2017-18 Report Shows Fewer Concussions

August 8, 2018

By Geoff Kimmerly
Second Half editor

Concussions are down, according to data compiled by the Michigan High School Athletic Association during its third year of collecting head injury reports from member high schools. 

The work is not done – but this year’s data reinforces trends that emerged during the first two years of reporting and will assist the MHSAA as it explores solutions to continue reducing the incidence of head injuries in school sports.

The 2017-18 concussion report found a 9.6-percent decrease in the number of confirmed concussions from the previous year. Student-athletes at MHSAA member high schools encountered during 2017-18 a total of 3,580 head injuries – or 4.8 per member school, compared to the 2016-17 average of 5.2. Total participation in MHSAA sports for 2017-18 was 284,920 – with students counted once for each sport he or she played – and only 1.3 percent of participants experienced a head injury, down from 1.4 in 2016-17 and 1.6 percent the first year of the study. 

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 2017-18 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 by clicking here.

Consistent with the first two years of the study, the MHSAA received data from more than 99 percent of its member high schools after 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; and those findings are not part of the published report.

The decrease in overall head injury reports collected for 2017-18 follows a similar reduction from 2015-16 to 2016-17 – and brings the total decrease to 19.6 percent fewer reports since the first year of the study. 

MHSAA Executive Director John E. “Jack” Roberts noted that the decreases in reports, both year to year and since the first year of the survey, likely have some relation to year-to-year fluctuation, refinement of the follow-up reporting process and a better understanding by schools of what is not to be included for the survey – including head injuries not diagnosed as concussions and head injuries that did not take place during MHSAA-sponsored activities. 

However, the findings of this year’s study – and their similarities to the findings from the first two surveys – has begun to clarify the identification and understanding of trends. Continuing to emerge perhaps most prominently is the higher incidence of concussion reports from girls sports – and pertinent questions about physiological and social causes behind those results. 

“With three years of reporting by virtually 100 percent of our high schools, what we’re learning is no longer anecdotal; the results are beginning to identify valid trends and genuine issues that need to be addressed,” Roberts said. “For example, it’s even clearer than before that girls are reporting three times the number of concussions as boys when comparing similar sports – soccer, basketball and baseball versus softball. As a result, we’ve already begun to incorporate these gender differences into our coaches education, and the writers of high school playing rules are obligated to focus on these gender differences as well.”

Although the total number of confirmed concussions was significantly lower again in 2017-18, a number of findings detailing those injuries fell in line with results of the first two surveys. 

Boys experienced 2,373– or 66 percent – of those injuries, the same ratio as 2016-17, and not surprisingly as boys have a much higher participation in contact sports. More than half of head injuries – 56 percent – were experienced by varsity athletes, which for the second year also fell within a percent difference of the previous year’s findings. 

A total of 2,330 head injuries – or 65 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 52 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, both at 24 percent, returned to activity after either 6 to 10 days of rest or 11 to 15. All of these findings were within 1-3 percent of those discovered from the 2016-17 data. 

Contact sports again revealed the most head injuries. Ranking first was football, 11 and 8-player combined, with 41 head injuries per 1,000 participants – a decrease for the second straight year, this time from 44 head injuries per 1,000 participants in 2016-17 and down from 49 head injuries per 1,000 football participants shown by the first study in 2015-16.

Ice hockey repeated with the second-most injuries per 1,000, with 32 (down from 36 injuries per 1,000 from 2016-17 and 38 per 1,000 in 2015-16), and girls soccer and wrestling tied for third with 25 head injuries per 1,000 participants – girls soccer down from 28 head injuries per 1,000 participants and wrestling down from 26 per 1,000 in 2016-17. 

Also consistent with 2016-17, the next five sports (after football and hockey) to show the highest incidences of head injuries were girls sports – girls soccer followed by girls basketball (22 per 1,000), girls competitive cheer (20) and girls lacrosse (20). Boys lacrosse (17), girls gymnastics (16) and boys soccer (12) were the only other sports to show 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 more than double the concussions per 1,000 participants as male soccer players (25 to 12), while female basketball players also reported more than double the number of concussions per 1,000 participants (22 to 9). Softball players reported seven concussions per 1,000 participants, and baseball players reported three per 1,000. Although the percentage differences vary from year to year, the results of all three comparisons remained consistent with what the survey found in 2015-16 and 2016-17.

The MHSAA in 2018-19 is directing its sport committees to focus on a pair of questions – how to increase participation and how to make their specific sports safer – the latter aiming to put some of what has been learned from concussion reporting into practice. The MHSAA also is continuing 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. 

“Regrettably, I do not see a nationwide head injury reporting effort likely,” Roberts said. “First, it’s hard to coordinate 50 states’ efforts. And second, if left to medical professionals, the survey tool might become so cumbersome that schools would be reluctant to participate – and certainly, it would not get the 99.9 percent cooperation that we’ve enjoyed from schools over these three years.” 

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. 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. 

Novi Principal, Past MHSAA Council VP Carter to Receive Inaugural Hampton Award

By Geoff Kimmerly
MHSAA.com senior editor

March 4, 2024

Nicole Carter grew up in a family of educators, aspired to become one herself, and has dedicated her career to providing opportunities in all facets of education – including educational athletics – to all students through her vision and inspiration. To celebrate Carter’s continuing contributions especially to underrepresented groups in school sports, she has been selected as the inaugural honoree of the Michigan High School Athletic Association’s Nate Hampton Champion of Progress in Athletics Award.

The Hampton Award was created by the MHSAA’s Representative Council to honor Nate Hampton, who retired in 2021 after serving in education and educational athletics for 50 years, including the last 32 years as an MHSAA assistant director. Honorees have championed the promotion and advancement of opportunities for women, minorities and other underrepresented groups within interscholastic athletics, while serving as an administrator, coach, official, educator or school sports leader in Michigan.

Carter, in her 10th year as principal at Novi High School, was selected as the first recipient of the Hampton Award by the Representative Council at its Fall meeting in December and will be recognized during the Boys Basketball Finals on March 16 at Michigan State University’s Breslin Center.

“As an advocate and strong proponent of athletics, I understand wholeheartedly the impact they have on the whole child,” Carter said. “This is a surreal moment for me, and I’m truly honored to be the recipient of this award, keeping in mind the impact Nate Hampton had on athletics in the state of Michigan over several decades – it’s very humbling.”

Carter began at Novi in 1999, teaching for eight years before moving into administration as dean of student activities for three years and then assistant principal for three. She became principal with the 2013-14 school year and leads a staff of 140 in educating more than 2,100 students.

While leading one of the state’s largest and most highly-regarded high schools – and one of Michigan’s most diverse, with her students’ families speaking more than 70 languages at home – Carter has provided her expertise through several more efforts. She served four years on the MHSAA Representative Council, from 2019-23, and as its vice president for the 2022-23 school year. She has served on the MHSAA’s Sports Medicine Advisory Committee, and volleyball and classification committees, and presented at the annual Women In Sports Leadership Conference on social and emotional skill building. She also has served as president of the Kensington Lakes Activities Association.

“Nicole Carter serves with the mindset of providing opportunities for all students as the principal at one of the largest and most diverse high schools in Michigan, and students statewide benefitted from her leadership during her time as part of the Representative Council and Executive Committee,” MHSAA Executive Director Mark Uyl said. “No matter the topic or details of a situation, Nicole looks at it from a rational point of view in deciding what’s best for kids. She continues to emphasize that academics must be the highest priority in a student’s education, and she can provide that perspective with a wider lens as someone with a strong background in and understanding of the role of athletics.”

Service through education is a tradition in Carter’s family. Her grandfather Charles Butler Nuckolls served as a principal in Kentucky for 40 years prior to desegregation. Her father Gene Nuckolls also spent 40 years in education, including as principal of Saginaw High School and assistant superintendent for Saginaw Public Schools, while Carter’s mother Shirley Nuckolls dedicated 40 years as a teacher, assistant principal and guidance counselor within the Saginaw district.

Carter’s selection for the Hampton Award is something of a full-circle moment for her family. Gene Nuckolls hired Hampton as supervisor of athletic and physical education for Saginaw Public Schools in 1987. 

Carter was named Michigan High School Principal of the Year in 2022 by the Michigan Association of Secondary School Principals (MASSP) and Michigan Association of Student Councils and Honor Societies (MASC/MAHS). She additionally has been recognized as a Diversity Champion as part of The Community House honor roll recognition program, and was selected as an African American Educator of the Year by the Michigan Lottery in 2016. She also was recognized in 2017 by the Oakland County Coordinating Council Against Domestic Violence.

Drawing from her athletic background and perspective, Carter noted that she strives to be a coach and mentor – as well as a teacher of teachers and students as principal at her school.

She also has continually looked to create inclusive opportunities during her tenure, citing Novi’s Special Olympics Unified Sports program as a significant point of pride for the school.  

“I always lead from the lens of equity and inclusion and accessibility, and I’m always trying to identify opportunities for students to find their place,” Carter said. “Ensuring every single student in our school has a sense of belonging is one of my top priorities as principal.”

Carter is a 1993 graduate of Saginaw Heritage, where she played basketball, soccer and softball. She earned bachelor’s degrees in political science, with a minor in English, and secondary education from Michigan State University in 1999 and her master’s in curriculum and instruction from MSU in 2001. She also has an educational leadership degree from Oakland University. Carter taught civics/economics and U.S. government and politics at Novi before moving into administration.

PHOTOS courtesy of Novi Community School District.