Women Have Harder Time Recovering From Concussions Than Men

Even when men and women play the same sport, women have a harder time recovering from head injuries than men, a recent study of soccer players finds.

Publishing their findings in the American Journal of Sports Medicine, a group of research kinesiologists at Michigan State University led by Dr. Tracey Covassin report that

The researchers found that the differences between men and women could not be explained by body mass index, that is, despite the fact that a larger body enables the brain to stable during a harder blow, there were differences between the sexes that cannot be explained by size alone.

Just How Big a Problem Is Concussion In Young Athletes?

Americans have been seeing a retinue of brain injured (American-style) football players in the news, most of the retired players now in the 30's to 50's, but the overwhelming majority of concussions do not occur in professional sports. 

Other epidemiologists estimate that the risk of a high school aged player's having a concussion in the USA is (for readers outside the United States, the game the rest of the world calls "football" Americans call "soccer") :

• 1 time in 1600 games for boys playing (American) football.

• 1 time in 4000 matches for boys' wrestling.

• 1 time in 5500 matches for boys' soccer.

• 1 time in 4000 matches for girls' soccer (that is, girls are more likely than boys to suffer concussions when playing soccer).

• 1 time in 9000 games for boys' basketball, and

• 1 time in 11,000 games for girls' basketball.

Overall, concussions don't happen all that often--but kids play lots of sports. Among adults, professional boxing and roller derby are the sports most likely to result in brain injuries to both men and women who play them.

But in kids, boys are most likely to suffer concussions in football and girls are most likely to suffer concussions in soccer.

Not Usually a TKO

A concussion may not be immediately recognized at all, because the initial symptoms may be subtle. A teen who has suffered a traumatic brain injury on the field or on the court may display:

• A blank look, or confusion.

• Unusual mood swings, especially as the athlete tries to compensate for confusion.

• Double vision or blurred vision, seeing stars.

• Slower reaction times, slower reflexes.

• Pretraumatic (retrograde) and/or posttraumatic (antegrade) amnesia, with pretraumatic amnesia lasting just a few seconds and posttraumatic amnesia lasting minutes or hours.

• Vomiting and loss of consciousness, both of which are signs of significant brain injury requiring emergency medical treatment.

Read More: Traumatic Brain Injury Symptoms

But because athletes want to keep on playing, they tend to mask minor symptoms, so that a concussion may not be recognized.

But second, third, and later concussions do much more damage.

The Biggest Risk After A Concussion

Coaches, parents, and players tend to overlook the single greatest risk after a concussion:

This increased risk only makes sense. Subtle damage to the brain can interfere with reflexes, vision, memory, and judgment so that subsequent additional damage to the brain is almost inevitable. So how can coaches, parents, and players know when it is safe for an athlete to return to the field.

Provocative Testing

Typically players are allowed to go back to their sports--usually after a week or more--when they pass provocative testing. First, there needs to be an absence of any symptoms of the concussion. There must be no evidence of memory loss. The player needs to have normal reflex times. There should not be any mood swings. The player certainly should not be experiencing vomiting or bleeding.

But a few minutes on the sideline is never enough.

Dizziness at the time of the original injury predicts longer recovery time. Injuries to the inner ear canal that cause dizziness usually take more than 21 days to heal, longer in girls than in boys and in women than in men, because dizziness results in delayed reaction time and delayed reaction time increases the risk of additional injury.

What Is the Risk of Chronic Brain Problems?

The injuries caused by a concussion set up the player for additional encounters that result in injury--along with other members of the team. But there is also the specter of Alzheimer's-like brain injuries, like those of the football players most of us have seen in television news reports, or the boxers who suffer dementia pugilistica.

Very, very few kids who play sports for fun suffer these injuries, although up to 15% of professional boxers do. Nonetheless, in elite high school football programs, players may be so driven to succeed, or so hopelessly mismatched against larger teams with larger players, that serious, permanently disabling brain injuries become relatively likely--perhaps 1 chance in 50, instead of 1 chance in 500. We don't know whether there are similar statistics for girls in women on elite soccer teams, for the simple reason that no one has taken the time to compile the statistics.

Read More: The Most Common Fitness Injuries

How to Protect Your Girl from Head Trauma

Most girls who suffer head injuries in sports incur them while playing soccer, and there are no helmets in soccer.

No matter how much she wants to rejoin her team, make sure she has time to make a full recovery.

Educating players, coaches, and parents about the risks associated with head injuries, their symptoms, and the significance of reporting them is paramount. It's also crucial to teach players the right way to head the ball, emphasizing using the forehead while keeping the neck muscles firm and driving power from the legs, not just the neck.

One should be cautious about repetitive heading drills, especially with younger players, to reduce the cumulative impact over time. Furthermore, regular conditioning and strength training, especially focused on neck muscles, can be beneficial as a strong neck might absorb and dissipate forces that could jolt the brain inside the skull.

A frequently overlooked aspect is the equipment itself. Making sure the soccer ball is inflated correctly can reduce the risk it poses when headed. Likewise, maintaining a safe playing environment by inspecting the field for potential hazards and ensuring goalposts are securely anchored can prevent unnecessary accidents.