12/03/2024

ST. LOUIS — A Saint Louis University primary care sports medicine physician says there is a gender gap in research about the effects of concussions on athletes, which may be leaving women and girls without the care they need. 

A concussion is a traumatic brain injury caused by a bump, blow, or jolt to the head or body. It can lead to a variety of health issues, including persistent headaches, dizziness, sleep disturbances, fatigue, changes in mood, and problems with memory or thinking. In rare cases, a head injury leads to swelling and bleeding in the brain and can even turn fatal.

Trauma during professional or recreational sports is a common cause of concussions in youth and adults. Research has found that the number of women and girl athletes treated for concussions has tripled in the last twenty years. However, sports concussion research has not looked much into disparities between sexes.

Jamil Neme, M.D., associate professor in the Department of Family and Community Medicine at SLU’s School of Medicine and director of the Concussion Clinic at SSM Health Saint Louis University Hospital, has closely monitored research trends. Neme said structural brain differences might explain why women and girls are more prone to concussions and experience longer recovery from injuries than men and boys.

“Take soccer, for instance; athletes have roughly the same exposure to headers; however, intrinsic factors like decreased neck muscle strength may predispose females to more concussions,” he said. 

Neme added that more research is needed to determine which physiologic or biomechanical, social, and environmental factors influence injury rates between males and females. Other extrinsic factors, such as delays in care, have also been shown to influence concussion recovery.

In the dynamic and often high-impact world of sports, concussion management is an essential aspect of athlete health care. Players on the field, coaches on the sidelines, and fans in the stands should all be aware that concussion care is necessary for the safety and well-being of athletes. Sports medicine physicians – often orthopedic surgeons or non-operative physicians who are board-certified in treating people of all ages with musculoskeletal injuries or athletes' medical conditions – are pivotal in concussion management in sports. 

This process begins with an initial assessment, where a doctor or athletic trainer evaluates an athlete immediately after an incident, checking for balance, coordination, and reflexes. The assessment might include a detailed neurological exam to evaluate an athlete’s sensory and motor responses. Cognitive tests are a critical component of the diagnosis. These tests assess an athlete’s memory, concentration, and ability to process information.

Neme notes that there have been advances in concussion treatment. At one time, researchers believed that removing all physical activity and mental stimulation following a concussion would give the brain time to rest and heal. More recent data shows that progressively increasing cognitive and physical activity following one or two days of relative rest accelerates recovery and gets patients back to what they love faster.

Preventing concussions will always be better than the most sophisticated recovery techniques, Neme says. Significant work has shown that reducing impacts and improving techniques during practices can reduce concussion risk. Others have identified specific training techniques that have been eliminated or altered at various levels of play. 

Neme said that more work needs to be done to identify aspects of all sports that place athletes at risk and have them removed or altered to reduce injury risk.