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Concussion Impact Among Young Athletes— A Gender Difference?

by John Axelrod | New York University

F Posted in: Sports and Culture P Posted on: April 9, 2012
Screen shot 2012-04-09 at 1.40.41 AM

NYU soccer player Molly Henning collided head first with an opposing player during a game last season and never reported her resulting headache to a coach or trainer. For two weeks she suffered through bad migraines without reporting any of her symptoms.

“When you’re in the moment in a game, you don’t want to leave the field so you just try and muscle through it,” Henning said.

Henning said she didn’t report her concussion because she didn’t want to be withdrawn from the game and risk sitting on the sidelines for weeks recovering. But in the end, this non-action put her soccer career at a much greater risk.

Most of the concern about concussions — a topic that has run rampant through the media in recent months — is focused on men’s sports. Football is the primary sport that comes to mind when thinking about this serious head injury. However, studies have shown that women are more susceptible to concussions than men, and most concussions in women’s sports come from one game above all — soccer.

According to the Journal of Athletic Training there were 135,901 concussions among high school athletes during the 2005-2006 school year. The sport in which the highest number of concussions were sustained overall was football, but the second highest number came from women’s soccer, which accounted for about 21.5 percent of all concussions in high school sports that year. Men’s soccer accounted for just 15.4 percent. In just about every sport, the Journal of Athletic training reported that women sustain more concussions than men. In that same year there were 12,923 concussions in women’s basketball and 3,823 in men’s. There were also 78 percent more concussions in softball than baseball.

The Journal of Athletic Training’s study determined that men and women suffer concussions from player collisions at about the same rate, but that the rate of concussions from contact with equipment and the ground was much higher among women. It is evident that women are more vulnerable to concussions than men, but according to Dr. Dennis Cardone, an associate professor of orthopedic surgery at NYU Langone Medical Center, it is not so clear why this is the case.

“We don’t know why women are more susceptible yet,” Dr. Cardone said. “It could be a strength issue, it could be hormonal or genetic. We don’t know why yet.”

One theory as to why women are more vulnerable to concussions in soccer has been attributed to biomechanical differences. On average a woman has about 26 percent less mass in the head and neck than a man. A 1998 study by the American Journal of Sports Medicine suggested that smaller head to ball ratios and weaker necks could explain why women are more vulnerable.

Despite the increased risk of getting a concussion for female athletes, not much had been done to make sports safer until recent years. In 2010 the NCAA issued an updated mandate requiring institutions to implement stricter concussion protocols.

One of the most notable new protocols is the concussion test. At the start of every athlete’s collegiate career he or she must undergo a computerized neurocognitive test that measures cognitive function, information processing, memory recall, attention and reaction time. If an athlete sustains a concussion, that player will not be allowed to return to play until he or she can meet his or her original baseline score on the test.

Nikki Webb, NYU’s coordinator of athletic training, believes the concussion test is critically important to ensuring that athletes have made a full recovery.

“It’s important to not let concussed athletes play again until they can return to their neurocognitive baseline,” Webb said. “Even after their symptoms resolve they still might not be back to normal cognitively.”

Another new provision of the guidelines is that a player suspected of a head injury cannot return to the field the same day.

“This is a great rule, because previously athletes were allowed to return 10-15 minutes after their symptoms subsided, but they  (the symptoms) would usually come back,” Webb said.

Over the past few years, teams have put much more emphasis on limiting concussions overall.

“Having less contact practices and following rules and technique are ways to limit concussions,” Dr. Cardone said.

One of the leading causes of head injuries in basketball comes from taking charges on defense, and teams have put much more emphasis on practicing proper form when taking charges. Soccer teams have also limited the amount of time they spend practicing going up for headers, and when they do practice them it is only lightly to emphasize proper technique.

Another potential solution proposed in the Journal of Athletic Training’s study was improved protective gear for women’s sports. The study stressed that more emphasis should be placed on developing equipment for women’s sports that is more protective of the head.

Dr. Cardone also mentioned the possibility of implementing a strengthening program for the neck, but he stressed that not enough evidence is available yet to prove the effectiveness of such a program.

Safer practice methods and a more sophisticated protocol for athletes diagnosed with concussions have made sports safer, but, according to Dr. Cardone, the most important thing is recognition and reporting symptoms.

“Once players feel symptoms, they need to report them immediately,” Dr. Cardone said.

Yet despite increased awareness of the dangers of head injuries, many athletes still choose not to report their symptoms.

“People who are more competitive will try and muscle through a concussion if they think it’s manageable,” Henning said. “No one wants to sit out for a few weeks — they want to be on the field.”

However, this urge to play through the injury poses a serious risk to a student-athletes’ future health. Athletes who suffer multiple concussions and don’t report them are at risk of permanently damaging their brain. Consequences of repeated concussions range from chronic headaches to memory loss and depression.

A lot has been done recently to minimize the risk of concussions in sports, but they are still an inevitable occurrence, and in most cases it is on the athlete to report their symptoms for their own good.

“There are no physical symptoms with concussions, they are all reported,” Webb said. “You need to have a good relationship with your student-athlete so they trust you and will be honest about their symptoms.”

John Axelrod John Axelrod John Axelrod is a NGJ Staff Writer and a sophomore at New York University, double majoring in Journalism and Politics. He also writes for TheFanHub.com is a deputy sports editor for Washington Square News.

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