Why We Need to Pay More Attention to Concussions in Female Athletes

Believe it or not, female athletes in many sports have a higher risk for concussions than their male counterparts. Several recent studies have shown that in both high school and collegiate sports women have significantly higher rates of concussions than men who play the same sport (meaning they have a higher likelihood of injury per unit of playing time).

For female softball players, it’s double the rate of male baseball players. It’s the same for basketball and soccer. However, hockey had the most pronounced difference—female hockey players have the highest rate of concussions among athletes in any sport.

The question is why.

Potential Risk Factors for Concussions in Female Athletes

Unfortunately, there’s not enough scientific research about why female athletes are more likely to experience concussions. Some researchers suggest that differences in overall neck strength may explain why women are more likely to have a concussion than men. Hormones also could be a factor, as preliminary results from one study indicated that women injured two weeks before their periods recovered more slowly after a head injury than those who suffered a concussion two weeks after their periods. Other research indicates that a drop in hormones during certain points in a woman’s menstrual cycle may make them more susceptible to injury. However, female athletes also tend to report concussions more than male athletes. We are able to get more insight into these injury rates as a result of having better data.

Experts also argue that a greater amount of emphasis is placed on concussions in male athletes. However, we also need to pay close attention to female athletes. In the documentary, “Concussions & Female Athletes: The Untold Story,” experts at the Tucker Center for Research on Women and Girls in Sports said that all athletes face pressure to downgrade their injuries and get back in the game to help their team. With concussions, this is especially true. Some female athletes in the documentary said they likely had experienced more concussions than what was on record.

This is particularly alarming because multiple concussions can increase an athlete’s susceptibility for future concussions: a person who has sustained even a mild concussion is more likely to have future concussions because the body is more sensitive in responding to impact.

It’s important for female athletes who experience concussions to get properly assessed, so they get the best treatment and follow-up care. Concussions can have a greater impact on female athletes’ playing ability, and more importantly, overall health because research shows they experience greater cognitive decline and slower reaction times after injury than male athletes.

If you or a female athlete you know gets hurt, a sports medicine, primary care, urgent care or emergency room physician should evaluate a suspected head injury as soon as possible to determine the extent of the injury and develop a plan of care.

Computerized neuropsychological testing programs (ImPACT, CogSport, etc) are new computerized tests that can be helpful tools in diagnosing and managing concussions.  When an athlete’s symptoms have resolved, these tests can help us to ensure that the brain is working at normal efficiency.  This testing has been recommended for athletes participating in contact sports. If a person takes a baseline test while they are well and healthy, their post-concussive scores will be compared to their pre-concussive scores, as well as national averages for their age and background. If an athlete does not have a baseline test, their post-concussion scores are compared to national averages only. These results can help your physician to provide a personalized recommendation for when you can return to play.

Considering the research on injury rates and recovery after a concussion, it’s extremely important that female athletes follow the protocol set forth by their doctors. Getting back on the field or the court before you are completely healed isn’t the best thing for your long-term brain health.

Though we still need more research to understand why female athletes are more susceptible to concussions, we also need to shed more light publicly on this issue. Despite what you see on ESPN or read in the paper, concussions aren’t only a male phenomenon—female athletes also are at risk. We need to educate all women and girls, from the youth league level to professional sports, about the steps they should take to protect their brain health.