MHSAA Announces 2015-16 Concussion Data
September 12, 2016
By Geoff Kimmerly
Second Half editor
The Michigan High School Athletic Association has completed an unprecedented yearlong collection of head injury reports from its member schools, mandated in 2015-16 for the first time as part of an effort to identify and reduce the incidence of those types of injuries in educational athletics.
The MHSAA requested that member schools report, by sport, possible concussions by their student-athletes during both practice and competition. Reporting for the 2016-17 school year is underway, and schools again are required to designate if potential concussions occurred during competition or practice and at which level – varsity, junior varsity or freshman.
The full report of all head injuries experienced during 2015-16 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.
The MHSAA received data from more than 99 percent of its member high schools after the end of the fall, winter and spring seasons, and continued to track each injury report through its conclusion this summer. Member junior high and middle schools also were allowed, although not mandated, to report their potential head injuries; those findings are not part of the published report.
It is the hope that universities, health care systems and the National Federation of State High School Associations will take part in analyzing the data. The MHSAA will work, in particular, with Michigan State University’s Institute for the Study of Youth Sports to explore these findings and their relation to possible changes and additions in coaches education.
“We know that school sports are safer than they’ve ever been, thanks to advances in equipment, increased and more complete coaches education and rules designed to bring higher levels of safety to both practices and competition,” said John E. “Jack” Roberts, executive director of the MHSAA. “However, this unprecedented effort will allow us for the first time to set a baseline by which we can determine year-to-year progress as we work to reduce the incidence of head injuries in school sports, while providing questions we will seek to answer with assistance from our research partners.”
Student-athletes at MHSAA member high schools encountered during 2015-16 a total of 4,452 head injuries – or 5.9 per member school. Total participation in MHSAA sports for 2015-16 was 284,227 – with students counted once for each sport he or she played – and only 1.6 percent of participants experienced a head injury. Boys experienced 3,003 – or 67 percent – of those injuries, although boys participation in sports, especially contact sports, also was higher than girls.
More than half of head injuries – 54 percent – were experienced by varsity athletes. A total of 2,973 – or 67 percent – came in competition as opposed to practice. More than half took place during either the middle of practice or middle of competition as opposed to the start or end, and nearly 56 percent of injuries were a result of person-to-person contact. The largest percentage of athletes – 28 percent – returned to activity after 6 to 10 days, while 20 percent of those who suffered head injuries returned after 11-15 days of rest.
Not surprisingly, contact sports revealed the most head injuries. Ranking first was 11-player football with 49 head injuries per 1,000 participants, followed by ice hockey with 38 and 8-player football with 34. However, girls soccer was just behind with 30 injuries per 1,000 participants, and girls basketball ranked fifth with 29 injuries per 1,000.
A startling disparity in the number of reported head injuries suffered by girls and boys playing the same sports was the most significant finding revealed by the concussion reporting. Soccer, basketball and baseball/softball are played under identical or nearly identical rules, and in those sports females reported significantly more concussions than males playing the same or similar sport.
Female soccer players reported 30 concussions per 1,000 participants. Male soccer players, meanwhile, reported only 18 concussions per 1,000 participants. Female basketball players reported 29 concussions per 1,000 participants; male players reported 11. Softball players reported 11 concussions per 1,000 participants, and baseball players reported four per 1,000.
“Experts tell us that it’s not surprising that girls report more head injuries than boys. But we found it stunning how many more head injuries were reported for girls than boys,” Roberts said. “As we delve deeper into the data, we hope to identify what physiological, social and psychological factors may contribute to this disparity – and how we can better prepare school personnel and especially coaches to watch for over- or under-reporting.”
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 possible concussions is part of a three-pronged advance by the MHSAA in concussion care begun during the 2015-16 school year which is producing data related to the frequency and severity of head injuries. The MHSAA in fall 2015 launched the largest-ever state high school association sideline concussion testing pilot program, with 62 schools taking part by using one of two screening tests designed to detect concussions. One of the objectives of the pilot was to increase awareness of concussions and improve sideline detection, and results indicated that the average number of possible concussions reported by pilot schools exceeded the average reported by schools outside the pilot group. For the 2016-17 school year, 34 schools are taking part in one of the two pilot programs as the project was concentrated to include schools which were diverse in size and location and able to best conduct the pilots to completion. The pilots will focus on sports for which most concussions occur, according to the mandated reporting by all schools during the 2015-16 school year.
The MHSAA also is 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. During 2015-16, a total of 159 claims were made – with more than half coming in football (55) or girls basketball (29).
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.
The MHSAA is a private, not-for-profit corporation of voluntary membership by more than 1,400 public and private senior high schools and junior high/middle schools which exists to develop common rules for athletic eligibility and competition. No government funds or tax dollars support the MHSAA, which was the first such association nationally to not accept membership dues or tournament entry fees from schools. Member schools which enforce these rules are permitted to participate in MHSAA tournaments, which attract more than 1.4 million spectators each year.
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.