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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.

More Than X’s & O’s

April 17, 2015

It’s nearly the fourth quarter. We are just completing year six of eight years in which we have been addressing four important health and safety issues that, for ease of conversation, we call the “Four H’s.” These are much more important than the X’s and O’s of sports.

During the 2009-10 and 2010-11 school years, the first quarter, our focus was on Health Histories. During this time we made enhancements in the pre-participation physical examination form, stressing the student’s health history, which we believe was and is the essential first step to participant health and safety.

During the 2011-12 and 2012-13 school years, the second quarter, our focus was on Heads. We were an early adopter – before state law mandates – of removal-from-play and return-to-play protocols, and our preseason rules/risk management meetings for coaches included information on concussion prevention, recognition and aftercare.

Without leaving that behind, during the 2013-14 and 2014-15 school years, the third quarter, our focus was on Heat – acclimatization. We adopted a policy to manage heat and humidity – it is recommended for regular season and it’s a requirement for MHSAA tournaments. The rules/risk management meetings for coaches during these years focused on heat and humidity management. At the mid-point of this two-year period, the MHSAA adopted policies to enhance acclimatization at early season football practices and to reduce head contact at practices all season long.

Without leaving any of the three previous health and safety “H’s” behind, during the 2015-16 and 2016-17 school years, the fourth quarter, our focus will be on Hearts – sudden cardiac arrest and sudden cardiac death. Coinciding with this emphasis is the requirement that all high school level, varsity level head coaches be CPR certified starting this fall. Our emphasis will be on AEDs and emergency action plans – having them and rehearsing them; and this summer we are expecting to deliver to every high school free of charge the “Anyone Can Save a Life” program developed in Minnesota and being distributed nationwide with the assistance of the National Federation of State High School Associations.