We recently ran a blog on the growing realisation that head injuries in rugby and football can possibly cause dementia and other brain injuries, often only discovered and diagnosed in later life and after the player has retired from professional sport.  A recent report from America now suggests that teenage girls who play football run nearly twice the risk of concussion as boys and take longer to recover.

Concussion in girls was also thought to be less easy to spot. What this means is that they may be less likely to be removed from the game and allowed to play on.

This is something that is very common as well with horse riders, who very often just get back on the horse and carry on in competitions.  When they arrive at the finish line, many report a complete lack of memory as to how they got there!  In affiliated or professional competition, re-mounting is forbidden, but in the “fun” competitions, this can be overlooked

The study leading to the report looked at 40,000 female high school footballers and the same number of boys over 3 years.  There were approximately 1500 concussions in all, two thirds of them female. Boys tended to be injured colliding with other players, whereas girls tended to become concussed after contact with the ball or hitting an object such as a goalpost.

The boys also seemed to be removed more quickly from play and recovered more quickly; girls took about two days longer to recover.

Dr Willie Stewart, senior author of the study and honorary professor at the University of Glasgow, said:

“This highlights female athletes are at greater risk of concussion and the threshold for them should be lower. We need to think less about collisions and more about contact because girls are told to sit out less than boys.”

It’s not fully understood why girls should be at a higher risk of concussion and with a slower recovery than boys.  It could be because of “lower neck strength and girth” and hormones could play a part.  Girls could also report symptoms more than boys, perhaps because of a greater awareness of their own bodies and how they function.

Of course, there is also the point that until fairly recently, when contact sports such as rugby and football have become much more widely played by girls and women, they were sports often confined to male players. Professor Stewart said research in this area was therefore based around boys, despite the fact there were big differences in the way boys’ and girls’ bodies responded to head injuries and the way they were managed.

This might suggest an approach to management based on acknowledging differences where they can be evidenced, for which more research would be needed. This research was funded by the Football Association and the Professional Footballers’ Association, NHS Research Scotland and the Penn Injury Science Center, among others.

Guidance for safety in sport is developing all the time as medical knowledge grows. Heading the ball is still allowed, but it is introduced more gradually and not used perhaps as much as it was. If a concussion is suspected the mantra is:

“If in doubt, sit them out”

You should also be sure that there is proper trained and professional medical care on hand at any event where an injury could occur -which, yes, is all of them! But a risk assessment beforehand should help with this.  It is often not so much the injury as the lack of trauma care in the short time after an injury that causes most damage.

But above all, enjoy your chosen sport, whatever it is!

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