Females reporting more concussions in high school sports

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Female athletes in Michigan high schools have a much higher rate of reported concussions than males and researchers are asking why. One question is whether female athletes get hurt more or report more.

Per 1,000 participants

Anastasia Niforos / MHSAA

Per 1,000 participants

The Michigan High School Athletic Association has played a large role in concussion safety and research. It requires all high schools to report on every concussion. This is now its second year doing this and it had 4,452 confirmed head injuries at the high school level.

MHSAA Executive Director Jack Roberts said this number doesn’t translate to a big number per school, however, it has turned up the gender difference.

“There were many more concussions reported for females than males in gender-neutral sports like soccer, basketball, etc. Almost twice as many, roughly. This caught our attention immediately,” said Roberts.

The association found that this gender difference is widely reported in research, much of it coming from Michigan State University. There are theories about why. One supports the difference in anatomy between males and females.

“There is a structural difference in the neck and the head. Typically, girls have a less strong neck and thinner skull,” said Roberts.

Roberts said another theory is that the female brain works differently and the recovery time is longer. Most importantly though, he noted that sociologically in high school females are more likely to report concussions where males are less likely to report head injuries or injuries of teammates.

“Since there is this difference between males and females, each should be coached differently and coaches should be taught how to coach differently. The way we coach girls should be slightly or significantly different than boys,” said Roberts.

Tracey Covassin, director of the undergraduate athletic training education program and sport concussion laboratory at MSU, does research to improve the standard of care for athletes who sustain sports-related concussions. One theme she focuses on is sex differences and concussion outcomes.
“Specifically, female athletes have reported more total symptoms, vestibular and ocular-motor deficits and neurocognitive impairments following a SRC (sports-related concussion). Females are more likely to report concussions due to them being more honest. They are more concerned about their health. Males have more opportunities to turn into professional athletes and make money,” said Covassin.

Another primary theme her research focuses on is the epidemiology of sport-related concussion. She recently published an update on SRC injury rates between male and female athletes.

“Our research found that female collegiate athletes participating in comparable sports have a higher injury rate than males in high school. Specifically, female athletes participating in soccer, basketball,

6 stages of return to play

Anastasia Niforos / Safe Kids Kalamazoo County

6 stages of back to game play after a concussion

and softball had a higher injury rate compared to male athletes,” said Covassin. This mirrors what statistics from Michigan high school showed. This mirrors what statistics from Michigan high school showed.

Lauren Foltz, a junior at Okemos High School, had three concussions, two from playing sports and the other from dancing. She said the one she sustained during soccer practice was by far her worst.
“Before practice I was just passing the ball around with my friends. One of them took a shot and the ball hit the back of my head. It hurt, but I was OK. Then, later, another teammate and I were going to head the ball and our heads collided hard. I kept playing, but had a headache after my dad picked me up and then I got super dizzy and collapsed,” said Foltz.

She said that her high school has concussion protocols, but she feels that most of the time people go back too early or aren’t informed about what they need to do to recover. She has seen this especially with male athletes.

“I think a lot of the time they try and play through it and make it seem very minor. To boys, concussions are seen as weak and they just want to continue playing,” said Foltz.

Amanda Carr, a clinical and occupational therapist at Origami Brain Injury Rehabilitation Center, said she has worked with athletes who have suffered from several concussions and brain injuries.

“Individuals with their very first concussion usually heal on their own without rehab. History of multiple concussions is a different character. Those lead to moderate and severe injuries. Unfortunately, there are cases where patients have had to stop playing sports” said Carr.

Marci Abraham, the athletic trainer at East Lansing High School, said sports such as soccer and football tend to produce the most head injuries. What she has seen this year is that in sports such as soccer and basketball more girls have gotten concussions.

“There is this question if girls are just reporting them more or getting them more and if boys are playing through them,” said Abraham.

Ken Hintze, athletic trainer at Lansing Catholic High School, said so far this year football and hockey have produced the most concussions. He has had more boys report concussions because he is consistently with the football team for practices and games but believes every concussion is different.

“In my opinion I don’t see a gender difference. I think they are very different in their own way. I’ve had people with memory issues with very little symptoms and I’ve had athletes with great memory recall, but their symptoms are through the roof. Each concussion is very individualized. In more scenarios personalities will change and you can tell,” said Hintze.