Study: Females More Likely To Suffer Concussions in High School Sports

Posted: Jan 26, 2012 11:40 PM by Jason Notoras - jnotoras@kristv.com
Updated: Jan 27, 2012 10:25 AM

CORPUS CHRISTI -- Multiple studies (1, 2, 3, 4) reveal that females are more likely to have a concussion playing high school sports. (2) According to a recent publication in the Journal for Athletic Trainers (NATA), girls may be upwards of 68-percent more susceptible than their male counterparts.

"In basketball, it seems that females get more concussed than the males," CCISD Head Athletic Trainer Lee Knox said speaking from his own experience.

Research in multiple articles back up his findings. Studies (1, 2) done from 2004-2011 indicate that girls concussion rate is double that of the boys in basketball, and nearly 3-times more common in soccer. Only football has a higher number of reported cases on concussions.

One reason researchers believe soccer players are at risk is due to the repetitive heading drills. With reports (5) of athletes heading the ball upwards of 5,000 times a year. That is almost triple the number (1,300) where head trauma is expected to begin.

"I guess since females don't typically play the glory sport (football), which is seen by hundreds more people in the stands during (high school) games, you don't hear about their concussions as much. But there are female high school athletes that we have had problems with getting concussions. It's occurred throughout the realm of sports. I'm even taking care of a couple cases right now."

The U.S. Center for Disease Control estimates 2-million high school athletes suffer from brain trauma each year. They go on to report that 75-percent of those cases are concussions. The number of reports continues to climb (A 1998-2008 study (4) shows that the rate of female concussions grew 15-percent a year in the decade being observed), despite trainers and coaches taking more preventative measures.

"There were new regulations this year. We even spoke to all of the kids and the coaches before the season, but these kids are just becoming more and more athletic and competitive."

Other variables play a factor. Researchers try to account for the following outliers;
Females being more willing to report their concussion-like symptoms
Males being too proud to report
Males fearing losing playing-time or a spot on the roster, so they do not report

"In the older days, you didn't see women playing football or playing soccer aggressively," said Dr. Mathew Alexander, a local Neurological Surgeon. "Now they play with the males or play more competitively, and you see more women getting hurt. Or (you see) more instances of (females) reporting it."

A 2011 article (1) in the American Journal of Medicine found that in their research girls symptoms lasted longer than boys. Headaches and migraine could be more prolonged in females, giving them a larger window of opportunity to seek a professional opinion and diagnosis.

"A brain injury is not like a broken bone. It's soft like a toothpaste or a jello consistency. So once you start having (concussions), you can have seizures, weakness, numbness, memory problems. At school you see children with active injuries struggling with concentration and headaches. So it can totally change someone's life."

Dr. Alexander adds that athletes can come back from a single concussion, but they need to be careful. Today society is seeing the impact from athletes brain injuries from 30, 40, 50 years ago. And since researchers are just starting to thoroughly document and study the impact concussions in females, it may be another few decades before any long-term impacts and evidence is available.

"What happens now can cause problems down the road. One blow is not as bad as multiple, when you keep having the brain undergo injury. That's when you start having permanent brain injury."

And while research does point out females are more likely to suffer concussions, there is no identifiable discovery as to why.

What makes this topic even more tricky is that blunt force comes in vastly varying forms, but the end results may be very similar.

"I've had patients in surgery who have done anything from hitting their head on a cabinet to falling off a two-story building, who had the same CT Scan. It just matters on the brain itself, because skull pathology is different."

Dr. Alexander sums up the discussion with this. "We want our athletes to be the best, but we also want them to live long-term great lives, too."

A balancing act that continues to tug toughness against modern science.

Follow Jason Notoras on Facebook and Twitter (@JasonNotoras)

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1 - Meehan WP, d'Hemecourt P, Collins C, Comstock RD. "Assessment and Management of Sport-Related Concussions in United States High Schools" Am. J. Sports Med. 2011;

2 - Gessel LM. Fields SK. Collins CL. Dick RW. Comstock RD. "Concussions Among United States High School and Collegiate Athletes" J. Athl Train. 2007;

3 - Frommer L, Gurka K, Cross K, Ingersoll C, Comstock R.D., Saliba S. "Sex Differences in Concussion Symptoms of High School Athletes" Journal Ath. Training 2011;

4 - Lincoln A, Caswell S, Almquist J, Dunn R, Norris J, Hinton R. "Trends in Concussion Incidence in High School Sports: A Prospective 11-Year Study" Am. J. Sports Med. 2011;

5 - S Gupta "Big Hits, Broken Dreams: Soccer 'Heading' May Cause Brain Damage" CNN 2011

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