July 17, 2013

Concussions among women exceed men as awareness is found lacking

By Curtis Eichelberger / Bloomberg News

Emily Peters wanted to play college soccer so badly that when she suffered a concussion during her junior year in high school, she kept it a secret.

Two years later, after receiving a fourth concussion when a teammate elbowed her in the head during preseason practice at the University of Pittsburgh, Peters developed symptoms ranging from dizziness and nausea to impaired vision and headaches. The university forced her to leave the team, and now, at 22, she said she can't get out of bed quickly without getting dizzy, suffers headaches as often as twice a day and wonders if she'll ever fully recover.

"I try not to think about it too much, because what can I do?" Peters said in a telephone interview. "I don't know what's going to happen in 10 years or 20 years or even five."

Football head injuries get attention as retired professional players suffer long-term effects. But girls and women are more likely to suffer concussions than boys and men in comparable sports such as soccer, basketball, and baseball or softball. Females also take longer to heal and have more symptoms after being injured, according to doctors and medical researchers.

"There has been a marked increase in concussion awareness among athletes, coaches, parents, clinicians and sports administrators," said Brian Hainline, the National Collegiate Athletic Association's first chief medical officer. "However, there has been less public focus on concussion in other sports, and in particular, concussion in females. We need to be ever vigilant that there are mothers, sisters, nieces and girlfriends who may also suffer with concussion as a result of sport participation."

In the top division of college sports, there were 76,252 women athletes and 90,837 men during the 2009-2010 school year, the most recent numbers available. Schools in the top football division, the Football Bowl Subdivision, spent about $1.1 billion on women's sports in fiscal 2012, according to the NCAA's Revenues and Expenses report.

Concussions are brain injuries caused by a hard blow to the head or body. They can alter the victim's behavior, thinking or physical functioning.

The injury is sustained by the brain moving inside the skull, usually during a rapid motion that rotates the head from side to side. A male's neck is generally bigger and stronger than a female's, which provides him added protection. Females have less strength and natural ability to rotate their heads faster from side to side, which makes them more vulnerable, Tracey Covassin, athletic trainer at Michigan State University in East Lansing, said in a telephone interview.

"It's physics," said Covassin, who wrote her doctoral dissertation on gender differences and neuropsychological impairments of concussions among collegiate athletes.

Between 2004 and 2009, the NCAA's rate of concussion per 1,000 practices and games for women's soccer was 2.2 compared with 1.4 for men. In basketball, women had an average 1.2 concussions, while men had 0.6, according to college sports' governing body. Football players led the survey with 3.1 concussions per 1,000 practices and games.

Athletes get between 1.6 million and 3.8 million concussions annually in the U.S., according to the NCAA Sport Science Institute's website.

The University of Pittsburgh Medical Center's Sports Medicine Concussion Program treats 18,000 concussion patients a year, 60 percent of them girls and women, Executive Director Micky Collins said. Football, ice hockey and girls soccer send him the most patients.

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