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.
25 Years Later, Scholar Athletes Shine On
By
Geoff Kimmerly
MHSAA.com senior editor
October 3, 2013
Jennifer Bissell and Scott Kieser had ideas how their futures might unfold when they stepped onto the Pontiac Silverdome turf to accept the inaugural Michigan High School Athletic Association Scholar-Athlete awards on Nov. 25, 1989.
Bissell’s bio in the MHSAA Football Finals program mentioned the Vestaburg senior planned to attend Grand Valley State University and study broadcasting and public relations. Kieser, a senior at Unionville-Sebewaing, was set to attend Michigan Tech University and major in secondary education.
Inevitably when high school students are deciding on careers, some of those plans changed.
Kieser’s didn’t much; he did attend Michigan Tech, and after considering engineering during his first year stuck with education and is now a teacher and coach at Bay City Western High School. Bissell – now Dr. Jennifer Forrest – ended up with destinations different, nearby and then afar. She attended Central Michigan University on her way to becoming an orthopedic surgeon in Durango, Colo.
But the impact of high school sports – and what it meant to be named the MHSAA’s first Scholar Athletes – is not lost on either nearly a quarter century later.
“I vaguely remember ... watching the game from the booth, going out onto the field and the announcement,” Forrest recalled this week. “(But) I was very honored to get that award. It looked at both how well you did in school and participation in sports.”
“To walk on the field, shake Mr. (Jack) Roberts’ hand, see the award, it was a great honor,” Kieser said. “I was very lucky to have a lot of coaches in high school that inspired me and made me enjoy the learning in the classroom and all of the great life lessons I learned on the field, the basketball court and those arenas.”
The MHSAA has been fortunate as well to have Farm Bureau Insurance as its sponsor for all 24 years of the Scholar-Athlete Award. The program has evolved substantially from 1989-90 – when two students were recognized during the fall, winter and spring seasons – to this winter’s 25th celebration, during which Farm Bureau will award $1,000 scholarships to 32 student athletes based on their achievements both academic and athletic.
Each month building up to March's presentation, Second Half will catch up with some of the hundreds who have earned Scholar-Athlete Awards.
Now both 40 years old, the first winners certainly fit the bill. Forrest was a three-sport athlete participating in cross country, volleyball and softball and was president of Vestaburg’s student council. Kieser was co-captain of USA’s football and basketball teams, vice-president of his school’s student council and a member of the Tuscola County Leadership Forum.
And they’ve made good on the promise they showed and the awards they received as their futures lay ahead of them that Thanksgiving weekend.
Lists of exceptional accomplishments
The record board at Vestaburg High School still lists “J. Bissell” for fastest 5K time – at least one sign that Forrest’s legacy lives on in her little hometown.
One of her two older siblings still live there, her sister-in-law is a teacher at the high school and her niece Jaycee cracks up when people occasionally think the name on the leaderboard is hers.
During her days walking those same school halls, Forrest never pictured herself in an operating room. In fact, she never wanted to picture the possibility.
Forrest babysat for a doctor while in high school and decided she wanted no part of the doctor lifestyle with its unpredictable schedule and 80-hour work weeks. But she was interested in physical therapy, and despite her early leanings toward studying communications settled on CMU and its sports medicine program.
She spent three hours in the CMU training room most afternoons her freshman year, helping with the gymnastics and track and field teams among others. As a sophomore she worked in a physical therapy office, which she found to be a little monotonous – and so she started considering that occupation she figured was out of the question only a few years before.
Forrest did end up in medical school, at Wayne State University, but figured she’d become an emergency room doctor and definitely never a surgeon. And then she changed her mind on that one too – Forrest ended up going into orthopedic surgery, did a residency at University of California-Irvine, married another doctor from northern California and eventually ended up in Durango – a destination that seems meant to be for a family that loves biking and snow sports.
Each Memorial weekend Forrest races in the Iron Horse Bicycle Classic, which pits competitors against a steam engine traveling 50 miles (and climbing 5,500 feet) from Durango to Silverton.
“Partly because of my background in sports, I gravitated toward sports-related injuries,” Forrest said. “I enjoyed being in sports in high school, and I’m still a road cyclist, still into sports myself.”
Forrest’s bio now on the Animas Orthopedic Associates website lists her as practicing general orthopedics with special interests in arthritis management, joint replacement surgery, hand surgery, pediatric orthopedics and orthopedics trauma.
She and her husband have three daughters ages 6-9 who also are active athletically, and they make the trip back to Michigan at least once every few summers.
While her continued appearance on the Vestaburg record book surprised Forrest at first, her name also appears on another impressive list – among the CMU Admissions Office’s “notable CMU alumni” alongside CBS sportscaster Dick Enberg, various NFL and NBA players and the author of “Marley & Me.”
“I don’t think of myself as that,” Forrest said.
“I really liked science and medicine, and in the long run it all worked out fine.”
Back to school to make a difference
Kieser remembers being in sixth and seventh grade and dreaming of being on the varsity football and basketball teams. When he got his chance, he understood the importance of setting the right example for the younger hopefuls looking up to him.
He continued to do the same at Michigan Tech and has made guiding young athletes and students his life’s work at Bay City Western.
Kieser was the starting quarterback at Michigan Tech in 1993 and 1995 (missing 1994 with a broken foot) and was ranked among the top 50 nationally in Division 2 for total offense per game and passing efficiency. He decided to go out for the basketball team as a junior and started as a senior while earning the team’s scholastic achievement award with a 3.65 grade-point average while studying mathematics.
He also received both teams’ sportsmanship award, and was recognized by Burger King during his senior year as a Burger King National Scholar Athlete Award winner (the announcement appeared during the broadcast of the University of Michigan/Notre Dame game that fall). Tech’s football program received $25,000 for that accomplishment, and a scholarship in Kieser’s name is given to this day to an incoming freshman football player.
“Now that I reflect on it, that honor I won in high school really motivated me to continue that through college,” he said.
And beyond. Kieser teaches calculus and geometry at Bay City Western and is the junior varsity football coach. He hired in at the school right out of college in 1996 both as a teacher and the boys basketball varsity coach, a post he manned for seven seasons. All told, he’s coached some sport – track and field, soccer, baseball, football, basketball – at the high school, middle school or youth levels every year since he graduated at Tech.
He did consider engineering and the heftier paycheck that likely would’ve followed. But, “as I got a little bit older, I realized ... you’re not working for money (as a teacher). You’re working to help kids become the best they can be. Playing sports in college helped me mature, and I wanted to help as many other kids as possible reach their potential.”
He tries to teach his players to have pride in doing things the right away, respecting their opponents and the officials even despite the heated situations that arise in every game – the lessons he learned growing up across Saginaw Bay.
“I feel like the luckiest person in the world teaching and coaching and being involved I athletics,” Kieser said, “trying to encourage more kids to get involved, go out for a sport, do the best they can in the classroom, being the best they can be.”
PHOTO: MHSAA Executive Director Jack Roberts (far left) presents Scott Kieser with his Scholar-Athlete Award in 1989 at the Pontiac Silverdome, while Jennifer Bissell receives hers from Larry Thomas, the then-executive vice president of Farm Bureau Insurance.