Concussions are a known risk for athletes playing at a recreational or professional level.
They lie on the spectrum of brain injuries with symptoms including headaches, dizziness and sensitivity to light and sound after a blow to the head or neck. Discussions around concussions oftentimes focus on male athletes in sports like football.
But in recent years, research has started to highlight a concerning trend. Concussions for female athletes have tripled in the past two decades. However, there’s little research to explain why that is. Dr. Jamil Neme has seen the problem firsthand. He directs the Concussion Clinic at SSM Health St. Louis University Hospital and is an associate professor in the university medical school's family and community medicine department.
St. Louis Public Radio’s Marissanne Lewis-Thompson spoke with Neme about why he believes now more than ever there needs to be research that further examines the gender disparities in concussion research.
This interview was edited for clarity and length.
Marissanne Lewis-Thompson: Concussions for female athletes have tripled in the last two decades. What’s led to this trend?
Jamil Neme: In general, we certainly have more or better reporting of head injuries in sports. We have a lot more awareness. So, these things get diagnosed appropriately. Historically, research was done on male athletes. As more and more research continues to come out, we start to see a little bit more inclusion of different demographics. Then we get to see maybe what differences there are. Also, the increase in female involvement in sports as well. With more girls playing sports, we're going to have more incidents of head injuries.
Lewis-Thompson: The conversation surrounding traumatic brain injuries typically centers on male athletes, particularly in football. Why has research into female athletes who’ve experienced concussions taken a back seat?
Neme: It just has taken a little bit of time to get good quality studies looking into what the differences are, and what that might mean for females versus males. Historically, where those research articles were done primarily on males, now we're just kind of having more and more on female athletes.
Lewis-Thompson: When you're thinking about this particular dynamic, it is surprising that the conversations are not being had in terms of young girls. There have been plenty of conversations about boys getting into football or how to keep them safe. Are you surprised by that at all?
Neme: I am surprised and I'm not. That would be a gender bias. We know that the boy is going to get into rough things and want to play contact sports. We're going to want to make sure that we give them the right information. We just don't expect that from our girls, but that's certainly changed a lot. With the rise of female athletes and people getting excited about it, there's going to be a lot more opportunities. I think it is reassuring. Another reason for those increase in numbers is also increased awareness. The girls maybe are more up front with their symptoms and coming to their parents, or coaches, or doctors and saying that they might have had a head injury and want to get checked out. Whereas there might be some bias against being forthright with that information with some of the boys.
Lewis-Thompson: Why are female athletes more susceptible to concussions?
Neme: Intrinsic factors like if females have smaller neck size or strength, then that may set them up for higher incidence of concussion. There may be other things at play including playing surfaces, and one other factor might be direct access to care.
Lewis-Thompson: Historically, women’s medical concerns are not taken seriously. How does that reality affect their recovery outcomes?
Neme: That is a difficult one especially in something like concussions where a lot of these symptoms are subjective. So, it's important for the medical provider to take in all of the things and all of the symptoms that their patient, regardless of what demographic they are, listen to all of these symptoms going on and see where the management needs to go next. So, it certainly means that we have to be better at our active listening and seeing how we can help our patients.
Lewis-Thompson: There is currently a lack of research into gender disparities in concussions. What are some key areas that need a closer examination?
Neme: I think we get into more of, are there more intrinsic reasons why? I alluded to the neck muscle strength and size. Maybe there are hormonal differences or maybe there's age discrepancies. Maybe there is something different with time to recovery. There is certainly a lot of room to figure out if there are differences and what we can do about them.
This story has been updated.
