Preliminary Concussion Data Announced
December 9, 2015
By Geoff Kimmerly
Second Half editor
The Michigan High School Athletic Association this school year requested for the first time that member schools report possible concussions by their student-athletes during both practice and competition. Preliminary data from the fall season shows two percent of more than 100,000 high school athletes experienced concussions, and 27 percent of high schools responding reported that none of their athletes experienced concussions while participating in MHSAA sports.
The MHSAA received data from 744 – or 99 percent – of its member high schools at the end of the fall season. The average number of concussions reported by member high schools through Dec. 4, 2015, was 3.2 concussions per school. Fifty-two percent of reporting schools stated they had two or fewer concussions by athletes this fall.
Football, the fall season’s most-played sport with 39 percent of all fall participants, revealed 79 percent of all concussions reported for the season. Boys soccer, with nearly 14 percent of fall sport participants, revealed 11 percent of all concussions reported.
Data collected by the MHSAA remains preliminary, in part, because results noted include pending reports that have not been verified. After completion of these follow-up reports, the final number of concussions that actually occurred this past season may be lower than the preliminary numbers being reported at this time. The data analyzed to date is for high schools only, although middle schools also have the opportunity to report possible concussions. A full breakdown of the data including concussions by gender, sport, team level (varsity through junior high) and setting (practice or event) will be reported after the conclusion of the spring 2016 season.
The reporting of possible concussions is part of a three-pronged advance by the MHSAA in concussion care during the 2015-16 school year, all of which are producing data related to the frequency and severity of head injuries. The MHSAA this fall became the first state association to offer pilot sideline concussion testing, with 62 schools taking part in one of two programs. One of the objectives of the pilot programs was to increase awareness of concussions and improve sideline detection; and preliminary results indicate that the average number of possible concussions reported by pilot schools exceeds the average reported by schools outside the pilot group.
Of 36 schools reporting the most concussions this fall, 11 are part of the MHSAA’s pilot sideline detection programs. Those programs – King-Devick Test and XLNTbrain Sport – utilize technology to provide on-site testing of athletes who have sustained possible concussions, with results of those examinations then compared against baseline tests taken by athletes previously.
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. The program will produce additional data about the frequency and severity of head injuries. While it is still early, only 34 claims have been made on the insurance policy designed to assist in payment for concussion care. Twenty of the claims are for football, 11 for soccer.
“These three efforts combined are part of making our good programs better,” MHSAA Executive Director John E. “Jack” Roberts said. “We’re pleased to provide these services to our schools, and we anticipate having a comprehensive report after the end of the school year, with that data then used by the National Federation of State High School Associations and research institutions to continue to make our games safer.”
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.
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 for activity by a doctor (M.D. or D.O.), physician’s assistant or nurse practitioner.
“These pilot programs, and the reporting of potential concussions by all of our schools, have made administrators, coaches and athletes more aware of the possibility of concussions and the importance of immediate detection and care,” Roberts said. “Many of our schools have long had programs in place to detect concussions and provide care. The opportunities to test, report and receive financial assistance in the event of a concussion have encouraged all of our schools to consider additional ways to better care for their student-athletes.
“These latest in a long line of health and safety initiatives will establish a baseline, and eventually allow us to determine if we are making progress year-to-year in Michigan school sports in this critical area of health and safety.”
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.