21 June, 2019
Concussions in Females
Approximate reading time: 3-5 minutes
A hit to the head can seem so innocuous when we don’t lose consciousness. This is the first misconception around concussions. Majority of the time, a concussion occurs without the loss of consciousness. Second misconception is that concussions are a male-dominant condition. Thirdly concussions are purely a sports-injury.
Your grandma falls bending for the remote. Your friend has a lover’s-quarrel black-eye. Your sister a drunken stumble. Your mum misjudges the steps. Your daughter slips from the swings. Concussions don’t just occur from sports.
More concussions in females
Concussions occur more frequently in the ladies. This can be seen in sports without gender specific rules.
Females experience more concussions and more severe symptoms.
There are a number of reasons why it is believed that females are more at risk.
- More acceleration due to smaller head and neck.
Instinctively we know that we would rather be involved in a low speed car accident than one on the freeway. This is due to acceleration. The greater the acceleration, the greater the potential injury.
- Smaller heads means that objects, such as soccer balls, are relatively bigger.
Following on from the car analogy, we would rather be in the truck, than hit by the truck.
- Weaker neck muscles and less neck girth are less able to protect from external force.
- Different hormonal levels which may be detrimental in the concussion.
Another proposed reason is that females are more likely to take action, seek advice and get diagnosed. This may skew the research data in favour of the ladies.
There can be a lot of pressure on athletes to not get injured for fear of getting dropped from the team or feeling like they have let the team down. This is a problem with under-reporting of concussions. We don’t really know how prevalent concussions really are.
Female concussion symptoms
There are a multitude concussion symptoms. We frequently talk about the physical, psychological and sleep disturbances but rarely do we hear about the hormonal changes after a concussion.
In addition to the standard concussive symptoms of headaches, dizziness, mood disorders, sleep disturbances and fuzzy head, women can experience changes in their menstrual cycle.
To date, there have been minimal studies on female concussions with the majority of the scientific literature focusing on concussions in male driven sports such as AFL, NFL and NRL. As such a lot of the female specific changes are noted from clinical experience rather than the scientific literature.
Majority of concussions improve over 7 - 10 days requiring rest, monitoring and appropriate advice on activities to avoid and when to reintroduce them.
For others, the concussion lasts longer and requires rehabilitation. Your neuro-rehabilitation therapist will assess whether you are at risk of prolonged symptoms by asking you questions about your past & current health as well as performing a concussion assessment.
Concussion treatments should involve a holistic approach including:
- Exertion advice to appropriately rest the brain
- Home exercises to strengthen the fragile brain function, such as the inner ears (vestibular system)
- Supplement & dietary advice to decrease inflammation around the brain
- Neck & shoulder muscle strengthening
- Females are more likely to sustain a concussion
- When a female sustains a concussion, she is more likely to experience more symptoms and have a greater severity of those symptoms
- Female concussion symptoms can vary such as hormonal disturbances
About the Author
Dr Cassie Atkinson-Quinton - Chiropractor, Neuro-Rehabilitation Therapist, Perinatal Yoga & Pilates Instructor
Women are complicated and beautiful creatures. Our unique physiology makes us more susceptible to migraines, chronic pain, autoimmune conditions, Alzheimer's, gut issues, anxiety and more. Our hormonal changes through puberty, menstrual cycle, pregnancy, breastfeeding and menopause can all upset the fine balance in the body & brain. This is what fascinates Dr Cassie and has driven her to study clinical neuroscience in depth and continues to learn at University of NSW with a Graduate Certificate in Women's Health.
Similar articles you'll enjoy:
- Belanger L, Burt D, Callaghan J, Clifton S & Gleberzon BJ (2013). Anterior cruciate ligament laxity related to the menstrual cycle: an updated systematic review of the literature. J Can Chiropr Assoc 2013; 57(1)
- Covassin T & Elbin RJ (2011). The Female Athlete: The Role of Gender in the Assessment and Management of Sport-Related Concussion. Clin Sports Med 30 (2011) 125–131 doi:10.1016/j.csm.2010.08.001
- Harmon KG, Drezner JA, Gammons M, Guskiewicz KM, Halstead M, Herring SA, Kutcher JA, Pana A, Putukian M & Roberts RO (2013). American Medical Society for Sports Medicine position statement: concussion in sport. Br J Sports Med 2013;47:15–26. doi:10.1136/bjsports-2012-091941
- Wunderle K, Hoeger KM, Wasserman E & Bazarian J (2014). Menstrual Phase as Predictor of Outcome After Mild Traumatic Brain Injury in Women. Journal of Head Trauma Rehabilitation: September/October 2014 - Volume 29 - Issue 5 - p E1-E8. Doi: 10.1097/HTR.0000000000000006