Concussion awareness is at an all-time high and that’s a good thing.
The subject has been brought to the forefront of the sports world by the NFL and college football playoffs, as well as by the recently released major motion picture “Concussion” starring Will Smith.
However, a major demographic isn’t represented by those headline grabbers: females of all ages.
This isn’t to say female athletes aren’t being treated for concussions.
“We see plenty of girls and women who suffer concussions in basketball, softball, tennis and swimming,” says Summer Ott, Psy.D., Director of the Memorial Hermann IRONMAN Sports Medicine Institute Concussion Program and neuropsychologist with the UTHealth Department of Orthopedics.
Still, the media coverage of female concussions is disproportional.“There is a lack of research focusing on females with concussion and recovery,” Dr. Ott says. “There are indications that the recovery process and effect for females is different and that has been evident. Why this is so has yet to be determined.”
Symptoms of concussions, acutely, are similar in both genders. But why those symptoms change over time based on mitigating factors like hormones or management has not been answered.
Higher Concussion Reporting Rate and Longer Recovery Time for Girls
Three prevailing hypotheses based around physiology, social acceptance and biochemistry attempt to explain why females report concussions at a higher rate in sports that both males and females play; and why females generally experience poorer neurocognitive function, more post-concussive symptoms and a longer recovery period from concussions than males do.
The first is that females have historically been told they have weaker neck strength and therefore the blow or the impact is more forceful for them.
Several studies support this line of thought. One of the most recent came from the Journal of the American Medical Association (JAMA) Pediatrics, which found that among high school soccer participants from 2005 to 2014, high school girls experienced concussions at a much greater rate than high school boys. The study results showed 4.50 concussions for girls per 10,000 athlete exposures (athlete-to-athlete contact and headers), while the rate for boys was 2.78, a 61 percent difference.
It also may be more socially acceptable for a female to be concussed, which could lead to a potential bias in reporting between the two genders. For instance, the recovery process for females might be protracted in reported data because they may be more forthright in communicating symptoms like continued headaches.
The third premise focuses on hormonal changes, pre- and post-injury, and how they potentially prolong the recovery process for females.
Putting Concussion Theories to the Test
Dr. Ott is currently leading a team of researchers from The University of Texas Health Science Center at Houston and the UT Medical Branch and Transitional Learning Center in Galveston in a two-year pilot study funded by a grant from the Moody Endowment. The study aims to determine if the duration of concussion symptoms in female adolescent athletes is related to the reporting of emotional distress shortly after a sports-related concussion is suffered by studying the hypothalamic panel and psychiatric status.
While the research community looks to expand its knowledge of female concussions, events like the International Summit on Female Concussions, TBI (Traumatic Brain Injury) and Headache in Washington, D.C., in February promote open dialogue among experts to develop a better model of care. Dr. Ott will serve as a discussion panel moderator at the Summit. www.pinkconcussions.com/programs
“Do females have a different set of symptoms or a different cluster of symptoms when compared to a male?” Dr. Ott asks. “We can’t treat everyone the same. We need to explore the differences in symptomatology.”
There are plenty of questions to be answered about concussions among males and females. The good news is that the discussion has started and there is increased awareness about concussions in females.
Regardless of gender, concussion patients benefit from earlier diagnosis., “If there was any kind of blow to the head, that should be your first indicator to start a dialogue or line of questioning,” Dr. Ott says. “The idea is that there will be less chronic issues related to concussions because we have this emphasis of acute diagnosis and management. That should be there for both genders to slow down the progression of a concussion.”
To learn more about concussions, visit the IRONMAN Sport Medicine Institute.