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 2013
May 20, 2013
A change in the transfer regulation and the addition of safety training for assistant and subvarsity coaches were among the most significant actions approved by the Representative Council of the Michigan High School Athletic Association during its annual Spring Meeting, May 5-6, in Gaylord.
The Spring meeting of the 19-member legislative body of the Association’s more than 1,500 member schools is generally the busiest of its three sessions each year. The Council considered 40 committee proposals and also dealt with a variety of eligibility rule, postseason tournament and operational issues.
The most significant change to the MHSAA body of regulations concerns students who transfer between schools for reasons related to athletics. Effective for the 2014-15 school year, a transfer student will be ineligible for 180 school days if he or she has partaken in an activity during the previous 12 months that demonstrates the transfer is related to athletics. Offending activities may include practicing, competing or training with a member of the new school’s coaching staff including during summer activities or non-school sports seasons like for AAU basketball. Attending an open gym at the new school or being coached by a current or incoming coach while the athlete still attended his or her former high school also would be considered an offending activity.
Currently, a school that loses a student for athletics-related reasons must report this to the MHSAA for that student to incur the 180-day transfer penalty. This is no longer necessary if the above activities are verified. The rule change beginning with the 2014-15 school year will consider a student’s activity taken place during the previous 12 months. Transfers may still qualify for one of 15 exemptions that allow for immediate eligibility.
The Council also approved another step in the MHSAA’s ongoing focus on health and safety issues. Also beginning with the 2014-15 school year, all assistant and subvarsity coaches at the high school level must complete the same MHSAA rules meeting required of varsity head coaches or, alternatively, one of the free online sports safety courses posted on or linked from the MHSAA Website that is designated as fulfilling this requirement.
Here is a summary of other actions taken at the Spring Representative Council Meeting which, unless noted, will take effect during the 2013-14 school year:
Handbook/Administrative Matters
• In cases of serious injury or extended illness, including concussion or suspected concussion and symptoms of sudden cardiac arrest, students must be re-examined by a physician (MD or DO) and provide a written release from that physician before returning to practice or competition. The clearance may not be on the same date on which an athlete was removed from activity. The emphases on sudden cardiac arrest and practice are new.
• A first-time 9th grader whose first 9-12 enrollment is in a non-traditional school or program may retain eligibility at a traditional school if that student registered at the traditional school before enrolling in the non-traditional school or program.
• A faculty member may supervise a school’s team or individual competitors in cases when the head coach is unable to do so for failure to complete the annual rules meeting requirement. Previously, only an administrator was allowed to take over that supervisory role when the head coach was not allowed to be present for this reason.
• When students in grades 9 through 12 are involved, high school administrators including athletic directors may not sponsor or support out-of-season programs or perform out-of-season functions which the school itself is prohibited from sponsoring or supporting – even if the administrator is not acting as affiliated with the school. Booster clubs, alumni groups, parent organizations and other groups that exist because of the school currently are governed by the same regulation for grades 7 through 12.
• Coaches in bowling and golf may be present at a non-school facility for those respective sports when more than three of their district’s students (grades 7-12) are present, even if the coach is not employed by the facility, as long as the coach is not directly coaching or teaching more than three players and the presence of more than three students is coincidental and not prearranged by the coach.
• Beginning in 2014-15, the maximum length for all junior high/middle school sports seasons will be 13 weeks. Also, the earliest start date for junior high/middle school fall sports, beginning this fall (2013), is the 14th Monday before Thanksgiving.
Sports Matters
• In Baseball and Softball, teams and individuals will be limited to 38 contests beginning with the 2014 season. Currently, teams may participate in a combination of 56 dates and contests.
• In Competitive Cheer, additional policies and penalties were adopted to assure teams utilize the correct number of competitors in all three rounds of competition.
• In Golf, devices that measures distance may be utilized in MHSAA tournaments beginning this fall. This does not, however, include smart phones. Also, beginning in 2014, the spring Lower Peninsula boys tournament will begin and end one week earlier than is scheduled for the current season.
• In Soccer, a National Federation (NFHS) rule was adopted for MHSAA play requiring a team to play short-handed (11 vs. 10) after a player receives a second yellow card. Currently, a player is ejected after the second yellow card, but his or her team is allowed to substitute another player to take the ejected player’s place on the field. The 10-minute sit-out period after receiving a first yellow card was eliminated.
• In Volleyball, beginning with the 2014 season, the royal blue, gray and white ball is required for all high school-level regular-season and MHSAA postseason matches.
The Council also reviewed reports on membership, with 758 senior high schools and 751 junior high/middle schools in 2012-13; eligibility advancement applications, which totaled 15 for the year; the use of Educational Transfer Forms, which remained stable this year; school violations, which remained significantly below recent average; attendance at athletic director and coaches in-service workshops; officials’ registrations; rules meeting attendance; and officials reports submitted for the past three sports seasons. The Association’s $9.9 million budget for the 2013-14 school year also was approved.
The Representative Council is the 19-member 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.