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.

Jackson's Imprint on MHSAA Stretches 45 Years, Across 4 Executive Directors

By Geoff Kimmerly
MHSAA.com senior editor

October 5, 2022

First impressions can be significant, as many a saying goes. And Karen Brown unknowingly provided one in 1978 that helped affect the course of athletics in this state over the next 40-plus years. 

A Michigan State University student named Karen Leinaar had shown up at the Michigan High School Athletic Association for a meeting about a 5K road race she was planning that was unrelated to the MHSAA except that the building provided a good meeting place – and Brown, just a year out of high school, was the first person to greet her at the old Trowbridge Road headquarters.

Seeing someone her age immediately made Leinaar more comfortable. She ended up returning to that office several times over the years, registering as an MHSAA game official while still an MSU student and then starting a career in 1982 that has included nearly 40 years as a high school athletic director and two decades of shaping policy as part of the MHSAA Representative Council.

That’s the kind of impact that’s emanated from Karen Jackson, formerly Brown, and over the last 45 years as assistant to four of the five executive directors during the MHSAA’s 98-year history. Jackson finished that run with her retirement Friday.  

“She was always one that would welcome you, and whether you walked into the office or called on the phone, she always had an answer that would calm you down or provide you with the information you needed,” said Leinaar, who currently is serving as interim athletic director at Frankfort High School in addition to her duties as executive director of the Michigan Interscholastic Athletic Administrators Association. 

“I remember initially calling and needing something from Mr. Norris – it was always Mr. Norris – and she could answer the question,” Leinaar added, referring to retired MHSAA executive director Vern Norris, who served in that role from 1978-86. “You didn’t want to talk to scary Mr. Norris – Vern was a wonderful man, but he was like the superintendent or principal. Karen always had the answer. … It was always that smile that made you feel like you were more than welcomed, wanted in the office, and everything is going to be OK.”

Karen Jackson in 2022Jackson began at the MHSAA in June 1977, two days before her graduation from long ago-closed Harry Hill High School in Lansing. 

Her high school sports career amounted to about half a season on the Hill varsity volleyball team as a sophomore before she had to switch gears to begin working for the Lansing Regional Chamber of Commerce as part of a school co-op program.

Jackson graduated as a co-valedictorian of Hill’s Class of 1977. Despite her academic standing, she hadn’t received much guidance at school on the possibility of college. But she had a job offer from the Chamber – and also had heard from grade-school friend Deborah Norris (Vern’s daughter) about an opening at the MHSAA. 

The MHSAA was offering more money, and Jackson was hoping to buy a car – and so at 18, she became the secretary for executive director Allen W. Bush.

The title has changed over the years, from secretary to the executive director, to executive assistant, to senior executive assistant. The MHSAA’s administrative processes obviously have changed, mostly because of technology, from everything done on paper and through the mail to just about everything conducted digitally over the internet. 

But many of Jackson’s most important duties at the end of her tenure resembled those she was hired to carry out nearly half a century ago. 

Setting Exemplary Expectations

Bush retired a year after Jackson began, and she then assisted Norris for his eight as executive director. She served with Jack Roberts through his 32 years as executive director from 1986-2018 and then for these first 3½ under current director Mark Uyl.

She was considered the “baby” of the MHSAA staff during her first 12 years, until she turned 30 and her support staff teammates declared she wasn’t the baby anymore during a Christmas party serenade. Just about 33 years later, she’s leaving as one of two people left who worked in the old offices before the MHSAA moved to another East Lansing headquarters at Ramblewood Drive in 1996.

School sports happen thanks to a Karen Jackson or two in every community -- people who provide the unseen support that makes these programs possible every day. 

For the last 45 years, she’s provided a consistent anchor for service to 1,500 schools and millions of student-athletes across Michigan.

Jackson, sitting fourth from left, was the “baby” of the MHSAA staff after joining when she was 18. “She’s shaped so much of what we’ve done,” said MHSAA assistant director Kathy Vruggink Westdorp, who joined the staff during the 2003-04 school year after more than two decades working for Grand Rapids-area schools. “Her service to schools was imperative to what she was doing, and it was a valuable part for our membership. Hers was such a dedicated service, such an exemplary service – finding solutions, to do what’s needed.”

There are file cabinets and libraries and hard drives at the MHSAA office, the contents of which are known by only a handful of people on Earth – and Jackson perhaps the most as she did most of the sorting and maintaining of those files over the years.

For a 1996 Lansing State Journal feature on the MHSAA’s support staff, Jackson (then Yonkers) explained “there are always new challenges, new issues and controversies. It never gets boring. In the past 19 years, we’ve slowly shifted from dealing with athletic administrators, principals and superintendents to dealing with legislators, attorneys and courts.” 

The last 25 years has seen much of the work swing back to providing service directly to schools. And Jackson’s mind has become part MHSAA library and part card catalog of where to find those few snippets she might not recall immediately from the last half century. 

“I guess what I’m proud of is being able to find things, to know where to find things and how to find things that other people don’t,” Jackson said. “Yes, the technology has changed everything. … We used to have more schools – they used to have 40-some Detroit public schools – and there was a whole era of (litigation), but it’s calmed down now.

“I liked what I did, and it kept me on my toes – that’s for sure.” 

The MHSAA is rooted in its responsibilities as a championship and eligibility rules maker, and Jackson was involved in just about every communication in those areas during her time. Tournament changes are made at Representative Council meetings, and she’s reported the minutes for at least 150 of those, including piles of special sessions as the MHSAA managed sports through the COVID-19 pandemic. Eligibility waivers are requested at Executive Committee meetings, and she’s prepared somewhere north of 505 sets of minutes for those monthly sessions even as those agendas have grown in content substantially over the years.

Then there’s all of the correspondence from those four executive directors – all with the initials “kb” or “kj” to go with “AWB” or “VLN” or “JER” and “MU.” She also was in charge of MHSAA election ballots for 35 years, served as the lead organizer of cooperative programs, helped with football tickets for a time and briefly was part of the program-selling crew at early Football Finals at the Pontiac Silverdome.

“I think I’m pretty lucky, being on the Council and Executive Committee, that I’ve been able to work with her a lot. And most athletic directors, they may not even know who she is because they may not have contact with her or do anything with her – but she’s obviously been the unsung hero of that office,” said Vic Michaels, who serves as director of physical education & athletics for the Archdiocese of Detroit and has served on the Representative Council since 2003. 

“She just does so much that you don’t really know about, especially with the Council. Whenever I need anything, Karen’s the one I call. She is the history, really. She’s the keeper of that.”

Unprecedented & 'Never to be Replicated'

A longtime co-worker of Jackson, Shirley Hytinen, retired in 1998 after just a few months more than 43 years. She too had worked for four executive directors, as she began in 1955 during the Charles E. Forsythe era.

Jackson surpassed Hytinen’s tenure a few years into Uyl’s, and can readily recall some of what stood out from all four directors she’s assisted.  

Bush was “really stern” – he had served in the U.S. Marines – and she said he didn’t smile much until the day he announced his retirement, when it was “like a switch turned. He was smiling and happy and joking around.” 

Norris was “the sweetest guy in the world.” Jackson had bought her first house in her mid-20s and was preparing to move in with only her dad and his motor home to assist, when Norris showed up to help at 7:30 a.m. that morning to provide another set of hands. 

Roberts is known by Michigan administrators and national colleagues for his writing, and Jackson said jokingly she still “cringes” when she sees a yellow legal pad. She was an important proofreader and spent the majority of her career serving with her desk just a few paces away from that of the recent National Federation Hall of Fame selection, and she attended his induction this past summer and San Antonio.

Jackson and husband Jim have plans to travel in retirement. Roberts pointed out that during the 1980s, the MHSAA would conduct nine Executive Committee meetings, each averaging fewer than 10 requests for waivers. By the end of his 32 years, there were 11 Executive Committee meetings annually – with approximately 50 waiver requests presented on average. Still, he and Jackson were able to process the meeting minutes and continue to distribute those decisions within 24 hours. 

“Over the more than three decades that Karen and I worked together at the MHSAA, the work became increasingly more voluminous and complicated – and Karen kept finding ways to increase our efficiency and maximize our output,” Roberts said.

Like Norris when Bush was executive director, Uyl had been part of the MHSAA staff under Roberts since 2004 before eventually moving into the corner office. After those first 15 years together, Uyl knew what a valuable person he had just a few yards away to assist in his transition, and “he just says to do this” and allows his staff to run with it, which Jackson enjoyed.

Her duties have been shifted confidently, mostly to Jamie VanDerMoere, another longtime administrative assistant who is best-known to Michigan school sports people for her leadership with the annual wrestling championship tournaments.

Jackson recently was married to Jim Jackson, and they have plans as they close in on their first anniversary – they’re hoping to travel to Italy at some point and also The Masters in Augusta, Ga., next spring. “I’m not going to miss coming to work every day, but the people,” Karen Jackson said.

And many in school sports across Michigan, although they may not realize it, will miss the contributions Jackson has made to their community over the decades including the context she’s provided as thousands of decisions have been made.

“Not only her understanding of our regulations and the processes of our regulations, but understanding why we have those things in place – when someone does something 45 years, you get a lot of historical context,” Uyl said. “What’s made her so effective is understanding the why – and that to me is something that’s almost impossible to replace.

“When an organization has been around 98 years with only five directors, it says something to have worked for four out of the five. That will never be replicated again.”

PHOTOS (Top) From top left, Karen Jackson has been a mainstay of the MHSAA for decades – serving membership, working with administrators like Randy Allen and Gina Mazzolini or serving as assistant to executive directors like Jack Roberts (right) and Vern Norris. (Middle) Jackson, sitting fourth from left, was the “baby” of the MHSAA staff after joining when she was 18. (Below) Jackson and husband Jim have plans to travel in retirement. (MHSAA archives.)