Health Histories
September 4, 2012
Eighteen months ago we completed two new preparticipation physical examination forms: (1) a two-sided card delivered without charge to schools in whatever quantity they need; and (2) a four-page form that is downloadable at MHSAA.com.
Both are improved from the previous card in that they ask more about family and student health history which, more than any cursory exam, helps identify potential health risks before participation. Both were developed with the cooperation and consensus of a diverse panel of medical experts assembled by the Michigan Department of Community Health.
At schools’ requests, the MHSAA has distributed more copies of the two-sided card than there are students enrolled in MHSAA member schools; so we know the form has widespread use. But still, this particular form is not required, which allows schools with a special local resource to utilize something they like better, and this also allows families with special needs to use the documents that best meet their child’s circumstances.
The take-away on this topic is that today’s standard of care is a comprehensive physical with detailed family history prior to first participation in school sports and, thereafter, more cursory annual exams, except when the student has had an injury or illness that requires more review.
Heads and Heat
August 16, 2012
We are engaged in very serious discussions. They’re not only complicated, with unintended negative consequences possible from what are thought to be positive actions; they’re also a matter of life and death.
The topic is football – the high school sport under most scrutiny today and suffering from the most criticism it’s seen since the 1970s when catastrophic neck injuries spiked, liability awards soared, many insurers balked, and most helmet manufacturers abandoned the business altogether.
During recent years we have learned about the devastating long-term effects of repeated blows to the head; and we’re trying to reduce such hits. We’ve learned that 70 percent of concussions in football result from helmet-to-helmet contact, and we’re trying to have coaches teach blocking and tackling differently and have officials penalize “high hits” consistently and rigorously.
During the past several years we’ve learned that serious heat illness and heat-related deaths are 100 percent preventable, yet nationwide there were 35 heat-related deaths in high school football alone from 1995 to 2010; and we’re promoting practices that acclimatize athletes more gradually than “old school” traditionalists might advocate.
As we simultaneously address issues of heads and heat in football, some coaches may think we’re being overbearing, while many in medical fields say we’re out of date, citing higher standards of the American Academy of Pediatrics, National Athletic Trainers Association and National Federation of State High School Associations, as well as many of our counterpart organizations across the country.
As we consider in-season changes to improve athlete acclimatization and reduce blows to the head, we should be open to making out-of-season changes that work toward rather than in opposition to those objectives. There can be no sacred cows. The topic is too serious.
Ultimately, if we err in the outcome of this year’s discussions about heads and heat in football, it must be on the side of safety, on minimizing risks for student participants. They deserve it and, once again, the sport of football needs it.