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 Wrap-Up: Winter 2018
March 28, 2018
By Geoff Kimmerly
Second Half editor
With a number of important topics filling the agenda for its Spring Meeting this May, the Representative Council of the Michigan High School Athletic Association prepared for a number of possible votes by receiving and requesting additional information during its annual Winter Meeting on March 23 in East Lansing.
The Winter Meeting frequently serves as an opportunity for the Council to discuss items expected to come up for action at its final meeting of the school year, scheduled for May 6-7. Since June of 2017, the MHSAA has been pushing several projects forward – with work on the transfer rule and junior high/middle school sports receiving the most emphasis.
Addressing the chronically troubling nature of transfers in school sports, the MHSAA has facilitated nine months of discussions with leagues and administrative groups across the state to develop a proposal that would make the transfer rule sport-specific – that is, a rule that bases current eligibility on the sports an athlete has participated in in the past. The proposed new rule would make transferring students ineligible at a new school in the sports they played the previous year at their old school. However, transfer students would be immediately eligible in any sport they didn’t participate in the previous school year. A list of exceptions, including a change of residence, would still allow for transferring students to become eligible in all sports.
The Council discussed how support for this potential transfer rule change has grown, and suggested the MHSAA send further explanation of the proposal to school superintendents and principals before the meeting in May.
“Since last summer, there has been membership-wide discussion of proposals that pursue the elusive goal of adopting a transfer rule that is simpler and easier to understand and, therefore, more consistently enforced,” MHSAA Executive Director John E. “Jack” Roberts said. “There appears to be broad consensus that we are on the right path.
“If adopted by the Council in May, the full effect of the changes would not be felt until the 2019-20 school year. What sports are actually played by a student during 2018-19 would determine that student’s eligibility after a transfer for 2019-20.”
The Council also is continuing work on a number of efforts related to the MHSAA’s growing presence at the junior high and middle school level. Under consideration is a proposal increasing the number of contests permitted within the maximum 13-week seasons for several sports, and another proposal relaxing or eliminating the Limited Team Membership regulation for most sports at that level. The Council also is considering expanding the MHSAA’s role as a presenting sponsor at events involving junior high/middle school students.
MHSAA membership at the junior high/middle school level has increased by more than 100 schools – nearly 14 percent – and nearly 70 percent of 800 member junior high/middle schools have begun accommodating 6th-graders in their programs since the MHSAA’s Constitution was amended in 2015 to allow 6th-graders to be included.
“The emphasis on policies and programs related to 6th-, 7th- and 8th-graders is essential if sports at the high school level will remain relevant to students and useful to schools which are trying to engage youth in 21st-century learning,” Roberts said. “We’ve also put many policies under a microscope to see if they can be modified to respond to our customers’ desires for more competition at the 6th- through 8th-grade levels while remaining faithful to our mission of providing these younger student-athletes the opportunity to sample sports and develop new interests and skills.”
A number of other topics were discussed during the Winter Meeting in advance of actions that could take place in May or at the Council’s Fall Meeting in December:
• The Council is considering two leading options for setting the girls and boys basketball regular-season and MHSAA tournament schedules after the 2018-19 season. For 2018-19, for the first time, the boys and girls seasons will flip start and end dates, with the boys starting and ending their season first. This will be done to adjust to the availability of Michigan State University’s Breslin Center to host the boys Semifinals and Finals. For 2018-19, no other arena available is large enough to accommodate the crowd that traditionally attends the final games of the boys postseason.
One option for 2019-20 and possibly beyond includes continuing the current strategy of using multiple sites for Semifinals and Finals weekends while accommodating Breslin (or another largest arena’s) availability – for example, this year’s Boys Semifinals and Finals were played at Breslin, while the Girls Semifinals and Finals were played at Calvin College’s Van Noord Arena because Breslin was not available for the girls weekend. (Breslin and Van Noord will be used for the 2019 Semifinals and Finals weekends as well, again to accommodate Breslin’s availability.) The second option would put the girls and boys tournament schedules over the same three-week period and use the largest available arena to host games on only two days; Semifinals would be played at various sites for both genders, with all four girls and boys championship games played at the largest arena during one weekend.
• Also in girls and boys basketball, the Council will consider possibilities for seeding the top two teams in geographically-determined Districts. MHSAA staff have created plans for possible implementation as requested by the Council at its May 2017 meeting.
• In football, the Council is considering options to assist 8-player football schools with their regular-season scheduling.
“While transfers and junior high/middle school programs are fundamentally more important than single sport issues, we have an eye on several that will generate significant interest,” Roberts said. “Schools which sponsor 8-player football will be receiving plans to assist their scheduling of regular-season games, and they will be asked to provide reactions through an online survey during April.
“Basketball continues to have two issues which have more public interest than genuine importance. One – the boys and girls tournament schedule and championship venue after 2019 – is moving toward a vote in December. The other – limited seeding of boys and girls District tournaments – is scheduled for action in May.”
The Council also talked about ways of involving more junior high/middle school students and at more grade levels, and what possible new high school sports might draw students with a wider variety of interests and abilities. There also was discussion on how eligibility and transfer rules are applied to boarding school students and what modifications would promote competitive equity between boarding schools and both public and nonpublic schools.
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.