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.
Cohen Champions Treatment, Technology
By
Geoff Kimmerly
MHSAA.com senior editor
March 10, 2014
By Geoff Kimmerly
Second Half editor
Abby Cohen was looking for a problem to solve.
Two years later, she’s potentially only one more year from helping relieve a medical dilemma faced by 25 million Americans.
And the most impressive part might be that she graduated from high school a mere five years ago and is 23 years old.
Cohen, a 2009 MHSAA Scholar-Athlete Award winner as a senior at Bloomfield Hills Cranbrook-Kingswood, certainly could be called proactive, going back to her days as a volleyball, basketball and soccer standout for the Cranes. Less than a year after graduating from Washington University in St. Louis, Mo., she’s co-founder and co-CEO of Sparo Labs, which seeks to provide asthma sufferers with a proactive way of monitoring their symptoms and improving their treatments.
“Everyone has a different perspective on how to go about doing things,” Cohen said. “For me, growing up trying to improve in sports, I’d write down a list of things to do every day and actually do them, follow through. That aspect of always wanting to get better, and improve, is something that’s carried through to the rest of what we do at Sparo and in general how I approach things.”
On March 22, the MHSAA and Farm Bureau Insurance will recognize a 25th class of Scholar-Athlete Award winners. In advance of the celebration, Second Half has caught up with some of the hundreds who have been recognized (see additional links at the bottom of this page).
Cohen, who also served on the MHSAA Student Advisory Council from 2007-09, chose Washington based on its strong engineering problem and successful women’s basketball program. She studied bio-medical engineering and was a freshman on the Bears team that defeated Hope College for the Division III national championship in 2010.
But that first season was followed by a series of ankle injuries that required reconstructive surgery – and, effectively, ended her collegiate sports career. She still can play pick-up games, but four-hour daily practices and the other commitments of a varsity program would've been too much.
She missed basketball. But the end of her competitive career on the court, as it turned out, allowed more time to dive into a new pursuit – and, in her words, “work with another kind of team.”
“I’m a big believer in everything happens for a reason,” Cohen said. “It was disappointing having to have surgery to make everything feel better, for the long term, not just basketball. For me at that time, I didn't appreciate that with the extra time I could have, I could take the time to try new things, make the world a better place.”
Cohen planned at first to eventually become a physician. She shadowed a number of doctors, but decided that in the long run she could have a greater impact as an engineer designing products physicians could use.
In addition to her classwork, she helped form an extracurricular entrepreneurial group – and set out for an issue in need of repair. She and her now-business partner Andrew Brimer didn't realize how many Americans are affected by asthma, “that respiratory diseases are the only ones getting worse over time rather than getting better. That although technology is improving, why it’s not making a dent.”
They set out find out and make that dent themselves.
Through a series of interviews with patients, doctors, respiratory therapists and others in the field, Cohen and Brimer got an idea what could help – an affordable, easy-to-use device to allow patients to monitor on their own their symptoms so they can better manage them and the treatments to help. Cohen and Brimer designed a device that plugs into a smart phone and allows patients to blow into it like a whistle and register lung function readings – while also collecting data on medications, pollen counts, and other variables that affect lung function. Their device also should dent the health care costs that go with current testing, which generally requires an office visit.
Sparo will work over the next six months to improve its app interface and user experience, and then submit for Food and Drug Administration approval at the end of this year or the beginning of 2015 – with the hope it will then become available to patients later next spring.
Cohen is based in St. Louis, where she and Brimer have been able to work with three large local hospitals and within a nurturing entrepreneurial community. Brimer's brother owns a tech education company in New York which has provided additional support as she and Brimer discussed what was possible. “We were talking to patients and physicians, and it just seemed like the right thing to do,” Cohen said. “If we weren’t going to do this, who was?”
Cohen and Brimer have won 9 of 11 entrepreneurship grant competitions they've entered, netting more than $300,000 to get their lab rolling and allow them to hire two more engineers. Long-term, today’s work could just be the start of what Cohen hopes eventually will reach into developing countries as well.
She remains in touch with a number of teachers at Cranbrook-Kingswood – also, her mother Sheila Cohen teaches sixth-grade math at the school – and she spoke there at the end of 2013 as part of a TEDx event.
As she continues to build her team, Cohen is reminded of additional lessons she learned on the courts and soccer field – including a major one that will continue to pay as Sparo expands.
“Learning how to work on a team, with really different personalities, different people who all play different roles,” Cohen said. “That really came from sports – the ability to work with people and reach one common goal.”
Click to read the series' first installments:
- 25 Years Later, Scholar Athletes Shine On
- On Call as Doctor, Director, Mom
- "Mailloux Management" Goes Global
- Goorhouse Gives Back at Home
PHOTO: Abby Cohen (10) helps her teammates hoist a trophy while a player at Bloomfield Hills Cranbrook-Kingswood in 2009. (Photo courtesy of Cranbrook-Kingswood.)