Concussions And Women

Women are concussing at higher rates than men, but these female athletes receive almost no attention compared to their male peers. What’s going on, and what should you know about concussions as an active woman?
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Heads aren’t only turning, they’re also getting knocked around more, which is upping concussion rates. Concussions, especially among male athletes, are a hot topic these days, even getting Hollywood treatment in the 2015 movie Concussion, starring Will Smith. Yet here’s the surprise: Women have higher rates of concussions than men and can struggle more with recovery. So why is nobody talking about concussions in female athletes?

The Untold Story

As with some other health conditions, women have largely been ignored in concussion research. The main reason? “Women don’t play football, and that’s where some of the highest rates of concussions occur,” says Summer Ott, Pys.D., neuropsychologist and director of the Concussion Program at Memorial Hermann Ironman Sports Medicine Institute in Houston.

Yet times are changing, namely because researchers are now paying closer attention to concussions in female athletes and focusing on sports in which women do participate, including basketball and soccer, the two highest concussion-causing sports for women. Their research has unearthed some surprising differences.

Female Athletes Are More at Risk

For starters, female athletes in general have higher rates of concussions than male athletes. In fact, women who played basketball, soccer and softball concussed at higher rates than men playing basketball, soccer and baseball, according to a study from the Journal of Athletic Training that evaluated injury rates in 15 different collegiate sports. And, according to a study in the American Journal of Sports Medicine, girls had higher concussion rates than boys among high-school athletes. The study compared concussion rates among 20 different high-school sports.

Bouncing Back Isn’t Easy

Women also take longer to recover from concussions and often struggle with certain aspects of recovery more than men. In a study from Radiology, researchers scanned the brains of men and women who had suffered concussions from a variety of causes, including sports, and discovered that parts of the brain devoted to working memory were more active in men following their injury and less active in women. While working memory returned to normal within six weeks for the brain-injured men, that wasn’t the case for women.

The mechanism of concussion is the same for men and women. “Concussion is caused by the head making contact with something, usually two people hitting against each other,” says Steve Broglio, Ph.D., director of the NeuroTrauma Research Laboratory at the University of Michigan in Ann Arbor, adding that once you’ve had one, your risk for suffering a second increases.

When the head receives a blow, the brain, which is cushioned inside the skull by cerebrospinal fluid, can hit the inner side of the skull. Although most people associate concussions with loss of consciousness, the majority of people with concussions never lose consciousness, Broglio says, adding that it happens in less than 10 percent of injuries. Instead, common symptoms include prolonged headache, vision disturbances, dizziness, vomiting or nausea, impaired balance, confusion, memory loss, ringing ears, difficulty concentrating, sensitivity to light and loss of taste or smell.

Neck Strength, Hormones May Play Key Roles

So why then the differences between men and women? Although experts aren’t exactly sure, one theory involves neck strength. “Men typically have more muscle mass, including at the neck, than women, so when a woman is hit in the head, she’s less able to stabilize the head from moving around,” Broglio says.

Hormones also may play a role. Women who concussed during the two weeks leading up to their period took longer to recover and experienced poorer health one month later than women taking birth control pills or those who’d been injured during the two-week period after their period, according to a study from The Journal of Head Trauma Rehabilitation.

Finally, the differences may simply come down to the fact that women are better health advocates for themselves. “Women are more honest in their reporting and more concerned about their long-term health,” Broglio says. “Women also aren’t expected to suck it up and get back in the game.”

Heads Up, Cyclists, Soccer Athletes!

While concussions can happen to anybody, certain female populations may be at greater risk, including high-school female athletes. “Not only are they playing more contact sports like soccer and basketball, concussions also occur more frequently in developing brains,” Ott says. Another high-risk group is female cyclists who can take a blow to the head in a crash.

1.6 to 3.8 million: The latest estimates from the Centers for Disease Control and Prevention indicating the number of concussions that occur in sports and recreation activities every year.

Trouble is, though, concussions can often be tough to spot, especially if you have a history of migraines or dizziness, which are the two most common symptoms, Ott says. That’s why if you took a blow to the head, you should remove yourself from your sport and get evaluated by a medical expert who’s had concussion training. And if you have significant symptoms like vomiting, numbness or tingling or weakness in some bodypart, going in and out of consciousness and not remembering what’s going on around you, that could signal a more traumatic brain injury, so head directly to the emergency room, Ott says. Follow the same guidelines if you suspect your sport-playing daughter has suffered a concussion.

Patience Pays Off

Your recovery time will vary, but expect it to take at least seven to 14 days, knowing that women will take longer than men, Broglio says. Just don’t try to return to your sport too quickly. “If you continue to play while you’re still injured, your recovery will be longer,” he adds.

Consult the concussion-trained medical expert you’ve been working with to determine when you’re ready to return; at the very least, you should wait until all concussion-related symptoms have disappeared, Broglio says. Meanwhile, for your concussed daughter, all states have laws pertaining to youth sports concussions, including a return-to-play directive, which requires that these athletes be evaluated before returning to the sport.

While certainly worrisome, concussions when managed correctly aren’t a death sentence as the latest media hype would have you believe. “Concussions happen,” Ott says, “but people recover and they return to their lives as normal.”

3 Ways to Protect Your Noggin

You can’t prevent every concussion, but you can lessen your chance of it happening with the following strategies:

1) Strengthen Your Neck

While not a cure-all, exercises for a stronger neck could help prevent some concussions. Some of these include shoulder shrugs, dumbbell presses and barbell deadlifts.

One exercise Summer Ott recommends to strengthen your neck is the seated cervical retraction with resistance. How to Do It: A. Sit upright at the end of a sturdy chair and place the back of your head in a resistance band, holding both ends in your hands. B. Bring your hands straight out in front of you and, at the same time, pull straight backward on the resistance band with your head, tucking your chin. Hold for five seconds, then return to start. Do 10 reps, once a day.

2) Wear a Helmet

If your sport encourages the use of helmets, don one. Anything you can do to give your noggin protection will help.

3) Look for Qualified Coaches

If you’re in an adult league, ask whether that coach has background in the particular sport. And if you have a sports-minded daughter, check that her coaches are trained in that sport and applying appropriate training techniques, Steve Broglio says. If your daughter’s playing at the high-school level, check, too, that an athletic trainer is available at least during games. If not, talk with the principal, athletic director or school board.

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