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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. 

Rep Council Wrap-Up: Spring 2015

May 11, 2015

By Geoff Kimmerly
Second Half editor

The Representative Council of the Michigan High School Athletic Association took a number of significant actions during its annual Spring Meeting, May 3-4, in Glen Arbor, highlighted by changes to out-of-season coaching rules, a call for a member vote on a Constitutional amendment affecting middle school and junior high athletics, and initiatives to promote participant health and safety.  

The Spring Meeting of the 19-member legislative body of the Association’s more than 1,400 member schools is generally the busiest of its three sessions each year. The Council considered 13 committee proposals and also dealt with a variety of eligibility rule, postseason tournament and operational issues.

For the past eight months, the MHSAA focused member schools’ attention on an overhaul of out-of-season coaching rules. While support was lacking for a radically different approach, consensus developed for several significant changes within the existing approach for expanding contact between school coaches and their students out-of-season during the school year.

Included in the changes are that coaches will be permitted to work with up to four players in all situations out-of-season during the school year; previously, coaches could work with three or four players, depending on the circumstance. Coaches also will be allowed out of season during the school year to provide coaching in non-school competition to up to four students from that coach’s school. Under this same set of out-of-season coaching rules during the school year, the Council permitted more contact among school coaches and students allowing for previously banned offseason practice rotations to occur. Voluntary workouts out-of-season that involve rotations from conditioning, open gyms, weight lifting and sport-specific skill work may occur so long as there is no more than one four-player station with sport skills being coached. 

Following up on more than a year of consideration by the MHSAA Junior High/Middle School Committee and a Junior High/Middle School Task Force created in December 2013, the Council also approved a request for a membership vote to amend the MHSAA Constitution to allow for school membership beginning at the 6th grade. The membership vote is expected to be conducted in late October; if membership approves the amendment, the Council will consider for which sports 6th-graders will be eligible to compete with and against 7th- and 8th- graders.

The MHSAA’s historical concern for health and safety has been intensified during the past six years of an eight-year campaign focused on “4 H’s” – Health Histories, Heads, Heat and Hearts – and the Council approved several initiatives which continue to improve the environment of school-based sports.

The Council authorized up to three pilot programs to be conducted by volunteer schools, aimed at assisting in decision-making regarding the removal of athletes from activity after possible concussion events as well as in reporting and record-keeping of those events.

The Council mandated that member schools report head injury events through a web-based reporting system the MHSAA is developing. The Council also approved the purchase of another level of insurance aimed at assuring that children of uninsured or underinsured families receive prompt and professional care for suspected head injuries. Both the reporting requirement and the insurance protection are for eligible athletes in all levels of all sports, grades 7 through 12, in both practices and competition.

The Council was briefed on an electronic system that could be used to track pre-participation physical examination forms while improving injury reporting and record-keeping; currently, the MHSAA provides paper forms to member schools at no charge. The Council also was updated on MHSAA plans to provide at no cost to every high school in Michigan the ANYONE CAN SAVE A LIFE – Emergency Action Planning Guide, and informed on the MHSAA’s support of the MI HEARTSafe School initiative of the Michigan Department of Health and Human Services, which on May 13 will recognize 128 schools and/or districts for cardiac emergency preparedness.

Here is a summary of other actions taken by the Representative Council at the Spring Meeting, which will take effect during the 2015-16 school year: 

Handbook/Administrative Matters

  • Participation was expanded by the Council for 9th- and 10th-grade transfer students with no history of high school athletic participation who gain immediate subvarsity eligibility through a waiver by the MHSAA Executive Committee. Students who are granted such a waiver may now participate in designated non-scoring subvarsity heats or non-scoring races of varsity individual contests in sports such as swimming and diving, cross country and track and field. Previous to this action, subvarsity eligibility was permitted in subvarsity team sports only or subvarsity-only meets in individual sports. The subvarsity definition also will apply to international students present in the U.S. on an F-1 Visa but not from an MHSAA-approved international student program. 


  • Athletes in ice hockey and boys and girls soccer must compete in four regular-season games against other MHSAA schools to be eligible to compete with their school teams in the MHSAA Tournament. This currently is a requirement in alpine skiing, and a waiver procedure similar to what is utilized in skiing will be developed for hockey and soccer as well.


  • Non-school sports activities coordinated or directed by administrators and parents were added to situations which trigger an athletic link and an extended period of ineligibility for transfer students if those students then enroll at new schools that have association with those administrators or parents. The Council expanded the athletic-related transfer rule which previously involved only non-school coaches and transferring students who do not make a residential change. 

Classification

  • The Council created a “life line” allowance for schools to form a cooperative agreement in excess of the 3,500-student enrollment cap in sports sponsored by fewer than 250 schools. A program may be approved by the Executive Committee for up to three years, if during the previous year, the school or the cooperative program in which the school was a part dropped the sport because of a demonstrated lack of participation. Sports sponsored by 250 or fewer schools during 2014-15 were gymnastics, ice hockey, boys and girls lacrosse, boys and girls alpine skiing and boys and girls swimming and diving. This three-year “life line” allowance is similar to the regulation which allows for a “startup” cooperative program to be created among schools whose combined enrollment exceeds 3,500 students but the schools involved did not sponsor the sport in the previous school year.

Sport Matters

  • For boys and girls basketball, the Council approved an MHSAA Basketball Committee recommendation to seek permission from the National Federation of State High School Associations (NFHS) to allow teams to play up to two regular-season games made up of 18-minute halves instead of the current 8-minute quarters. If permission is granted by the NFHS, schools will be required to seek permission from the MHSAA prior to events and provide reports after 36-minute games are played.


  • In bowling, it was announced that Kegel is developing a bowling lane oil pattern for high school bowling called the “Allen Pattern,” named after former MHSAA Assistant Director Randy Allen, who administered the MHSAA bowling program from its inception during the 2003-04 school year until retirement in 2013. Michigan has the largest number of schools in the U.S. sponsoring interscholastic bowling. The Allen Pattern is being designed specifically for the high school level and will be utilized for the 2016 MHSAA Bowling Tournament.


  • In cross country, the MHSAA will appoint and administer a task force of coaches and athletic administrators to address unbalanced Lower Peninsula Cross Country Regionals – including some Regionals having more complete teams in competition than others because teams decide to not compete or cannot compete with a full lineup after Regional groups are drawn. The task force will present its findings to the Council in 2016.


  • For ice hockey, four-person officiating crews were approved for Quarterfinals. The MHSAA began using four-person crews for Semifinals and Finals in 2014.


  • In boys lacrosse, a “play in” game was approved for teams seeded 9-16 in each Regional. Play-in games will be played three days earlier than the traditional start of the MHSAA Tournament, with winners then playing teams seeded 5-8 at the traditional start of tournament play.


  • In wrestling, the Council approved a recommendation by the MHSAA Wrestling Committee that eliminates the second weigh-in at the MHSAA Team Finals. The Friday weigh-in before the start of Quarterfinals will be used for all three rounds of competition during Finals weekend.

The Council also reviewed reports on membership, with 754 senior high schools and 703 junior high/middle schools in 2014-15; eligibility advancement applications, which totaled four for the year; the use of Educational Transfer Forms, which held steady this year; school violations, attendance at athletic director in-service workshops and Coaches Advancement Program sessions, officials’ registrations, rules meetings attendance and officials reports submitted for the past three sports seasons. The Association’s $10.4 million budget for the 2015-16 school year also was approved. 

The Representative Council is the 19-member legislative body of the MHSAA. All but five are elected by member schools. Four members are appointed by the Council to facilitate representation of females and minorities, and the 19th position is occupied by the Superintendent of Public Instruction or designee.

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.