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: Fall 2015
December 14, 2015
By Geoff Kimmerly
Second Half editor
Results of recent changes to health and safety policies and possibilities for future work to help keep school sports safe were main topics of discussion by the Representative Council of the Michigan High School Athletic Association during its annual Fall Meeting on Dec. 4 in East Lansing.
Generally, Council takes only a few actions during its Fall Meeting, with topics often introduced for additional consideration and actions during its meetings in winter and spring. The Council heard reports on a number of subjects, chiefly the “4 H’s” of health and safety – Health Histories, Heads, Heat and Hearts – and the MHSAA’s recent work on these topics.
Among data most noteworthy, it was reported that 747 of 750 member high schools complied with the first-time requirement this fall that all head coaches have a valid certification in CPR. Eighty percent of high schools arranged in-person CPR training for all of their high school varsity head coaches, and two-thirds of high schools included assistant and subvarsity coaches in school-arranged in-person training.
The Council reviewed the preliminary concussion care data released to the public Dec. 9, recent actions by U.S. Soccer to reduce heading in youth soccer, discussion in the girls lacrosse community regarding head protection and actions taken by other states and the National Federation of State High School Association regarding football practice policies and their similarities to changes adopted for MHSAA schools prior to the 2014 season. Council members also examined results from this fall’s Update Meeting opinion poll, including questions related to the possibility of using electronic forms to track students’ health histories and the possibility of practice limitations for all sports similar to those adopted for football.
As a result of the recent amendment of the MHSAA Constitution allowing for membership at the 6th-grade level, a number of potential changes to the MHSAA Handbook necessitated by the amendment were presented to the Council, as was a draft of an updated 2016-17 Membership Resolution. Both are expected to be voted on at the March meeting.
The Council also received reports on athletic-motivated and athletic-related transfers, reviewed an updated list of Approved International Student Programs for 2015-16 and discussed concerns regarding the exception to the Transfer Regulation for residential students of boarding schools.
Changes to out-of-season coaching rules were among the most significant efforts taken up by MHSAA staff over the last year, and Council members shared their observations of the impacts of changes including the rule change that allows a school coach to work with up to four athletes at one time instead of the previous three. The Council discussed if the MHSAA should consider a policy requiring in all sports athletes to participate in a minimum number of contests against school teams to be eligible for MHSAA tournaments, but declined to take action on the topic beyond policies already in place for skiing, ice hockey and soccer. Council members also were presented with examples of calendars for a balanced school year and possible movement of standardized testing dates, which both have the potential to affect the school sports calendar in the future.
The Council voted on one matter concerning MHSAA tournaments, approving a recommendation by the Girls Lacrosse Committee to not accept the new overtime rule of U.S. Women’s Lacrosse that grants in tournament play sudden victory to the first team that scores. The MHSAA will retain its current overtime procedure for tournament games, which calls for two full 3-minute halves of stop-clock overtime – and, if the game remains tied after those first two halves – additional 3-minute overtime periods with sudden victory.
The Fall Meeting also saw the addition of Courtney Hawkins, athletic director at Flint Beecher High School, to the 19-person Council. He was appointed to a two-year term and also serves as his school’s varsity football coach. He fills the position formerly held by Maureen Klocke, athletic director at Yale High School, whose term ended. Also, Cheri Meier, principal at Ionia Middle School, was re-appointed for a second two-year term.
The Council re-elected Scott Grimes, assistant superintendent of human services for Grand Haven Area Public Schools, as its president; Benton Harbor athletic director Fred Smith was re-elected vice president and Vic Michaels, director of physical education and athletics for the Archdiocese of Detroit, was re-elected secretary-treasurer.
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 1,400 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.