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By Paul Ohanian
Lots of valuable and interesting information was shared at last weekend’s International Summit on Female Concussion and Traumatic Brain Injury, hosted in Washington, D.C. by Pink Concussions, a non-profit organization committed to highlighting current science and resources about female concussions. US Lacrosse provided financial support of the event.
Researchers, medical experts and presenters discussed sport-specific concussions and traumatic brain injuries (TBI), as well as concussion findings and injuries from the military and the general population.
Several members of US Lacrosse Sports Science and Safety (SS&S) Committee served among the presenters, including committee chair Dr. Margot Putukian, Dr. Shane Caswell, Dr. Andy Lincoln and Dr. Ruben Echemendia. Steve Stenersen, president and CEO of US Lacrosse, and Melissa Coyne, director of games administration, were also part of the program.
Here are eight takeaways that caught our attention:
1) It’s More Common Than We ThinkWhen discussing the general population, 24% of all females have sustained some TBI by the age of 25. Most of these incidents are mild, including concussions, and many are a result of non-athletic activities such as vehicle accidents or falls. From 2001-2010, TBI-related hospitalizations rose, by varying percentages, for females of all ages. Primary explanations for these trends include better symptom recognition and better concussion awareness due to educational initiatives.
2) Females Are Better at Reporting SymptomsOne of the common themes shared by many of the researchers was that both female athletes and non-athletes do a better job of reporting their symptoms to care providers than males do. This is especially important in the athletics environment because medical staff still rely heavily on reported symptoms for sideline diagnosis. The main symptoms reported by both genders are headache, dizziness and difficulty in concentrating. Females typically report more sensitivity to light and noise than males, and have longer return-to-play timelines.
3) Higher Rates of Concussion for FemalesIn data collected for high school and college athletes from 2009-2014, the rates of concussion for females was higher in the sports that share common rules (soccer, basketball, baseball/softball). Possible explanations for these variances included physiological differences (neck size and neck strength) as well as reporting variables. Lacrosse was not included in this comparison since the men’s and women’s games are governed by different rules, however, NCAA statistics show a concussion rate of 5.2 per 10,000 athlete-exposures for women’s lacrosse, the seventh highest rate among NCAA sports.
4) The Mechanisms of Concussion Are DifferentIn lacrosse specifically, the mechanisms of concussion vary between the men’s and women’s game. The primary cause of concussion in boys’/men’s lacrosse is body-to-body contact, while the principle mechanisms of girls’/women’s concussions are stick-to-head contact (accounting for about 50% of all head injuries), followed by player contact and ground contact.
5) Why They Don’t Report Among females, the two primary reasons that they don’t report symptoms related to concussion are “didn’t think it was serious enough” and “did not know it was a concussion.” Conversely, the primary reason male athletes don’t report symptoms is because they don’t want to miss games. In general, studies indicate females are more motivated to report possible injuries because they are more concerned about the effects on their future health.
6) We Can’t Fully Eliminate Concussions in SportsMany sports organizations, including US Lacrosse, continue to make efforts toward improved safety in their sports, but one national leader suggested that concussions must be considered as risk versus reward. “Since we will never eliminate concussion in sport, we have to decide if it is worth the risk,” said Brian Hainline, chief medical officer for the NCAA. “And I believe that as a society, we need sport, just like we need art and music.”
7) More Gender Specific Clinical Data is Needed A number of different studies were cited and data findings were discussed, but almost all panelists qualified their presentations by noting that more gender and age specific concussion research is needed. There remains a scarcity of data focused on the outcomes of concussions specific to gender. In the words of one presenter, “There’s still more unknown than known. We don’t know what we don’t know.”
8) It’s an Individual ThingGeneral consensus from medical experts indicated that all concussion management choices and return-to-play decisions must be made on an individual basis. A one-size-fits-all approach to concussion care is not sufficient. As one expert said, “If you’ve seen one concussion, you’ve seen one concussion.”
US Lacrosse has long advocated for a holistic approach to game safety, focused on sport-specific education and training, rules and equipment. As many of the experts noted during the summit, equipment modifications alone are not the answer. “We can’t put a helmet and headband on everybody and consider that to be a solution,” said Dr. Margot Putukian, director of athletic medicine at Princeton University and chair of the US Lacrosse Sports Science and Safety Committee.
For more concussion information, please visit uslacrosse.org/concussionawareness.
US Lacrosse encourages all teams, clubs and leagues to develop a concussion management plan (CMP), in consultation with a physician trained in the evaluation and management of concussion injuries.
Concussion Plan Guidelines
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