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.
New Rules, Reminders Promote Safety
August 6, 2015
By Geoff Kimmerly
Second Half editor
The first practices of the 2015-16 school year next week provide a valuable opportunity for reminders on the importance of athletes remaining refreshed during the hottest days of training – and also an opportunity to explain new Michigan High School Athletic Association rules in football aimed at further promoting safety during competition.
The first practices begin next week for approximately 110,000 student-athletes taking part in eight sports in which the MHSAA sponsors postseason tournaments. Football practice for more than 40,000 players can begin at MHSAA schools Monday, Aug. 10, followed by first practices for all other fall sports Aug. 12.
Each year, the MHSAA provides information to its member schools to help them prepare for hot weather practice and game conditions in the late summer and early fall. Those resources – including the MHSAA’s Model Policy for Managing Heat & Humidity– are available on the revamped MHSAA.com Health & Safety web page.
This also will be the second season for football practice changes made last fall to promote heat acclimatization and limit helmet-to-helmet contact. And earlier this week, 70 MHSAA high schools from across Michigan received training to take part in one of two sideline concussion testing pilot programs expected to benefit 20,000 student-athletes over multiple sports.
“There’s been a lot of attention focused on football regarding head safety, but the fact is all school sports need attention to the safety of student-athletes,” MHSAA Executive Director John E. “Jack” Roberts said. “We’re addressing all sports at all levels, practice and competition, to make sure our staff, who are interacting with the young people, know the best practices for safety in school sports. And we’re trying to communicate to the public that school sports really are safer than ever.”
The final weeks of July were another reminder of the importance of adjusting to hot weather as practices begin. The MHSAA Representative Council adopted in 2013 the Model Policy for Managing Heat & Humidity that, while not mandated for member schools, has been adopted by many at the local level. The plan directs schools to begin monitoring the heat index at the activity site once the air temperature reaches 80 degrees and provides recommendations when the heat index reaches certain points, including ceasing activities when it rises above 104 degrees.
The model policy is outlined in a number of places, including the publication Heat Ways, which is available for download from the MHSAA Website. Roberts reminded that the first days of formal practices in hot weather should be more for heat acclimatization than the conditioning of athletes, and that practices in such conditions need planning to become longer and more strenuous over a gradual progression of time. He added schools also must consider moving practices to different times of day, different locations, or change practice plans to include different activities depending on the conditions.
To assist in acclimatization, the football practice rule changes of 2014 allow for only helmets to be worn during the first two days, only shoulder pads to be added on the third and fourth days, and full pads to not be worn until the fifth day of team practice.
Practice in football must begin on Aug. 10 for all schools wishing to begin regular-season games the weekend of Aug. 27-29. Schools must have 12 days of preseason practice at all levels before their first game, and those 12 days of practice may not occur before 16 calendar days.
Practice sessions for all other sports begin Wednesday (Aug.12). In golf and tennis, competition may commence no earlier than after three separate days of team practice, and not before seven calendar days. The first day competition may take place in golf and tennis is Aug. 19. In all other fall sports, contests can take place after seven days of practice for the team and not before nine calendar days. The first day competition may take place in cross country, tennis, soccer, swimming and diving, and volleyball is Aug. 21.
This fall, two football dates precede Labor Day, and a number of MHSAA schools will play their first varsity games on Thursday, Aug. 27. In Week 1, 123 varsity games will be played on Thursday, 176 contests will be played on Friday, and 14 games will be played on Saturday.
Continuing the focus on player safety, additional rules changes were made in football for 2015 that again focus on minimizing injury risk:
- The definition of unnecessary roughness was expanded to include excessive contact with an opponent, including a defenseless player, which incites roughness. A defenseless player can be considered one no longer involved in a play, a runner whose progress has been stopped, a player focused on receiving a kick or a receiver who has given up on an errant pass, or a player already on the ground. Unnecessary and excessive contact can include blindside blocks and players leaving their feet to contact an airborne receiver attempting to secure the ball.
- The grabbing of a quarterback’s facemask by a defensive player, if it does not including the twisting, pulling or turning of the facemask, will be ruled incidental and result in a five-yard penalty instead of a roughing-the-passer penalty and automatic first down.
- A 2014 rule change stated that the kicking team must have at least four players on each side of the kicker when ready-for-play is signaled; a change this season states four players must be lined up on each side of the kicker when the ball is kicked. That fourth player may shift after ready-for-play but before the kick to comply with this formation rule, but may not go in motion more than five yards behind the ball. If the shifting player travels more than five yards behind the ball, it is a dead-ball foul for encroachment.
A few notable changes will go into effect for other fall sports:
- In cross country, the loosening on what runners are allowed to wear during competition continued after a ban on jewelry was lifted in 2014. Runners also now may wear sunglasses, and previous restrictions have been eliminated for specific styles of head gear – ski bands, head bands, stocking caps and hoods attached to other clothing. Previously, those head gear had to meet criteria including color and size of brand logos displayed.
- In swimming and diving, the ban on wearing jewelry has been lifted. The National Federation of State High School Associations deemed the ban unnecessary because there is little risk of injury to the competitor or opponents.
The 2015 Fall campaign culminates with postseason tournaments beginning with the Upper Peninsula Girls Tennis Finals the week of Sept. 28, and wraps up with the 11-Player Football Playoff Finals on Nov. 27 and 28. Here is a complete list of fall tournament dates:
Cross Country:
U.P. Finals – Oct. 24
L.P. Regionals – Oct. 30 or 31
L.P. Finals – Nov. 7
11-Player Football:
Selection Sunday – Oct. 25
Pre-Districts – Oct. 30 or Oct. 31
District Finals – Nov. 6 or 7
Regional Finals – Nov. 13 or 14
Semifinals – Nov. 21
Finals – Nov. 27-28
8-Player Football:
Selection Sunday – Oct. 25
Regional Semifinals – Oct. 30 or Oct. 31
Regional Finals – Nov. 6 or 7
Semifinals – Nov. 14
Finals – Nov. 20 or 21
L.P. Girls Golf:
Regionals – Oct. 7 or 8 or 9 or 10
Finals – Oct. 16-17
Soccer:
Boys L.P. Districts – Oct. 19-24
Boys L.P. Regionals – Oct. 27-31
Boys L.P. Semifinals – Nov. 4
Boys L.P. Finals – Nov. 7
L.P. Girls Swimming & Diving:
Diving Regionals – Nov. 12
Swimming/Diving Finals – Nov. 20-21
Tennis:
U.P. Girls Finals – Sept. 30-Oct. 3
L.P. Boys Regionals – Oct. 8 or 9 or 10
L.P. Finals – Oct. 16-17
Girls Volleyball:
Districts – Nov. 2-4 & 5, 6 or 7
Regionals – Nov. 10 & 12
Quarterfinals – Nov. 17
Semifinals – Nov. 19-20
Finals – Nov. 21
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.