Column: Not Just for Football Players

Men and women are different. Aside from learned gender roles, there are chemical and neurological differences that separate the two genders. This fact is noticeable, but especially when it comes to concussions, which women are more susceptible.

Sports physician Shannon Bauman evaluated male and female athletes at her specialty concussion clinic in Ontario between September 2014 and January 2016. She found concussions were often more severe in girls. There were differences, Bauman said, in subjective reported symptoms and objective cognitive and visual symptoms observed by doctors.

“Females are reporting more symptoms, but they’re also objectively having more physiological signs of concussion,” Bauman said, according to FiveThirtyEight.

Her data shows women also take longer to heal. Men who were treated at the clinic finished within two months. Only 12 percent of women heal from concussions this quickly. Around 35 percent of women were still experiencing concussions six months after their injury.

But why is this difference so stark? While researches have several ideas, the most common hypothesis deals with hormones in the body.

Women are more likely to have migraine headaches between puberty and menopause. The monthly hormone fluctuation, primarily the hormone Estradiol, plays culprit in creating migraines. Estradiol reaches peak levels when the uterus is preparing for a possible embryo, and drops suddenly if there is no embryo implantation. Estradiol also interacts with the trigeminal vascular complex, an area of the brain that controls migraine pathophysiology.

Migraines and concussions share similar expressions. Spreading depression, an inhibitory electrical phenomenon, refers to waves of lowered electrical activity in the brain. Migraine aura, a type of visual hallucination, is very similar to spreading depression.

Statistically, women in childbearing years experiencing migraines are more likely to become concussed and develop worsening symptoms.

Researchers are the University of Rochester School of Medicine and Dentistry found mild traumatic brain injuries heal slower when sustained during certain phases of the menstrual cycle, particularly linked to progesterone levels.

Bauman also suggested women might have less neck strength than men, so female necks have a harder time stabilizing the head after a hit, which results in more “sloshing” while the brain shifts in the skull. Females do have 25 percent less head-neck segment mass, five percent less head-neck segment length and 12 percent less neck girth than men.

But more research is still needed in this area. The next big question is whether women are at a greater risk of chronic traumatic encephalopathy. CTE is a neurodegenerative condition possibly linked to concussions. When most people think of CTE, they think football. But female soccer players are at 2.1 times the risk of concussion than male soccer players, softball players are at 3.2 times greater risk than baseball players, and females basketball players run 1.7 times the risk as their male counterparts.

Several US women’s national soccer players have pledged to donate their brains to CTE research upon their death. In the meantime, education should be the No. 1 priority.

Athletes – of all genders, sizes and types – should be properly educated on the risks and symptoms associated with concussions before hitting the field. Trainers and coaches need to be fully educated too, and should be able to identify symptoms. Trainers should also be conducting regular checks on players, especially in sports like lacrosse, rugby and football.

The difference in gender is a developing idea, but it shouldn’t be used to discourage women from playing the game. It just means there’s an extra burden of knowledge given to people who play and work with female athletes.

Too long concussions, and CTE, have gone unnoticed, under reported and ignored. It’s time to get educated.

Tess Fox can be reached at or on Twitter @tesstakesphotos


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