Women and men differ in rates of concussion and reporting of symptoms
Head injuries in sports are very much in the news nowadays. As an active woman, you may be wondering about your risk of sustaining a head injury, and if you are injured, what the long-term effects might be.
Here at Tulane University’s Women’s Sports Medicine Program, we have a team of providers who are very skilled at diagnosing and treating concussions. We are committed to educating our coaches, parents, and athletes not only about recognizing brain injuries, but also preventing them.
You may have read about studies that seem to contradict each other. Why the confusion surrounding women and head injuries? Minor traumatic brain injury (mTBI) has been studied extensively in sports medicine and orthopaedics, but only recently have female athletes been included in studies.
Studies including female subjects — even female mice — have been few, creating a bias in the scientific literature on the subject. A July 2017 report by NPR Science Desk correspondent Jon Hamilton underlines the extent to which female athletes have been excluded.
There are certainly differences in the way men and women respond to head injuries. Several questions merit further investigation, including:
- Are women more likely to experience concussion?
- Are they experiencing it different physiologically?
- Could it also be that they’re reporting their concussions in a different manner?
New, More Inclusive Research
The predominant use of male mice in studies is changing due to the National Institutes of Health’s requirement to include female animals in scientific studies.
Hamilton’s article refers to research by Dr. Mark Burns of Georgetown University’s Department of Neuroscience, into the links between traumatic brain injury (TBI) and Alzheimer’s disease. Dr. Burns is using both female and male mice in his investigations, which is critical to better understanding the differences between how men and women respond to head injury.
Dr. Burns has reported some sex-based differences in mice with severe brain injuries. In a recent peer-reviewed study published in the journal Glia, he pointed out that the “brains of male mice showed a massive immune response within a day, but the female response was much slower — up to seven days.”
And in a recent Columbia University study of human female athletes, researchers found that women may be more susceptible to concussions than men. They looked at the medical records of 1,203 athletes who played at Columbia University between 2000 and 2014. According to the study:
Among male athletes, 17 percent (140/822) had experienced at least one concussion during their collegiate career. Among female athletes, the rate was 23 percent (88/381). […] Though women experienced a higher rate of concussion, they recovered and returned to play as quickly as the male athletes.
Dr. Charles Bernick has been studying head injuries among about 700 men and 60 women fighters at the Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas. He brought up an important question about the apparent higher incidence of concussions among women:
The question is: ‘Is that because women are just more likely to report injuries, or is there a biological higher vulnerability?’
Concussions are typically accompanied by symptoms including headache, fatigue, and memory loss. Women may be more likely than men to report related symptoms such as depression and headaches. ScienceDaily reported on a study by University of California Los Angeles (UCLA) Health Sciences, which found that when playing sports with similar rules (such as soccer, baseball/softball, and basketball), female athletes sustained concussions at a higher rate than male athletes. Also, the female athletes tended to report more symptoms and more severe ones than their male counterparts did, and may take longer to recover:
Scientists have known for more than a decade that female athletes sustain concussions at a higher rate than males when playing sports with similar rules, such as soccer, basketball and baseball/softball. Females also tend to report more symptoms — and more severe ones — and may also take longer to recover from brain injuries than their male counterparts.
Head Injuries and the Musculoskeletal System
It’s important to know about these symptoms in order to make an informed decision about when to seek medical attention after an injury.
Head injuries often aren’t isolated. For example, one symptom of concussion is neck pain, which will often cause a patient to seek orthopaedic care. Even minor brain injuries can be accompanied by musculoskeletal injuries caused by the same traumatic event. Our team at the Tulane Women’s Sports Medicine Program is focused on early diagnosis via collaboration between experts. We are fortunate to have Dr. Greg Stewart, an expert in the diagnosis and management of concussions, as an integral member of our team. We are always on the lookout for any symptoms that might require another specialist, such as a neurologist for further management of concussion. We pride ourselves on providing thorough evaluations and focused management, so we can get our patients back to their active lives as quickly and safely as possible.
Head injuries should always be taken seriously. Please contact us for more information about head injuries or the Women’s Sports Medicine Program at Tulane.