Girls in sports have higher rates of concussion, longer symptoms. Researchers ask why

When we think of concussions, we often think of football players — big, brawny men in football helmets and pads crashing into one another. We do not think of girls playing soccer or cheer leading or falling from the playscape at a playground.

Girls who play soccer are more likely to have a concussion than boys who play soccer. JOHN GUTIERREZ / FOR AMERICAN-STATESMAN

Yet, in the last 10 years, numerous studies have shown that concussions are more likely to be reported by women and girls than by men and boys. A 2017 study published in the Journal of Athletic Training, looked at 27 high school sports in the 2011-2012 and 2013-21014 school years. And while football did have the highest rates of sports-related concussion, boys’ lacrosse and girls’ soccer also had high rates. The concussion rate of boys and girls playing the same sports showed that girls had a 56 percent higher rate of concussion than boys. Boys were more likely to have a concussion caused by colliding into another player; girls were more likely to get it by having contact with equipment such as a ball.

Football still has the highest incident of concussion, a 2017 study found. RICARDO B. BRAZZIELL / AMERICAN- STATESMAN 2014

Women and girls also are more likely to report lasting symptoms such as headache and dizziness. Boys in this study had their symptoms go away most of the time by seven days. Girls were more likely to not have symptoms resolve until 14 days to 28 days later.

Why would concussions be different between boys and girls?

Dr. Elizabeth Sandel is a medical director for Paradigm Management Services, which provides case management to those with concussions and severe brain injuries. Susan Freundlich

The true answer is we’re not exactly sure, says Dr. Elizabeth Sandel, a medical director for Paradigm Management Services, which provides case management to those with concussions and severe brain injuries, who is writing a book on concussions.

Of course, researchers and Sandel offer some theories. The first theory is there might be something physiologically different between boys and girls. It could be strength of the neck muscles. Doing isometric neck exercises has been shown to lessen concussion rates, Sandel says. Could it also be the size of the head and neck as compared with the size of the ball or other head that the body is hitting? “There might be something about movement of the head,” Sandel says.

Some researchers also have wondered about hormone swings girls experience and how that affects the body physiologically. We know that girls tend to have more migraines that boys, Sandel says. The effects of a concussion, such as headaches, might be felt more by girls, too, for this reason.

Some of it also could be how different sexes play the games. Girl soccer players were more likely to head the ball than boys. Cheerleaders fell from a higher platform and landed on their heads than boys in other sports, but boys were more likely to run into each other and have head-to-head contact.

The biggest reasons could be the way the boys and girls communicate and the social pressure to get back in the game. Concussions often rely on the person who had one reporting their symptoms. “Girls are more likely to speak up and not just shake it off,” Sandel says.

Girls also tend to use more words when they communicate. They will go into details about what they are feeling. “When girls are describing their symptoms, they are going into more details,” Sandel says. It might be that their symptoms are not necessarily more severe or lasting longer, but that the girls just talked about them more.

One study that Sandel looked at also seems to support this theory that it’s about the level of communication and the way different types of people reported their symptoms. That 2015 study in the Journal of the American Medical Association also found a link between the length of symptoms and people who had attention deficit disorder, learning disabilities or mental health concerns before the concussion occurred.

What does all this mean for parents of girls and boys? It means don’t discount girls playing sports from having a concussion, and it means training boys especially to report their symptoms and not shake off the lingering effects to try to get back in the game.

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