020-21 school year unless noted. Additionally, three sport changes were approved by the Council during its Winter meeting in March and not yet publicized; those too are noted below.
Regulations
• The Council approved a change allowing teams in sports governed by MHSAA summer competition limits – basketball, football, ice hockey, lacrosse, soccer and girls volleyball – to participate against all opponents present at out-of-state summer events. MHSAA member schools must continue to abide by the MHSAA travel limit – traveling only to events that are hosted either in bordering states/provinces (Illinois, Indiana, Ohio, Ontario and Wisconsin) or within 300 miles one way. MHSAA member schools now may participate at those events against out-of-state teams that exceed the travel limit by traveling more than 300 miles to the event site.
Sport Matters
• In baseball, the Council approved a Baseball Committee recommendation to adopt a suspended-game policy stating that any game called before it reaches regulation, or when the score is tied, is suspended with play to pick up at a later time from that point. However, if both schools agree, a game called prior to regulation may be replayed in its entirety.
• Also in baseball, during its Winter meeting, the Council approved a Baseball Committee recommendation renaming the “Super Regional” level of the MHSAA Tournament as the “Quarterfinal” level – with trophies and medals to be presented to both Regional champions after the day’s Regional Finals are completed and before the day’s Quarterfinal matching up those two teams. The Council also adopted at the Winter meeting a tournament schedule that during even-numbered years will see Semifinals for Divisions 2 and 4 played on Thursday and Divisions 1 and 3 on Friday. The Semifinal schedule will flip during odd-numbered years.
• The Council approved a series of Girls Competitive Cheer Committee recommendations. High school athletes now are allowed to transition to stunts or loads from the flatback position. Also at the high school level, bases will be allowed to rotate or move while a flyer is in the inverted position (in a static inversion), and to provide for the allowance of additional flairs at the point of static inversion.
• Also in cheer, the Council approved a Committee recommendation requiring three safety judges (instead of two) and five panel judges at MHSAA Regional events.
• In football, the Council approved a Football Committee recommendation extending the running clock when a team leads its opponent by 50 points to both the first and second halves of a game; the 50-point running clock stops only for player injuries and previously was employed only during the second half. The 35-point running clock employed during the second half, with stoppages also for penalty enforcement, scoring plays and called timeouts, will remain in effect if the differential dips below 50 and until it reaches 50 points again.
• Also in football, the Council approved a Committee recommendation allowing schools 15 summer dates of non-mandatory contact with an unlimited number of players (wearing helmets only). Schools may use these dates as they see fit, but of these 15 only seven dates may be used for 7-on-7 competition against other teams. This also eliminates the previous allowance for a camp.
• The Council approved another change in hockey to improve safety, adopting a Hockey Committee recommendation requiring all members of a coaching staff to wear HECC-certified helmets while on the ice for practices or games.
• In alpine skiing, the Council approved a Ski Committee recommendation that will allow athletes who qualify for an MHSAA Final in one discipline (giant slalom or slalom) during Regional racing to compete in both disciplines at the Finals level.
• In soccer, the Council approved a recommendation from the Soccer Committee to allow girls soccer athletes to compete in scrimmages at a maximum of two college ID camps during the spring girls soccer season, when these ID events generally take place.
• A pair of changes were adopted for swimming & diving, one affecting each group of athletes. The Council approved a Swimming & Diving Committee recommendation allowing swimmers to wear caps reading “State Team” during both regular-season and postseason competition. For diving, the Council approved a Committee recommendation to designate the number of qualifiers from each Lower Peninsula Regional to be in proportion to the number of entries at those respective Regionals in each division. This will allow Regionals with larger numbers of participants to contribute more Finals qualifiers, while eliminating the possibility that a Regional could send all entrants to the Finals regardless of performance because only 12 participate at that site. Each division will continue to advance 36 divers total to the MHSAA Finals.
• In tennis, the Council approved a Tennis Committee recommendation to play the MHSAA Final two-day tournament on Friday and Saturday unless there is a conflict with the host facility. In that case, that specific Final would be scheduled for Thursday and Friday.
• During its Winter meeting, the Council approved a Classification Committee recommendation that adds girls and boys tennis to the group of sports that schools may play as cooperative programs – with Executive Committee approval – if their combined enrollments do not exceed 3,500 students. The Council will reexamine this allowance after its first two years.
Junior High/Middle Schools
• The Council approved a Junior High/Middle School Committee recommendation to conduct MHSAA-sponsored cross country Regional meets for junior high/middle school athletes at eight sites across the state, based on “zones” currently designated by the MHSAA. These Regional meets will begin with the 2021-22 school year.
• The Council also approved a Girls Competitive Cheer Committee recommendation to allow junior high/middle school teams to participate in three competitions per week (instead of two) as long as one of the three is conducted on a non-school day or a day not followed by school.
Officials
• The Council approved a series of recommendations from the Officials Review Committee. Of particular note, coaches and athletes ejected from competition now are required to complete an online sportsmanship course from the National Federation of State High School Associations (NFHS) before returning to competition.
The Council also discussed various other topics, including possibilities for presentation during this fall’s Update Meeting statewide tour, and took action to clarify Handbook language regarding a few eligibility scenarios. The Association’s $11.5 million budget for the 2020-21 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.