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: Spring 2016

May 13, 2016

By Geoff Kimmerly
Second Half editor

The Representative Council of the Michigan High School Athletic Association continued to create opportunities for participation in high school athletics during its annual Spring Meeting, May 1-2, in Glen Arbor, with a pair of actions designed to assist more schools in forming cooperative programs. 

The Spring Meeting of the 19-member legislative body of the Association’s more than 1,400 member schools is generally the busiest of its three sessions each year. The Council considered 18 committee proposals and also dealt with a variety of eligibility rule, postseason tournament and operational issues.

Among proposals approved was a recommendation by the MHSAA Classification Committee designed to promote opportunities for schools demonstrating a long-standing lack of participation in baseball, bowling, competitive cheer, cross country, golf, soccer, softball, tennis and wrestling – provided those schools are part of the same public school district or fall under the same governing body. The new exception will allow, by Executive Committee approval, eligible schools to form cooperative programs regardless of enrollment limits placed on other schools and in other sports – currently, schools forming a co-op program in these sports must have an enrollment of fewer than 1,000 students.

The Council also voted to add opportunities for cooperative programs in all sports at the subvarsity level for schools showing a history of lack of participation. Again with Executive Committee approval, two or more member high schools may form a cooperative at the subvarsity level only regardless of student enrollment restrictions that would prevent the same cooperative at the varsity level. Students on these subvarsity cooperative teams would have varsity eligibility only with their school of actual enrollment should they be brought up to a varsity team. 

The Council continued its work on health and safety that has been emphasized during the past seven years of an eight-year campaign focused on “4 H’s” – Health Histories, Heads, Heat and Hearts.

The Council approved enhancements to the MHSAA Physical Exam/Clearance/Consent Forms that in part include an annual requirement that students and parents acknowledge reading concussion education information. This enhancement is consistent with requirements of the Michigan Department of Health and Human Services.

A number of changes regarding rules meeting requirements for coaches beginning in 2017-18 also were authorized. Concussion education will be the focus of the meetings’ health and safety section every other year, with other health and safety topics (including overuse injuries, sudden cardiac arrest and heat illness) alternating in off years. High school assistant and subvarsity coaches will be required to complete the same rules/risk management meeting as high school varsity head coaches after previously having additional options by which to satisfy the requirement. At all levels, coaches will not be allowed to coach in the MHSAA tournament for that sport in that season if they do not comply with the rules meeting requirement.

For football, the Council approved a Football Committee recommendation stating that teams, after their first game, should partake in no more than 90 minutes of collision practice per week. Currently, teams are allowed two days of collision practice after their first game, but this new recommendation suggests a minute limit as well. During other days of practice, players still may wear helmets and other protective pads (although neither is mandatory) and practice blocking and tackling technique against pads, shields, sleds or dummies.

The Council also heard plans for the second year of the MHSAA’s sideline concussion testing pilot program and received a summary of the first meeting of the MHSAA Task Force on Multi-Sport Participation.

Here is a summary of other actions taken by the Representative Council at the Spring Meeting, which will take effect during the 2016-17 school year unless noted: 

Handbook/Administrative Matters

•  Out-of-season coaching rules were adjusted to allow teams of both genders playing the same sport to both host four-player skill group sessions with different coaches but at the same facility at the same time. Currently, only one four-player group in each sport, per school, can train at a facility at one time.

•  Additional language regulating competition against out-of-state opponents prohibits MHSAA schools from participating in events involving teams from other states unless all of those teams at the event are bona fide school teams (not sports academy, club or community teams) and are members of their respective National Federation of State High School Associations (NFHS) member high school associations, if eligible.

Sport Matters

•  In bowling, the number of athletes allowed on an MHSAA Regionals and Finals roster was reduced from eight to seven after past seasons showed the eighth bowler rarely was involved in competition. Teams may bowl up to five during competition and may still have up to two substitutes, but the roster reduction should reduce congestion in the competition area of bowling centers during events.

•  In competitive cheer, the Council approved two committee recommendations intended to make uniforms more consistent for all teams: Beginning during the 2017-18 season, all hair bows must be one solid color and not include adornments; and beginning in 2019-20, all uniforms must be free from cutouts and adornments including sequins, rhinestones, studs, glitter, etc.

• For football, in addition to the collision practice recommendation, the Council voted to allow MHSAA staff to request permission from the National Federation to experiment with using a 40-second play clock for the 2016 season. If granted, individual schools, with agreement of opponents and/or their leagues, may request MHSAA permission to conduct a contest using this timing option. Teams automatically would have 40 seconds to snap the ball from the end of the previous play, rather than the current 25 seconds after the official sets the ball and signals for the play clock to begin. (If play has been stopped by a timeout or penalty, the offense still will have 25 seconds to snap from the time the referee sets the ball and starts the play clock.)

•  In golf, the Council approved a committee recommendation to add a sixth Regional tournament for the Lower Peninsula for both girls and boys, allowing for three more teams and three more individual players to qualify for the Lower Peninsula Finals. In adding the sixth Regional, the Council also voted to eliminate Lower Peninsula Districts from the boys tournament, pursuant to the Golf Committee’s recommendation. However, while eliminating one round of play for the boys, the addition of another Regional for both boys and girls will bring the field to 108 players for each gender for the MHSAA championship rounds.

•  In ice hockey, an additional option to MHSAA overtime procedures was approved that will allow teams playing a two-game total-goal series to proceed to an overtime shootout after the second game to determine a series winner if the total goals are tied at the end of the two games. Schools must receive MHSAA approval prior to the series start.

•  In boys lacrosse, a tournament with eight Regionals advancing champions to four Quarterfinals was approved; the current bracket includes only four Regionals and advances those champions to Semifinals in each division.

•  In volleyball, the Council approved an adjustment that standardizes where Class C and D Quarterfinals will be played when including one Upper Peninsula and one Lower Peninsula team. In even years, the Quarterfinal will be played in the Lower Peninsula for Class C and the Upper Peninsula for Class D. In odd years, Class C will be played in the Upper Peninsula and Class D in the Lower Peninsula.

The Council also reviewed reports on membership, with 755 senior high schools and 705 junior high/middle schools in 2015-16; eligibility advancement applications, which totaled five for the year; the use of Educational Transfer Forms, which again held steady this year; school violations, attendance at athletic director in-service workshops and Coaches Advancement Program sessions, officials’ registrations, rules meetings attendance and officials reports submitted for the past three sports seasons. The Association’s $10.7 million budget for the 2016-17 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 1,400 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.