Jan 29, 2015
Females Face Concussion Risks

By Nate Dougherty

Concussions among high school athletes are generally thought by most to be a boy’s injury, suffered by football players crashing into one another at top speed or hockey players slamming into the boards. Girls, whose sports often have rules against hitting, aren’t always at the front of people’s minds when thinking about head injuries. But a new study shows it’s female athletes who may actually be at a higher risk for concussions.

A study published in the Journal of Athletic Training noted that female high school soccer players suffer concussions 68 percent more frequently than male soccer players. The same study found that female concussion rates in high school basketball were three times higher than boys’.

“This finding re-emphasizes the fact that concussions aren’t just a concern for high school football players; they can happen to athletes playing all types of sports,” said Dawn Comstock, study co-author and an assistant professor at The Ohio State University College of Medicine, in an interview with ABC News.

Comstock is also a frequent contributor to Training-Conditioning.com and AthleticManagement.com blogs.

The study, which used data submitted by 425 certified athletic trainers during the 2005-06 academic year, found that football has the highest concussion rate, with 47 injuries per 100,000 players in games or practices, but among sports played by both boys and girls, the girls were injured at a higher rate. Girls’ soccer had the second-highest rate of all sports, with 36 per 100,000. The study also found that girls who suffered concussions took longer to recover and return to play than boys.

But some experts say that because girls aren’t traditionally seen as high risk for concussion, their injuries often go overlooked.

“Generally speaking, the medical profession does not do a very good job in recognizing that female athletes sustain concussions at an equal or even higher rate as males,” says Dr. Robert Cantu of Brigham and Women’s Hospital in Boston, one of the nation’s leading experts in concussion management, in an interview with The New York Times. “It’s flying under the radar. And as a result, looking for concussions in women is not pursued with the same diligence, and it’s setting girls up for a worse result.”

That was the case with Hannah Stohler, a junior at Conrad High School in West Hartford, Conn. As a soccer player, she twice slammed her head against the turf last season, and was told be a neurologist that she could return to play once her headaches went away. But upon return, she collided with another player during a game and was down for 10 minutes without vision. For the next three months she suffered headaches and disorientation, which sent her spiraling into depression.

“I thought [concussions] were a football thing–a boy thing,” Stohler told The New York Times. “Those guys are taught to hit hard and knock people to the ground. But anyone can get a concussion, and I don’t think a lot of girls recognize that.”

An increase in the number of girls participating in sports as well as styles of play–with girls less accustomed to hard physical contact because rules in many girls sports limit hitting–may contribute to the difference in concussion rates. Physiological differences factor in as well, like neck muscles, which help absorb blows to the head. According to Comstock, these muscles aren’t as developed in girls, leaving them at a higher risk for concussion.

But the results may also show there is a higher sensitivity to females who suffer injuries and an environment where boys feel an expectation to “tough it out.”

“Coaches and parents may be more sensitive to injury in the female head,” Christopher Ingersoll, editor-in-chief of the Journal of Athletic Training and a professor of sports medicine at the University of Virginia, told ABC News. “Culturally, it may be OK for girls to talk about a concussion. Athletes who play tough, macho sports may not be as open to talking about a concussion.”

The study also found that overall, concussion rates have risen from 5.5 percent of all sport-related injuries a decade ago to nine percent today. To help stop this trend, experts say parents, coaches, and primary physicians should better understand the signs an athlete has suffered a concussion and guidelines for a safe return to play.

An article on establishing guidelines for return to play can be found in Athletic Management‘s February/March 2005 edition.

Nate Dougherty is an Assistant Editor at Training & Conditioning.

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