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 2012
June 28, 2012
In addition to authorizing a vote of its membership to allow for waiver of its maximum age rule under certain circumstances, the Representative Council of the Michigan High School Athletic Association also approved a variety of regulations and sports activities policies during its annual Spring Meeting, May 6-7, in Gaylord.
The Spring meeting of the 19-member legislative body of the Association’s over 1,500 member schools is generally the busiest of its three sessions each year. The Council considered 33 committee proposals and also dealt with a variety of eligibility rule, post-season tournament and operational issues.
A couple of the most visible changes will take place in ice hockey beginning with the 2012-13 school year, which will see longer games in the MHSAA post-season tournament and the addition of a regular-season contest. Tournament games will now have 17 minute periods, something which had been allowed by local adoption for regular season games previously. The regular season game limit was also raised, as the Representative Council approved a Hockey Committee recommendation to reduce the number of scrimmages to one in exchange for the addition of a 25th contest.
Here is a summary of other actions taken at the Spring Representative Council Meeting which will take effect during the 2012-13 school year:
Handbook/Administrative Matters
- By prior mutual consent of competing teams, schools may agree to vary the color of game uniforms to commemorate events or causes important to those schools, provided all other uniform specifications are followed. The wearing of pink and camouflage uniforms, for example, to show support for breast cancer awareness or members of our armed forces wounded in action, among others, have become popular; but previously required advanced approval from the MHSAA.
- The Council approved a revision of the sections of the MHSAA Handbook addressing the sanctioning of meets conducted by non-school organizations or individuals and large interstate meets. They now reflect the requirements of the National Federation of State High School Associations, as well as previously unstated policies and procedures of the MHSAA.
- In junior high/middle school matters, the Council revised the Handbook so that schools may decide to allow student-athletes in the 7th and 8th grades to be members of an interscholastic team in more than one sport at the same time; and to allow a student who will exceed the maximum age limit as a 7th or 8th grader to apply for “Eligibility Advancement” while in 6th grade to begin a maximum of two years of junior high/middle school participation.
Sports Matters
- Responding to situations where celebrations by student-athletes and spectators have resulted in property damage at MHSAA post-season tournaments, the Council approved the following language for inclusion in participating team and tournament managers materials addressing team and spectator conduct.
- During contests, officials will penalize under applicable sportsmanship or playing rules those student-athletes or coaches who leave the field of play and contact or approach spectator areas for celebration.
- Each tournament manager or the MHSAA Staff may determine an acceptable number of crowd supervisors necessary for each school, dependent on the situation, including inappropriate celebrations and other crowd control issues.
- The cost for repair of replacement to facilities damaged as a result of participant and/or spectator conduct shall be paid by the school involved directly to the host facility within 30 days of the bill being submitted to the school. MHSAA reimbursement or revenue sharing will be withheld until paid by the offending school. Future tournament hosting privileges or school reimbursements to offending schools may be withheld if payment is not made.
- In Golf, the Council approved a committee recommendation to allow coaching contact for one designated coach during MHSAA tournament competition on all areas of the course, except when players reach the green. The school designated coach must be identified and approved by the school prior to the MHSAA tournament. Coaching privileges may not be transferred to persons not approved and designated by school administration. A committee recommendation to exempt one qualifying round of the Michigan Amateur Tournament from the limited team membership rule beginning in 2013, replacing the exemption approved in 2010 for the two U.S. Open qualifying stages, was adopted.
- In Boys Lacrosse, a committee recommendation to limit entry in the MHSAA post-season tournament beginning in 2013 to those schools that play no fewer than 50 percent of their regular season schedule against other MHSAA member school teams was approved.
- In Soccer, the Council did not adopt a National Federation rule adoption that eliminates a substitution for a player who receives a second yellow card. This action affects the 2012-13 school year only during which the Soccer Committee will consider this rule change further and its impact on Michigan’s ten-minute sit-out rule following a yellow card.
- A second day of weigh-ins will take place at the MHSAA Team Wrestling Finals, which will be independent of the previous day’s weigh-in, and all competitors would be given a one-pound growth allowance for consecutive days of weigh-in. The Council also approved a Wrestling Committee recommendation to permit wrestling practice to begin two Mondays before Thanksgiving. The first day of competition does not change.
The Council also reviewed reports on membership, with 763 senior high schools and 768 junior high/middle schools in 2011-12; eligibility advancement applications, which totaled nine for the year; the use of Educational Transfer Forms, which was stable this year; school violations, which declined significantly; attendance at athletic director and coaches in-service workshops; officials’ registrations, topping the 12,000 mark again; rules meeting attendance; and officials reports submitted for the past three sports seasons. The Association’s $9.8 million budget for the 2012-13 school year was also 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.