concussions

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Uneven Playing Field: Female Athletes Are More Likely to Get Concussions Than Males
Sep 26, 2024
When you think of an athlete who has suffered a concussion or other traumatic brain injury (TBI), you might conjure up images of boys on the football team ramming into each other at full speed. In every high school sport played by both girls and boys, concussion rates are higher among the girls. While football is the number one sport that sees the most concussions, girls’ soccer comes in second, with 8.4 concussions per 10,000 games and practices.

Research suggests that female athletes have a longer recovery time than their male counterparts and may experience worse symptoms. Women and girls are participating in sports at increasing rates, and it’s important to recognize the difference in concussion symptoms and recovery so athletes get diagnosed and treated promptly and appropriately.

Reasons Behind the Frequency
While there are physiological reasons why women are more susceptible to concussions, men are less likely to report symptoms of a concussion. Women, on the other hand, are more likely to seek out medical care, resulting in more documented cases of concussions in females.

“Women tend to have thinner skulls than men, along with smaller neck muscles, which can predispose female athletes to getting a concussion,” says Sarah Menacho, MD, a neurosurgeon and neurocritical care specialist at University of Utah Health. “Data shows that women are also more likely than men to report concussion-related symptoms, and these symptoms can persist for a longer time period prior to recovery than in male athletes.”

Understanding the Difference in Symptoms
Concussions occur after a blow to the head. In sports, this can happen after colliding with another athlete, such as during a header in soccer, or after being hit with a ball or other equipment, like a field hockey or lacrosse stick. This impact causes the brain to jostle around inside the skull, which can cause bleeding and other injuries to the brain.

After suffering a concussion, women and men both may experience telltale signs, including:

Headache
Nausea and vomiting
Amnesia
Confusion
Ringing in the ears
Fatigue
Blurred vision
However, women often present their symptoms differently than men.

“Women will often note more difficulty with vision and memory following a concussion but are less likely to experience a loss of consciousness than male athletes,” Menacho says. “Female athletes may also experience more trouble with mood-related symptoms like anxiety, depression, and difficulty sleeping but are less likely to report feeling more irritable after a concussion than male athletes.”

Female athletes also tend to have longer recovery times than males, though this isn’t always the case. Recent studies have shown that men typically recover from their concussions significantly faster than women. This is thought to be because women may experience more severe symptoms, which require more time to resolve before returning to sports.

Preventing Concussions to Stay in the Game
Sports can be unpredictable, and injuries are sometimes inevitable. However, schools and sports programs can take some measures to reduce the number of concussions, especially among female athletes. These measures include:

Implementing the use of protective head gear. Few women’s sports require the use of helmets by all their players, even if the male version of the game does, like lacrosse for example.
Rule changes. In 2015, the United States Soccer Federation banned heading of the ball for all athletes under the age of 10.
Staying informed. Knowing that female athletes are more susceptible to concussions during sports can help coaches, parents, and the athletes themselves know when to seek medical attention.
“Any athlete, male or female, with concern for a sports-related concussion should be immediately removed from play and assessed by a trained medical professional,” Menacho says. “The effects of multiple head injuries can lead to permanent cognitive damage and a predisposition to diseases such as Alzheimer’s and Parkinson’s, so it’s crucial that head injuries are treated immediately to prevent long-term issues.”

Learn About Brain Injury Symptoms >
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https://healthcare.utah.edu/healthfeed/ ... h%20Health.

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Post-concussion brain changes to white matter and cerebral blood flow

In a study of 187 college athletes, researchers found that those who got a concussion while playing (25 of them) still showed signs of brain injury on MRI scans when they were cleared to play their sport again, a couple of months later, and even a year after being cleared.

Persistent changes from pre-concussion scans were seen in the athletes’ cerebral blood flow and in white matter microstructure. But these effects were only in the brain — the athletes did not see clinical symptoms persist that long, the authors noted. More long-term research is needed to understand if and how the brain re-normalizes. The study also reinforces existing concerns about the damage that repeated concussions could cause, the authors add.

This study provides direct evidence of persistent postconcussion changes in CBF and white matter at RTP and up to 1 year later. These results support incomplete recovery of brain physiology at medical clearance, with secondary analyses emphasizing the sensitivity of CBF to clinical recovery.

Post-Concussion Brain Changes Relative to Pre-Injury White Matter and Cerebral Blood Flow
Read the study at: https://www.neurology.org/doi/10.1212/W ... 0000213374

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Why Do Female Athletes Get More Concussions in Contact Sports?
Feb 25, 2025 | By Dr. Jennifer Hunnicutt


Did you know that female athletes in contact sports experience more concussions and worse outcomes compared to male athletes?

Unfortunately, concussion research on female athletes is far less than concussion research on male athletes.

In today’s blog, we are highlighting findings from a recent literature review conducted by researchers in Germany. They investigated sex-specific differences in concussion rates, biomechanics, biomarkers, imaging, and outcomes in contact sports.

First, let’s define contact sports…

What are Contact Sports?
Contact sports are competitive physical activities that involve direct physical contact as an integral part of the activity. This contact can be intentional, such as tackling in football, or incidental, like collisions in soccer.

Examples of contact sports include:

● American Football
● Soccer
● Rugby
● Ice Hockey
● Boxing

Female participation in these sports is growing, making it essential to understand the unique risks they face.

The Literature Review on Concussions in Female Athletes in Contact Sports
Twenty-two research studies met criteria for inclusion in this literature review. Of the topics covered, there was a lack of research in biomarkers and imaging, while the topics of concussion incidence, biomechanics, and outcomes were more represented.

Why Do Females Get More Concussions in Contact Sports?
The review identified several factors that contribute to the higher concussion rates in female athletes:
Biomechanical Differences: Female athletes generally have less neck strength, smaller neck circumferences, and lower head-neck segment mass compared to males. These differences mean that female athletes experience greater head acceleration during impacts, making them more susceptible to concussions.

Hormonal and Biological Factors: Female brains differ in metabolism, cerebral blood flow, and inflammatory responses compared to male brains. These variations may play a role in their heightened vulnerability to concussions and the severity of symptoms experienced.
Increased Symptom Reporting: Studies suggest that female athletes are more likely to report concussion symptoms than males. This may stem from societal norms, with male athletes often facing pressure to “tough it out.”

What Happens After a Concussion?
The review also revealed key differences in how concussions affect female athletes:
More Severe Symptoms: Female athletes report more frequent and severe symptoms,
such as headaches, nausea, fatigue, and cognitive difficulties.
Longer Recovery Times: Women often take longer to recover and return to full-contact
play.
Greater Neurocognitive Deficits: Female athletes experience more significant declines in
memory, reaction time, and processing speed following a concussion.

How Can We Better Support Female Athletes?
These findings highlight the urgent need for tailored approaches to concussion prevention, treatment, and recovery in female athletes.

Here are some steps that can help:
Enhanced Training Programs: Strengthening neck muscles and teaching head
stabilization techniques may reduce the risk of concussion in female athletes.
Rule Changes: Modifications should be evaluated through research. For example,
research is showing that the rule to forbid body checking in women’s hockey is not
working – it is not reducing head impacts.
Increased Research: More studies are needed to understand the long-term effects of
concussions on female athletes and develop effective treatments.

Looking Ahead
While this review sheds light on the unique challenges female athletes face in contact sports, it also highlights the need for more inclusive and comprehensive research. By understanding the distinct risks and outcomes for female athletes, we can develop better strategies to protect their health and ensure their safety in doing the sports they love.

References
Fahr J, Kraff O, Deuschl C, Dodel R. Concussion in Female Athletes of Contact Sports: A
Scoping Review. Orthop J Sports Med. 2024 Oct 16;12(10):23259671241276447. doi:
10.1177/23259671241276447. PMID: 39421039; PMCID: PMC11483826

Author Recent Posts
Dr. Jennifer Hunnicutt is a licensed athletic trainer with a PhD in Health and Rehabilitation Science, who has worked with all types of athletes, including professionals and Olympians. She has held prominent research positions at Emory Sports Medicine and the NBA Hawks Center in Atlanta, GA, as well as serving on the national network of healthcare providers for U.S. Figure Skating. Now the owner of Hunnicutt Writing and Consulting, LLC, Dr. Hunnicutt collaborates with global institutions, spearheading innovation and research among professionals and businesses in Sports Medicine and Orthopedics. Learn more at https://drhunnicutt.com.

https://www.headcheckhealth.com/female- ... oncussions.