Girls, Boys and Concussions

September 13, 2016

On Monday the Michigan High School Athletic Association announced the major findings from the first year that member high schools were required to report all suspected concussions in the practices and competitions conducted in the 28 sports served by the MHSAA.

It surprises no one that 11-player and 8-player football ranked first and third, with 49 and 34 head injuries per thousand participants, respectively.

And while I’m told it’s not surprising to the experts that girls report more head injuries than boys, it is stunning to me how very many more head injuries are reported for girls than boys.

In sports with identical playing rules, girls reported head injuries with approximately twice the frequency that boys did.

In soccer, girls reported 30 head injuries per 1,000 participants, compared to 18 per 1,000 for boys.

In basketball, girls reported 29 head injuries per 1,000 participants, compared to only 11 per 1,000 for boys.

Girls reported concussions at the rate of 11 per 1,000 participants in softball, while boys reported just 4 per 1,000 in baseball.

Only a small percentage of either girls or boys were cleared by licensed medical personnel to return to activity in less than six days, and more than half were withheld between six and 15 days in soccer and basketball. The data suggests that clearance for girls to be returned to activity was slightly more gradual than it was for boys.

Researchers and reporters may find dozens of other observations and curiosities from the summary of 4,452 confirmed head injury reports submitted by the MHSAA’s 755 member high schools for MHSAA-supported sports in 2015-16; but what has the MHSAA’s attention is this giant gender difference.

Is this gender difference accurate, and if so, what are the physiological factors involved that make it so?

Is there a tendency for over-reporting by females, or under-reporting by males, and if so, what are the social and/or psychological factors that may cause this?

Regardless, what does this mean for how coaches work with boys and girls; and what does that mean for how we prepare coaches through the MHSAA Coaches Advancement Program?

The MHSAA will take to an even deeper level its nearly 30-year partnership with the Institute for the Study of Youth Sports at Michigan State University to explore the issues related to coaches education that have emerged as a result of the first year of mandated concussion reporting for Michigan high schools.

The 2015-16 school year was only a start; it identified some initial themes. The more important value will be realized after the 2016-17 school year, and subsequent school years, when year-over-year comparisons will be made and trends will become apparent that will demand action to further promote the welfare of participants in school-sponsored sports.

The Specialty of School Sports

July 24, 2018

(This blog first appeared on MHSAA.com on November 18, 2016.)


There is much finger pointing when it comes to sports injuries, and I’d like to point in a direction that is often missed.

Some people blame equipment – it’s either inadequate, or it’s so good that it encourages athletes to use their bodies in unsafe ways.

Some people say the rules are inadequate, or inadequately enforced by contest officials.

Some people say the pool of coaches is inadequate, or they are inadequately trained.

But let’s not miss the fact that risk of injury is inherent in athletic activities, and at least part of the reason injuries occur is because the participants are developmentally deficient. In fact, this may be the fastest growing contributing cause to injuries in youth sports. It’s not the sport; it’s the lack of development, the lack of physical preparation.

When rushed into early and intense specialization in a single sport, youth may not be ready for the rigors of that sport. Lindsay J. DiStefano, PhD, ATC, of the University of Connecticut, has researched the topic among youth basketball and soccer players and linked higher injury rates to lower sports sampling, and vice versa. Exposure to multiple sports during early childhood positively influences neuromuscular control and reduces injuries.

Do we encourage youth to sample several sports and help them learn basic athletic movements and skills? Do we offer opportunities to train and condition and focus special attention on strengthening knees and necks? Do we provide more time and attention on practice than on competition and assure safe technique is taught and learned?

Early and intense specialization, with excessive attention to competition, invites injury. There is a much healthier way for most youth – and that’s balanced, multi-sport participation – the specialty of junior high/middle school and high school sports.