In mid-1930, the WIAA Board of Control established the WIAA Benefit Plan to be overseen by the WIAA Secretary Neverman. “The WIAA also procured the services of a medical advisor for the Benefit Plan. The first such person was Dr. M. D. Bird of Marinette. He received a $100 honorarium for his first year’s work of reviewing unusual injury claims.” (Otte, More Than A Game, 1996, 120)
With the creation of the WIAA Benefit Plan, the WIAA established days-out limitations on athlete injuries and determined a required recovery period. In fact, the WIAA Benefit Plan limited the return to play from a major head injury (concussion) to one calendar year and the return to play from a minor head injury to 30 days.
The WIAA Sport Medical Advisory Committee (SMAC) was established in 1974 to replace the State Medical Society‘s Subcommittee on WIAA matters because the latter group “has only one practicing physician involved in athletics.” (Otte, 377) In 1975, the Committee met for the first time. The WIAA was among the first high school state associations in the country to develop a Sport Medical Advisory Committee.
The WIAA Medical Policies and Procedures Manual was distributed to the WIAA membership in 1975 and revamped for the 1990-91 school year. The publication provides guidelines on many medical matters for interscholastic athletic practices and contests. It currently is updated bi-annually and a hard copy is sent to all WIAA member schools after each update.
The Sport Medical Advisory Committee established the Wrestling 7% Committee in 1989 and in 1990; the 7% Committee recommended the skin-fold measurement system for all wrestlers to determine a minimum wrestling weight. The program became mandatory in 1991. (Otte, 432) Later in 1996, the 7% Committee recommended a hydration test to work along with the skin-fold measurement process.
In a 1989 opinion which resulted in a 1990 rule change, “The Medical Advisory Committee supports a strong position on the use of steroids, recommending that a student who has been found to use them be ineligible for a minimum of one year and not reinstated without testing to make sure the athlete has ceased using them.” (Otte, 439) The rule change applied the code of conduct minimum to performance enhancing substances.
The WIAA, by Board of Control action as recommended by the Medical Advisory Committee, made a significant health move that was instituted at the beginning of the 1993-94 school year. Called the “day of rest” rule, it required teams in all sports to “rest from all physical activity for at least one calendar day after six consecutive days of practice or competition.” (Otte, 440)
In 1995, the SMAC adopted the wrestling skin form to be utilized when a contagious skin condition may exist. The examination must be done no more than three days prior to wrestling and furnished at weigh-ins.
The Committee began the discussion of Female Osteoporosis concerns in 2008 and later developed the Female Triad guidelines in 2010. Female Triad was officially described as a syndrome of: disordered eating, lack of menstrual cycles, and osteoporosis in females. In addition, the SMAC identified concerns with Sickle Cell Trait.
In 2011, the SMAC worked with legislators to develop concussion legislation. As the concussion legislation was passed, the Committee worked with the Wisconsin Department of Instruction to provide educational materials for member schools and other youth athletic organizations.
The SMAC worked with the Wisconsin Football Coaches Association to develop an acclimatization plan in 2012 and a policy was implemented for the 2014 season. The SMAC also discussed player-on-player contact. Player-on-player contact was limited beginning in the fall of 2014 to no contact the first week, 75 minutes the second week, and 60 minutes for the rest of the season. The plan was later adopted by the NFHS as a recommendation.
The Committee discussed transgender participation and eligibility in 2013. After reviewing the NCAA policy and several state associations’ models, the SMAC made a recommendation to the Board of Control for adoption in June of 2013.
After discussions in 2004, 2007, and 2010, the SMAC prepared guidelines for sudden cardiac arrest to member schools in 2013. The Committee adopted the Anyone Can Save A Life emergency action plan for member schools and the NFHS Foundation provided a copy to be distributed to all WIAA member schools in 2015.
The SMAC began discussions in May of 2015 regarding baseball pitcher arm care. A study conducted on Tommy John surgeries from 2007-2011 stated that 57% of 790 surgeries during that time period were on adolescents in the 15-19 year-old age group. A pitch count was adopted with input of the Wisconsin Baseball Coaches Association in May 2016 for implementation in the spring of 2017.
At the May 2016 meeting, the SMAC adopted a change from the wrestling half-pound per day weight loss to the 1.5 percent per week weight loss plan based on the recommendation of the 7% Committee. The 1.5% weight loss program will provide an individualized weight loss plan for every wrestler based on their skin-fold measurement.
In addition, the SMAC adopted guidelines for Relative Energy Deficit in Sport (RED-S) to emphasize the condition effects all athletes; not just females. Due to the energy deficiency in RED-S normal body functioning is impaired and can affect metabolic rate, immunity, cardiovascular health, protein synthesis, as well as menstrual function, and bone health.
In May of 2017, the SMAC updated the concussion information, absorbed the Female Triad information into the RED-S information, and added mental health/wellness.
May of 2019, the SMAC discussed sport specific requests and began a process to update the WIAA Medical Policies and Procedures.
Throughout the spring and fall of 2020, the SMAC provided guidance and advice pertaining to the Coronavirus pandemic. Beginning with the season ending of winter sports through the cancellation of spring sports, Covid-19 (as it was designated), began a new chapter in WIAA member schools and their offerings of athletic programs. During June, 2020, the SMAC began working on guidelines to mitigate risk for summer contact and the WIAA staff began recommendations of sport specific guidelines.
By July 1, 2020, the SMAC had recommended summer contact guidance in an effort for schools to conduct coaching contact during the summer and to prepare for the possible resumption of sports in the fall. In addition, work began on the Return to Fall Sports considerations. Winter considerations were developed in October and work began on the Spring recommendations.
In addition to the Covid-19 work, the SMAC also provided a recommendation restricting CBD usage by athletes to prescription by a licensed health care provider.